What are Arrhythmias?
An arrhythmia is a problem with the rate or rhythm of your heartbeat. It means your heart beats too quickly, too slowly, or with an irregular pattern. When your heart beats, electrical signals travel through the heart in a precise pattern, causing it to contract and pump blood. Arrhythmias occur when these electrical signals don't work properly.
While many arrhythmias are harmless and don't require treatment, some can be serious and may increase your risk of stroke, heart failure, or sudden cardiac death. Understanding the type and severity of your arrhythmia is important for proper treatment.
Types of Arrhythmias
Arrhythmias are classified by where they start in the heart and how they affect your heart rate:
By Heart Rate
- Tachycardia: A fast heart rate (more than 100 beats per minute at rest)
- Bradycardia: A slow heart rate (less than 60 beats per minute at rest)
- Irregular rhythm: Heartbeats that are uneven or erratic
By Location
- Atrial fibrillation (AFib): The most common type, causing rapid, irregular beating of the upper chambers
- Atrial flutter: Similar to AFib but with more organized rhythm
- Supraventricular tachycardia (SVT): Episodes of rapid heartbeat starting above the ventricles
- Ventricular tachycardia: Rapid, regular beating of the lower chambers
- Ventricular fibrillation: Life-threatening, rapid, erratic electrical signals in ventricles
- Premature contractions: Extra beats that occur early, can be atrial or ventricular
Symptoms
Many people with arrhythmias have no symptoms at all. When symptoms do occur, they may include:
- Palpitations (feeling like your heart is racing, fluttering, or skipping beats)
- Pounding in your chest
- Dizziness or lightheadedness
- Fainting (syncope) or near-fainting
- Shortness of breath
- Chest discomfort or pain
- Weakness or fatigue
- Difficulty exercising
- Anxiety
Causes and Risk Factors
Many factors can cause or contribute to arrhythmias. In some cases, the cause is unknown. Common causes and risk factors include:
- Current heart attack or scarring from a previous heart attack
- Blocked arteries in your heart (coronary artery disease)
- Changes to your heart's structure, such as from cardiomyopathy
- High blood pressure
- Diabetes
- Thyroid problems (overactive or underactive thyroid)
- Sleep apnea
- Smoking
- Excessive alcohol or caffeine use
- Drug abuse
- Stress and anxiety
- Certain medications (including some cold and allergy drugs)
- Genetics (some arrhythmias run in families)
Diagnosis
To diagnose an arrhythmia, your doctor will review your symptoms and medical history and conduct a physical examination. Several tests can help diagnose arrhythmias:
- Electrocardiogram (ECG or EKG): Records the electrical signals of your heart
- Holter monitor: A portable ECG device worn for 24-48 hours or longer
- Event monitor: Records heart activity when you experience symptoms
- Echocardiogram: Uses sound waves to create images of your heart
- Stress test: Monitors your heart during exercise
- Tilt table test: Checks how your heart rate and blood pressure respond to position changes
- Electrophysiological testing: Maps electrical signals through your heart
Treatment Options
Treatment depends on the type and severity of your arrhythmia, your symptoms, and any underlying heart conditions. Not all arrhythmias need treatment. When treatment is necessary, options include:
Lifestyle Changes
- Avoid triggers: Limit caffeine, alcohol, and tobacco
- Manage stress: Through relaxation techniques and stress management
- Exercise regularly: As recommended by your doctor
- Maintain healthy weight: Excess weight can contribute to arrhythmias
- Treat sleep apnea: If present, as it can worsen arrhythmias
Medications
- Antiarrhythmic drugs: Help maintain normal heart rhythm
- Beta blockers: Slow the heart rate
- Calcium channel blockers: Control heart rate and rhythm
- Blood thinners: Reduce stroke risk (especially with AFib)
Procedures and Devices
- Cardioversion: Uses electrical shock or medication to restore normal rhythm
- Catheter ablation: Destroys tissue causing abnormal rhythms
- Pacemaker: Sends electrical impulses to maintain normal heart rate
- Implantable cardioverter-defibrillator (ICD): Monitors and corrects dangerous rhythms
- Maze procedure: Creates scar tissue to block abnormal signals
Living with Arrhythmias
Many people with arrhythmias live normal, active lives with proper treatment and monitoring. Keep all scheduled appointments with your healthcare team, take medications as prescribed, and report any new or worsening symptoms promptly.
If you have AFib or certain other arrhythmias that increase stroke risk, taking blood thinners as prescribed is crucial. Wear a medical alert bracelet if you have a serious arrhythmia or an implanted device.
When to Seek Emergency Care
Call emergency services immediately if you experience sudden chest pain, severe shortness of breath, or fainting. If you have an ICD and it delivers a shock, follow your doctor's instructions about whether to seek immediate care.