Why arrhythmia should not be ignored in younger people?

Data show that heart disease is one of the most common reasons for mortality among Indian men aged 35-54. Preventive measures, including testing such as calcium scans, can help to discover and keep problems in check.

A significant number of people dying young due to sudden heart attacks has once again brought back the spotlight on heart ailments being on the rise in India.

Not just heart attacks, other cardiovascular diseases (CVDs) are also posing grave concerns for the people, especially for those who might look fit and healthy physically, but tend to ignore certain alarming signals that prove fatal at a later stage.

The number of people suffering from Sudden Arrhythmic Death Syndrome (SADS) has been on the rise lately, say the country’s leading cardiologists. They also say that such cases have been on the rise among the youth under 40.

What is arrhythmia?

Arrhythmia, a heart disorder, occurs when the electrical signals coordinating heartbeats do not work properly.

The faulty signaling causing the heart to beat irregularly, and faster than its natural rhythm of 60 to 100 beats per minute, is called tachycardia, and too slow, compared to the average rhythm, is called bradycardia.

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The disease may also lead to several other heart issues such as heart failure, sudden cardiac arrest, etc. Hence, it is important to undertake regular health check-ups.

No national figures of arrhythmia

In a densely populated young country like India, there is a significant lack of epidemiological data regarding arrhythmia in the population and the number of people suffering from this disease.

“Data is very important. We know SADS is on the rise, but by how much is what data will tell us. That will determine our approach and aggressiveness in handling SADS,” Dr Rajneesh Kapoor, Vice Chairman, Interventional Cardiology, Heart Institute, Medanta Hospital, Gurgaon, said.

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Coupled with the missing national figures, India also lacks large-scale population-based prevalence studies of arrhythmia.

Dr Sanjeev Kumar Kalkekar, Interventional Cardiologist, Apollo Hospitals, Navi Mumbai, said having detailed data will provide insights into the problem to help reduce the disease burden and guide proper treatment.

“Sudden cardiac deaths are alarmingly high in India. Most of these patients have either undiagnosed myocardial infarction or genetic disorders. So, getting a routine health check-up at the age of 25 for males and 30 for females, or before undertaking a vigorous exercise regime is recommended,” he said.

Dr Rudradev Pandey, Associate Director - Intervention Cardiology, CK Birla Hospital, Jaipur, said India needs retrospective studies and government-led health initiatives that combine data from public and private hospitals for arrhythmia to provide accurate and timely treatment.

Increased diagnosis leading to enhanced detection

Dr KK Talwar, senior cardiologist and former president of the Medical Council of India said a national database for arrhythmia is the far-fetched goal, because the disease can only be detected after undergoing medical tests.

“Genetic testing is one of the important tools for detection. Earlier, the people weren’t getting tested regularly. However, now many people are undertaking annual health check-ups, which is leading to more people being detected with arrhythmia,” he added.

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The younger population at risk

A report by the Indian Council of Medical Research (ICMR) on CVDs in India published in Lancet Global Health 2018, says that heart diseases accounted for 28.1 percent of the total deaths in India in 2016.

Cardiologists blame genetic disorders, along with high-risk lifestyle red flags, including smoking, tobacco consumption in any form, alcohol intake, diabetes and obesity as responsible factors for arrhythmia in the younger population.

“While no exact data is available regarding the growth of arrhythmia, we do see younger patients coming in with arrhythmia now. Earlier, we would only see the elderly reporting arrhythmia issues. But now, people almost a decade younger are coming in with the issue,” Dr Rahul Chhabria, Cardiologist, Jaslok Hospital, Mumbai, said.

Chhabria further said that early recognition of chest pain, giddiness and blackouts must not be ignored.

Physical fitness isn’t foolproof

People who are physically fit and healthy must get an electrocardiogram (ECG) or echocardiography performed to see if they have an underlying arrhythmia or are at risk of developing the medical condition.

“If a patient complains of palpitations, a thorough evaluation is recommended, followed by Holter monitoring,” Dr Rudradev Pandey, CK Birla Hospital, Jaipur, said.

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Is there a link between air pollution and arrhythmia?

A research paper presented at Heart Failure 2022, a scientific congress of the European Society of Cardiology (ESC), linked bad air quality with arrhythmia. However, cardiologists feel robust data is still needed to establish these claims.

“We also do not have robust data available regarding the impact of bad air quality on arrhythmia. In fact, such studies have clearly shown how the air quality can increase the risks of a lot more heart conditions beyond arrhythmia as well,” Dr Sudeb Mukherjee, Cardiologist, AMRI Hospital, Mukundapur, Kolkata, said.

Dr Mukherjee said lifestyle habits exaggerate the impact of the environment.

“In urbanised societies especially, we are seeing people leading a sedentary lifestyle, and this impacts our heart health to a large extent,” he said.