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An arrhythmia is when the heart is beating in an abnormal rhythm. They can be life threatening, and are treated with the antiarrhythmic class of cardiac drugs.

British train services suffer quite badly from timetable arrhythmias, although ectopic trains are a rarity.

In summary

Broadly speaking, arrhythmias are split according to two things: site and heart rate.

Put into medical speak:

  • Site of abnormality
    • Supraventricular
    • Ventricular
  • Abnormalities of heart rate
    • tachyarrhythmias
    • bradyarrhythmias

Supraventricular Tachyarrhythmias

Atrial ectopics are extra contractions of the atria, not part of the normal heart rhythm. You can get premature or abnormal P waves. They only matter to recognise them as not that bad. Sometimes, they are conducted through and you get a ventricular ectopic. These are common. The two big ones are atrial flutter and atrial fibrillation. Re-entry supraventricular tachycardia is where a second electrical connection between atria and ventricles exist. The final thing is Wolff-Parkinson-White syndrome which is important because they like to ask questions on it (though it's pretty rare).

Ventricular Tachyarrhythmias

Essentially this is split into narrow complex tachycardia, or broad complex tachycardia which consists of:

Broad-complex tachycardia


Essentially, these are due to a blockage of the hearts conduction system. There are lots of different types: