A Brief Discussion of Arrhythmia in Traditional Chinese Medicine ----- There are many types of arrhythmia, and it is difficult to determine their severity solely by pulse diagnosis.

Cardiac arrhythmias are mainly classified into three categories.

Cardiac arrhythmias are a common occurrence in TCM clinical diagnosis. The most easily identifiable are bradycardia and tachycardia. Bradycardia is defined as a heart rate below 60 beats per minute ( Hong Kong generally accepts 50-60 beats per minute, while mainland China defines it as below 60 bpm), while tachycardia is defined as a heart rate above 90 bpm. This has already been discussed in the article "Is a Heart Rate Too Slow or Too Fast Serious?"

Another type is a problem with the heart's electrical signal conduction system, which prevents pulses from being conducted normally. The most common problem is a blockage in the transmission of signals from the atria to the ventricles.

The third type of common arrhythmia includes premature beats.

This is the focus of this article: rhythms generated by pacemakers other than the atrial node (SA node) can lead to abnormal pulses, causing irregular heartbeats. Common examples include premature beats, which include premature ventricular contraction, premature atrial contraction, and premature junctional contraction. A premature beat occurs when a pacemaker originating outside the SA node sends an impulse too early, causing an abnormal pulse that travels to the ventricle, resulting in irregular contractions of the atrium or ventricle. This causes the next heartbeat to occur earlier than expected, hence the name premature contraction.

Resting electrocardiogram or Holter electrocardiogram to determine

To determine the type of arrhythmias, a resting electrocardiogram (ECG) or a 24-hour Holter monitor (HOG) is necessary. Most people experience no discomfort; these are benign or functional premature beats. However, some may experience palpitations (i.e., feeling one or more heartbeats), weakness, shortness of breath, or dizziness. Premature heart beats are common in healthy individuals, including children and the elderly. They are often caused by overexertion, mental stress, indigestion, emotional excitement, or overeating. They typically occur at night or during rest and significantly decrease or disappear with activity or exercise.

According to our clinic's statistics, during the COVID-19 pandemic, approximately 10 out of every 100 patients who tested negative experienced premature beats ), along with symptoms such as shortness of breath and fatigue. These symptoms mostly disappeared after treatment. If the patient has no discomfort and no relevant medical history (such as hypertension, heart disease, infection, fever, or medication history), observation is recommended; medication may not be necessary. For some patients, the symptoms are related to emotions and involve issues with the autonomic nervous system; in these cases, traditional Chinese medicine can be very helpful.

Pathological premature beats must be treated by a specialist in either traditional Chinese medicine or Western medicine.

Another group is called pathological premature beats - mostly caused by known heart diseases, such as coronary heart disease, dilated cardiomyopathy, mitral valve prolapse, congenital heart diseases such as tetralogy of Fallot, heart failure, etc., as well as drug side effects, surgery, and cardiac catheterization examinations. These require joint treatment by Chinese and Western specialists.

I have premature ventricular contractions (PVCs), is that a heart condition?

No, premature beats (PVCs) are not a heart disease in themselves, but they can be a symptom of heart disease. Most people who experience PVCs do not have an underlying heart problem and they are usually harmless. However, if someone with pre-existing heart disease experiences PVCs frequently, it may indicate a more serious problem or could lead to a dangerous arrhythmia.

Does cardiac arrhythmia require treatment?

Some arrhythmias are benign: including premature beats, partial or asymptomatic sinus arrhythmias, and partial conduction blocks (such as incomplete right bundle branch block), which generally do not require treatment.

How do I determine if treatment is needed?

This part requires a professional evaluation from a Chinese or Western medicine cardiologist, including: medical history, triggers for attacks, speed of onset, duration, frequency of attacks, accompanying symptoms, and risk factors for heart disease.

When should we pay attention?

1. For people with pre-existing heart disease: premature beats may be a sign of more serious illness or may lead to a longer-lasting and more dangerous arrhythmia.

2. A high frequency of premature beats (PVCs) may affect cardiac function and should be taken seriously. Generally, if the frequency of PVCs exceeds 10%, it may affect cardiac function in the long run.

3. If the symptoms are bothersome: Even healthy people with frequent premature beats or obvious symptoms can be treated through lifestyle adjustments or traditional Chinese medicine.

Note:

Atrial fibrillation, also known as type III arrhythmia, is a common clinical condition that requires treatment. Atrial fibrillation involves an irregular heartbeat, and patients may not experience discomfort. However, some may experience shortness of breath, dizziness, fatigue, and palpitations, especially after physical exertion, prolonged work, or meals. Diagnosis of atrial fibrillation requires an electrocardiogram (ECG); pulse diagnosis alone can only detect an irregular pulse, and a simple pulse rhythm is insufficient for a definitive diagnosis.