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Arrhythmia Symptoms, Signs, Causes, and Treatments

A heart arrhythmia refers to an irregular heartbeat resulting from improper electrical signals that control the heart rhythm. This can make the heart to beat too fastor too slow or cause an inconsistent heartbeat pattern.

Arrhythmias may feel like a pounding, racing, or fluttering heartbeat. While some are harmless, others could lead to life-threatening symptoms.

It is sometimes okay for the heart to beat fast or slow. It could beat rapidly while exercising or slowly when sleeping.

The treatment options for heart arrhythmia may include medications, pacemakers and surgical procedures. The primary aim of the treatment is to manage or eliminate heartbeats that are too fast, too slow and irregular. Adopting a heart-healthy lifestyle can also be beneficial in preventing damage that contributes to arrhythmias.

By Able Health I Medically reviewed by Dr. Alireza Estedlal

Page last reviewed: February 2024 I Next review due: February 2026

Understanding Arrhythmia: What is it and How Does it Affect the Heart?

Arrhythmia is an irregular or abnormal heartbeat. The human heart has electrical system controlling the coordination and timingof the contractions. This mechanism ensures regular paces of the heartbeat for normal, healthy hearts. In the end, it enables effective blood circulation in the body. But in people with arrhythmia, this system tends to malfunction, leading to too fast, too slow, or irregular heart pulse.

Arrhythmia may lead to significant effects on the heart. For too fast a heartbeat (tachycardia) the heart might not have sufficient time for blood filling before another contraction occurs. This could result in less blood flow to tissues and vital organs. Likewise, the heart may fail to pump adequate blood to meet the required body demands in heartbeats that are too slow (bradycardia). In addition, irregular heart rhythms could interfere with normal heart functions and increase the possibility of blood clot formation.

Appropriate heart rhythm maintenance is essential for general heart health. This ensures that blood rich in oxygen effectively reaches all areas of the body. It also enables optimal organ and tissue functions and promotes overall well-being. For that reason, it's important to understand and address heart rhythm abnormalities as soon as possible.

Types of arrhythmia

Heart arrhythmias are generally classified according to the heart rate speed. The types include:

  • Tachycardia (fast heartbeat): The heart rate is over 100 beats per minute.
  • Bradycardia (slow heartbeat): The heart rate is below 60 beats per minute.

Tachycardia

The types of tachycardia or fast heartbeat include:

  • Atrial fibrillation (AFib): This chaotic signaling of the heart leads to fast and uncoordinated heartbeat. While the condition may be temporary or can begin and stop on its own, other episodes might fail to stop until it's treated. Also, AFib is connected with stroke.
  • Atrial flutter: Similar to AFib, atrial flutter is characterized by more organized heartbeats. This condition has also been linked to stroke.
  • Supraventricular tachycardia: This is a comprehensive term that includes irregular heart rhythms that begin over the ventricles (lower heart chambers). Supraventricular tachycardia leads to pounding heartbeat episodes that occur and stop abruptly.
  • Ventricular fibrillation: Fast, chaotic electric signals that cause quivering of the lower heart chambers rather than coordinated squeezing. This severe condition could result in death within minutes if a regular heartbeat is not reinstated. Ventricular fibrillation is typically caused by an underlying cardiac condition or a severe injury.
  • Ventricular tachycardia: Fast, irregular heart pulse that begins due to defective electrical signals in the ventricles. The ventricles are unable to fill with blood properly due to increased heart rate; hence, the heart may fail to pump sufficient blood to the body. Generally, ventricular tachycardia may not lead to severe problems in persons with a healthy heart. However, this condition could be an emergency requiring immediate medical attention for people with underlying heart disease.

Bradycardia

Bradycardia is defined as a heart rate that is less than 60 beats per minute. However, a low resting heartbeat does not necessarily indicate an issue. If you are in good shape, your heart might easily pump sufficient blood throughout the body, even with beats below 60 in a minute.

You can develop a form of bradycardia if you have a slower heart rate and your heart doesn't pump enough blood. The types of bradycardias are:

  • Sick sinus syndrome: The role of sinus nodes is to regulate the hearts pace. Malfunctions of the nodes can cause the heart rate to fluctuate between beating too fast and too slow. Sick sinus syndrome can occur due to scarring around the sinus nodes, which slows, interferes with, or obstructs heart rhythm signals. Older people are mostly affected by this condition.
  • Conduction block: Blockage of the electrical paths of the heart can lead to signals triggering the heart rhythm to slow or stop. While some blocks don't cause symptoms, others can result in slower or skipped heartbeats.

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Premature heartbeats

Premature heartbeats are considered additional beats occurring one at a time and sometimes in patterns alternating with a regular pulse. Extra beats coming from the heart's top chamber are known as premature atrial contractions (PACs), while those from the bottom are referred to as premature ventricular contractions (PVCs).

Although a premature heartbeat might feel like a skipped beat, the extra beats are not a problem. Rarely do they indicate a more severe condition. Even so, a premature beat could contribute to enduring arrhythmia particularly in those with underlying heart disease. Having recurrent premature ventricular beats can occasionally result in a weak heart.

In addition, premature heartbeats can develop while resting. Other factors like stress, strenuous activities, and stimulants including nicotine or caffeine, may also cause premature pulses.

Common Symptoms of Arrhythmia: How to Recognise the Warning Signs

It is important to understand the warning signs of arrhythmia for early detection and treatment. Although arrhythmia might not cause symptoms in some people, others may experience different signs indicating an irregular heart pulse. These are common symptoms to watch out for:

  • Irregular heartbeat: This is the most common arrhythmia symptom, which can cause people to feel like their heart is racing, skipping beats or fluttering.
  • Pounding or fluttering in the chest: Those with arrhythmia may occasionally report a feeling of pounding or fluttering in the chest, which could be accompanied by pain or discomfort.
  • Shortness of breath: Arrhythmia can interfere with the normal circulation of oxygen and blood in the body, resulting in shortness of breath. This is particularly during physical activities or exertion.
  • Light-headedness or dizziness: An abnormal heart rhythm can disrupt the flow of blood to the brain, leading to light-headedness or dizziness.
  • Fatigue or weakness: Sometimes, arrhythmia can cause the heart to overwork more than usual, causing weakness or fatigue even with slight physical activities.

Generally, it's essential to note that each person may experience these differently and might not necessarily point to arrhythmia. Even so, you should consult a medical practitioner for more assessment whenyour symptoms are frequent or affect your everyday life.

Causes of Arrhythmia: What Triggers Abnormal Heartbeats and How to Prevent Them

Many factors, like underlying medical problems, outside triggers and lifestyle choices, can lead to arrhythmia. Therefore, recognizing these causes can ensure that people take the necessary preventive measures to lower the risks of arrhythmia occurrence or aggravation.

These are some of the common causes of arrhythmias:

  • Heart disease: Conditions such as heart attacks, artery disease, heart valve problems or other cardiac disorders can increase the possibility of arrhythmia.
  • High blood pressure: If not controlled, high blood pressure can strain the heart and interfere with the regular rhythm.
  • Thyroid problems: Having an overactive or underactive thyroid gland could disrupt the rhythm of the heart and cause arrhythmia.
  • Smoking and alcohol intake: Cigarette smoking and too much intake of alcohol can cause detrimental impacts on the heart's health and trigger arrhythmia.
  • Stress and anxiety: For those who are vulnerable, prolonged stress, and anxiety can contribute to arrhythmia. You can thus manage stress and minimize the risk by practicing relaxation techniques and finding support.

Management of underlying medical conditions and adoption of a heart-healthy lifestyle are key to preventing arrhythmia. In addition, the essential preventative approaches include:

  • Regular exercise
  • Maintaining a healthy weight
  • Incorporating a balanced diet
  • Reducing alcohol consumption
  • Quitting smoking
  • Controlling stress level
  • Taking prescription drugs as directed

Risk factors

Factors that are likely to increase the risk of arrhythmias are:

  • Coronary artery disease, underlying heart conditions, and prior heart surgery: A heart attack, constricted heart arteries, heart valve disease, heart failure, previous heart surgery, cardiomyopathy, and other cardiac damages are the common risk factors for nearly all types of arrhythmias.
  • High blood pressure: High blood pressure increases the possibility of coronary artery disease. Also, it can cause the left lower heart chamber walls to stiffen and thicken, altering the way electrical signals pass through the heart.
  • Heart problems present at birth: These problems are also known as congenital heart defects and can disrupt the normal heart rate and rhythm.
  • Thyroid disease: An overactive or underactive thyroid gland is likely to increase the possibility of irregular heartbeats.
  • Obstruction sleep apnea: This disorder leads to breathing pauses while sleeping. It can also cause slower heart pulse and irregular beats including AFib.
  • Electrolyte imbalance: Electrolytes are substances such as potassium, calcium, magnesium, and sodium present in blood that help the heart in triggering and sending electrical signals. Having too high or too low electrolytes in the body can affect cardiac signaling and cause irregular heartbeats.
  • Some medications and supplements: Certain prescription drugs, as well as some coughing and cold remedies, can contribute to heart arrhythmias.
  • Excess alcohol intake: Too much alcohol consumption can interfere with the heart's electric signaling, which can raise the risk of developing AFib.
  • Use of nicotine, caffeine, or illegal drugs: Stimulants are likely to trigger the heart to beat rapidly and could result in severe cases of arrhythmias. Cocaine and amphetamines are examples of illegal drugs that can significantly affect the heart. Others may lead to sudden fatality because of ventricular fibrillation.

Diagnosis of Arrhythmia: How Doctors Identify and Treat Heart Rhythm Disorders

Arrhythmia diagnosis entails thoroughly assessing a person's health history, physical exams, and running specialized tests. Medical practitioners often use different diagnostic equipment to pinpoint the precise kind of arrhythmia and evaluate the ideal treatment method.

The most common arrhythmia diagnostic methods and procedures are:

  • Physical examination and health history: Your provider will perform a comprehensive physical exam and ask about the symptoms, health history, and your family record of heart problems.
  • Electrocardiogram (ECG): This non-invasive examination records the electrical activity of the heart. It can be used to detect abnormal rhythms, and give important details regarding the type and degree of arrhythmia.
  • Holter monitor: This is a portable gadget that continually records the electrical activity of the heart for 24 to 48 hours. Doctors can use this device to identify any heart rhythm irregularities that might be undetectable during a quick ECG.
  • Echocardiogram: This procedure creates pictures of the anatomy and function of the heart using sound waves. It can also be used to detect underlying structural damage and anomalies that might be triggering arrhythmia.

After confirming a diagnosis, medical doctors can proceed to create a suitable treatment plan personalized to the person's condition.

Management and Treatment

How is an arrhythmia treated?

Arrhythmia treatment is based on the kind and severity of the condition. However, treatment may not be required in some cases. The available treatment options for heart arrhythmias are medications, lifestyle changes, therapies, devices and surgery.

Medications

Arrhythmias can be treated with a range of medications. However, since each person is different, you might need to experiment with several drugs and dosages to determine which one is most effective for your case. The medicines for arrhythmias are:

  • Antiarrhythmic medications to either prevent arrhythmia occurrence or convert it to sinus rhythm or normal rhythm.
  • Drugs that regulate the heart rate.
  • Anticoagulant or antiplatelet therapy medications including warfarin or aspirin that lower the possibility of blood clot formation.
  • Medicines that address related disorders whichmight be contributing to irregular heart rhythm.

Furthermore, it's critical to understand the following:

  • The names of the prescription drugs.
  • The reason you use them.
  • When and how frequently you should take them.
  • The side effects of the drugs.

Lifestyle changes

Making simple lifestyle adjustments can help manage heart arrhythmias. Some of these changes can include:

  • Controlling blood pressure and the levels of blood glucose
  • Steering clear of tobacco products
  • Limiting alcohol consumption
  • Avoiding stimulants and caffeine
  • Striving to maintain a healthy weight

Therapies

Some individuals may require therapies in addition to medications to manage and eliminate abnormal heart rhythms. The medical practitioner will determine which course of action is ideal for your condition and inform you of the advantages and risks of each therapy.

Among these therapies are:

  • Cardioversion: The heart synchronizes with electrical impulses; hence enabling the regular rhythm to resume.
  • Catheter ablation: To help 'disconnect' the irregular pathway of the rhythm, a catheter is used to convey high-frequency electric energy toward a small tissue area inside the heart. Ablation can address AFib, many SVTs, atrial flutter and particular ventricular and atrial tachycardias.
  • Pulmonary vein isolation: This form of ablation isolates regions that can lead to AFib by creating scars in ring form. People who have paroxysmal, persistent, or frequent atrial fibrillation can benefit from this procedure.

Devices

During the procedure, your cardiologist can put in some devices in the electrophysiology laboratory. The treatment devices for heart arrhythmias are:

  • Permanent pacemaker: To prevent slow heart beating, and maintain a regular rate, this device is used to convey small electric impulses to the muscles of the heart.
  • Implantable cardioverter defibrillator (ICD): The ICD continuously monitors the heart rhythm. If it detects a rapid, irregular pulse, it gives the heart muscle the energy to beat at anormal pace. The device also treats life-threatening cardiac rhythms, including ventricular fibrillation and ventricular tachycardia.
  • Biventricular (B-V) pacemakers and defibrillators (also known as cardiac resynchronization therapy or CRT): These are medical devices that aid in synchronization of the left ventricular contraction. They have a lead that enters the left ventricle in addition to those that penetrate the heart's right side. Individuals who have heart failure and uncoordinated contractions of the left ventricles may require this tool.

Surgery

A heart surgery may be necessary for individuals with arrhythmias for the following reasons:

  • To address heart conditions that might be contributing to arrhythmia, such as coronary artery bypass surgery or valve surgery.
  • Maze procedure to treat AFib that fails to respond to drugs and non-surgical treatments.
  • A doctor can occasionally use minimally invasive or surgical methods to put tiny wires known as biventricular pacemaker leads on the heart.

Prevention

How can I lower my risk of arrhythmia?

These are a few tips to help reduce the risks of arrhythmias:

  • Quit using tobacco products.
  • Cut back on alcohol intake.
  • Limit or quit using caffeinated products such as coffee, tea, colas, and certain over-the-counter drugs, as they can increase the symptoms in people who are sensitive to caffeine.
  • Avoid taking stimulants by watching out for those present in cough and cold medicines, as well as nutritional or herbal supplements. Certain ingredients in some of these drugs promote abnormal heart rhythms. You should thus ensure that you read the label and consult with your doctor on the right medication for your condition.
  • Control high blood pressure.
  • Aim for an appropriate healthy weight.
  • Control your levels of blood sugar.
  • Address sleep apnea.
  • Refrain from activities that seem to trigger arrhythmia.

Living with Arrhythmia: Coping Strategies and Support for Patients and Their Families

It can be physically and emotionally challenging to live with arrhythmia. Nonetheless, there are a number of accessible coping techniques and support services to assist people in effectively managing their condition. Some of these arrhythmia coping strategies include:

  • The significance of self-care: People with arrhythmias must prioritize their well-being. This entails taking prescription drugs as directed, leading a healthy lifestyle, controlling stress, getting enough sleep, and visiting the doctor regularly.
  • Support groups and resources: Patients and their families can get important knowledge, emotional assistance, and a feeling of belonging by joining support groups or looking for online sources. They can also learn from other's experiences and share their own to cope with the difficulties of living with arrhythmia.
  • Coping approaches for patients and their families: Personalized coping tactics can help minimize, and manage arrhythmia's psychological and physical effects. These strategies may involve relaxation exercises, managing stress, taking up joyful hobbies or activities, and maintaining open lines of communication with family members.

With the adoption of these coping tactics and making use of accessible support resources, people who have arrhythmias can improve their general state of health and boost their life quality.

Complications of Arrhythmia: How Heart Rhythm Disorders Can Affect Overall Health

Arrhythmias that are mismanaged or left untreated can cause major complications that impact a person's general health. So, to avoid long-term damage, it's essential to identify and address these possible effects.

Some of the common arrhythmia complications are:

  • Stroke: Some forms of arrhythmias, including AFib, are more likely to increase the possibility of blood clot formation in the heart. A stroke may result from a clot that makes its way to the brain.
  • Heart failure: Arrhythmias have the potential to weaken the heart gradually with time. When the heart is unable to pump sufficient blood to meet the requirements of the body, heart failure occurs.
  • Abrupt cardiac arrest: Arrhythmias can occasionally make the heart cease beating abruptly. This is referred to as sudden cardiac arrest and needs urgent medical care.

Knowing the possible complications associated with arrhythmia highlights the significance of early diagnosis, proper treatment, and continuous management to avoid severe health effects.

Research and Future Directions: Advancements in Arrhythmia Treatment and Management

Arrhythmia diagnosis, treatment, and management are constantly improving thanks to ongoing research and technological advances in healthcare. Scientists are looking into innovative ways to understand better the primary triggers of arrhythmias and come up with more targeted remedies.

Current research focuses on developing implantable gadgets that can track and manage arrhythmias instantaneously using genetic evaluations to identify those who are at higher risk of having an arrhythmia and using stem cell treatment to restore affected cardiac tissue.

Furthermore, researchers are examining how lifestyle choices like diet and activity might help prevent and treat arrhythmia. To enhance the accuracy of diagnosis and customized treatment regimens, research is also being conducted on the incorporation of artificial intelligence and machine learning algorithms into arrhythmia management methods.

In general, these advances have a lot of potential to improve the results and quality of life for people who have arrhythmia.