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Arrhythmia entails a broad spectrum of disorders of heart rate and rhythm abnormalities. Arrhythmia is broadly categorized into bradyarrhythmias and tachyarrhythmia based on the heart rate. They are further divided according to the origin, means of transmission, and syndromes associated with it. Patients with an arrhythmia may exhibit a broad spectrum of clinical presentation from being entirely asymptomatic to sudden cardiac arrest. Arrhythmias can be paroxysmal, leading to difficulty in estimating true prevalence. This activity outlines the evaluation and the treatment of various arrhythmias and highlights the role of the interprofessional team in managing patients with these conditions. Objectives: Describe the broad categories of arrhythmias Outline the typical presentation of various arrhythmias. Identify the typical electrocardiographic features and treatment options for arrhythmias. Explain the importance of collaboration and communication amongst the interprofessional team to ensure the appropriate selection of candidates for further electrophysiological testing and management option with defibrillators and pacemakers. Access free multiple choice questions on this topic.

Arrhythmia is an abnormal rhythm of the heart. The only normal rhythm of the heart is a normal sinus rhythm. In this rhythm, an impulse is generated in the sinoatrial (SA) node, which is conducted through and slowed down while passing through the atrioventricular node (AV). It is then conducted through the bundle of His, to the left and right bundle branches, and eventually into the Purkinje fibers. Any deviation from this conduction pathway results in arrhythmia. Arrhythmias can be classified based on various criteria. The most common way to categorize them is based on the rate of conduction as bradyarrhythmia with a heart rate of fewer than 60 beats per minute (bpm) and tachyarrhythmia with a heart rate higher than 100 bpm.

Arrhythmias can pose a diagnostic dilemma. The patient presentation can be varied even for the same arrhythmia and can require a different management approach based on the patient's clinical condition and characteristics. While clinical history, physical exam, and EKG findings may reveal particular kinds of arrhythmia, it can sometimes be challenging to form an appropriate management plan without an expert opinion. While an internist is always involved in the care of patients with arrhythmia, it is essential to consult an interprofessional team of specialists, including cardiologists, electrophysiologists, and interventionists. Based on the condition, the patient may need further evaluation with electrophysiological or ischemia workup for the cause of arrhythmia, which will eventually be treated by a cardiac catheterization or ablation procedure. The nurses are vital members of the interprofessional group as they will monitor the patient's vital signs, telemetry, and assist with the patient and family's education. It has been shown that hospitals with a dedicated arrhythmia team consisting of a nurse, electrophysiologist, noninvasive arrhythmia expert, and internist have shown significant improvement in the outcomes of patients.[11]