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Cardiac Arrhythmias: Assessment, Analysis, and Associated Dental Management Guidelines

CARDIAC ARRHYTHMIAS OVERVIEW

Cardiac arrhythmias can be an increase in heart rate, a decrease in heart rate, or an irregularity in heart rate, when compared with normal states. An increased heart rate can be associated with sinus tachycardia, atrial or supraventricular arrhythmias, and ventricular arrhythmias. When the heart rate is decreased, the patient is said to have bradycardia.

Sinus Tachycardia

Sinus tachycardia is associated with a pulse rate greater than 100 beats/min and it occurs in response to stress, anxiety, excitement, or exercise. The patient experiences no prolonged symptoms and no further treatment is required.

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Atrial or Supraventricular Arrhythmias

Atrial arrhythmias are seldom life threatening. The symptoms experienced with AF will depend on the severity of the arrhythmia. Common symptoms experienced are palpitations, light-headedness, dizziness, chest pain, shortness of breath (SOB), hypotension, CHF, syncope, or thrombosis-associated TIAs or CVAs. Thrombosis is often a complication of AF due to the chaotic beating of the heart. Drugs like the newer anticoagulants rivaroxaban or dabigatran, or the older anticoagulants such as warfarin (Coumadin), aspirin, or clopidogrel (Plavix), are often included in the management of AF for this reason—to prevent complications from emboli.

AF is frequently treated with cardiac glycosides (digoxin), calcium channel blockers (Diltiazam/Cardizam),/>