What are Arrhythmias and Irregular Heartbeats?

An arrhythmia is a type of heart condition where your heart beats in an abnormal rhythm. The heartbeat can be too fast, too slow, or in an irregular rhythm. If the heart beats too fast, it is considered a tachycardia. If it beats too slowly, it is considered bradycardia.

Changes in electrical signals that control the heartbeat cause arrhythmias to occur. Treatment for arrhythmias include medications, implantation of a device such as a pacemaker, or surgery to repair the overstimulated heart.

Causes of heart arrhythmias

A heart arrhythmia is a heart condition that occurs when the electrical impulses that coordinate your heartbeats are not working correctly. When this happens, your heart will beat too fast, too slow, or irregularly.

Conditions that can cause an arrhythmia include:

  • Heart attack that is occurring in real time.
  • Scar tissue from a previous heart attack.
  • Conditions such as cardiomyopathy which can change the structure of the heart.
  • Coronary artery disease, which leads to blocked arteries.
  • High blood pressure.
  • Hyperthyroidism (overactive thyroid) or hypothyroidism (underactive thyroid).
  • Diabetes.
  • Sleep apnea.
  • COVID-19 infection.
  • Smoking
  • Consuming too much alcohol or caffeine.
  • Abusing drugs.
  • Stress.
  • Medications such as OTC cold medications.
  • Family history.

Risk factors for heart arrhythmias

Factors that will increase your chance of getting a heart arrhythmia to include:

  • Being older. Arrhythmias are more common in people over 60 years old.
  • Having co-existing heart conditions. Any heart condition that affects the heart’s function can increase your risk of developing an arrhythmia. Common heart conditions include coronary artery disease, heart failure, cardiomyopathy, high blood pressure, valvular heart disease, heart infections, congenital heart defects.
  • Smoking.
  • Consuming too much alcohol or caffeine.
  • Taking over-the-counter medications to treat a cough or cold.
  • Prescription medications to treat heart issues, thyroid problems, and asthma.
  • Taking illegal drugs such as Crystal meth or cocaine.
  • Having prior heart surgery.
  • Experiencing long-term stress.
  • Having electrolyte imbalances such as low potassium or low calcium.

Symptoms of heart arrhythmias

While most people overlook heart rhythm issues, some people can feel abnormal heartbeats. It may feel like your heart skipped a beat, added an extra beat, feels like it is going fast, or slowed down dramatically.

Other symptoms of arrhythmia include:

  • Anxiety.
  • Blurred vision.
  • Chest pain.
  • Trouble breathing.
  • Fainting.
  • Fatigue.
  • Lightheadedness, dizziness, or feeling weak.

Complications from heart arrhythmias

If left untreated, arrhythmias can cause severe complications. Complications include:

  • Cognitive impairment. Alzheimer’s disease or dementia can be caused by reduced blood flow to the brain over time.
  • Heart failure. Heart failure can develop over time, as the lower chambers of the heart cannot function as efficiently due to repeat arrhythmias.
  • Stroke. A blood clot can form due to blood pooling into the atria from repeated arrhythmia episodes. If the blood clot breaks off and travels to the brain, it could cause a stroke.
  • Sudden cardiac arrest. If you have ventricular fibrillation, it may lead to a sudden cardiac arrest.
  • Sudden infant death syndrome (SIDS). If your child inherits a conduction disorder, it can lead to SIDS.
  • Worsening arrhythmias. Arrhythmias can progressively worsen over time.

Diagnosing heart arrhythmias

Your doctor can diagnose arrhythmia by taking a full medical history, performing a complete physical exam, and reviewing diagnostic test results.

Diagnostic testing may include:

  • Electrocardiogram (ECG). An ECG can measure the electrical impulses of the heartbeat.
  • Holter monitor. A Holter monitor is a portable ECG device that can record your heart’s activity from your daily routine.
  • Event recorder. An event recorder is a portable ECG that allows you to record your symptoms as you experience them.
  • Echocardiogram. An echocardiogram is a non-invasive diagnostic test that takes pictures of your heart to evaluate the size, structure, and motion.
  • Implantable loop recorder. A loop recorder can record your heart’s activity if your symptoms are infrequent.
  • Stress test. A can monitor your heart’s activity during exercise.
  • Tilt table test. A tilt table test is an option for patients who are having fainting spells suspected of coming from arrhythmias.
  • Electrophysiological testing and mapping (EP). EP testing will map the electrical impulses through the heart.

Treatment for heart arrhythmias

Treatments for arrhythmias include lifestyle changes, medications, cardioversion, ablation, or implanting devices that shock the heart into rhythm and surgery.

Arrhythmia treatments include:

  • Lifestyle changes. Your doctor may recommend changing your lifestyle, such as aiming for a healthy weight, exercising, eating healthy, managing stress, and quitting smoking.
  • Vagal maneuvers. Some people can stop a supraventricular tachycardia arrhythmia by holding their breath, straining, dunking your face in ice water, or coughing.
  • Medications. In many cases, antiarrhythmic medications can help control a person's heart rate or restore a normal heart rhythm.
  • Cardioversion. During this procedure, an electrical shock is delivered to your heart.
  • Catheter ablation. During an ablation, your doctor will use heat or extreme cold to ablate a spot of the heart to correct the heart rhythm disturbance.
  • Pacemaker. A pacemaker is a device that is implanted under the skin to control abnormal heart rhythms. If the device detects an irregular heart rate, it stimulates the heart and restores the rhythm.
  • Implantable cardioverter-defibrillator (ICD). An ICD may be used if you are at risk for extremely fast arrhythmias or heart conditions that increase your risk for a heart attack. If the device detects an abnormal heart rhythm, the ICD will shock the heart to restore the normal rhythm.
  • Maze procedure. During this procedure, your doctor will make incisions to create scar tissue, which will interfere with stray electrical impulses that cause arrhythmias.
  • Coronary bypass surgery. Coronary bypass surgery can improve blood flow to the heart.

When to Seek Treatment

If you suddenly or frequently experience shortness of breath, weakness, dizziness, lightheadedness, fainting, or chest pain, seek urgent medical care.

Ventricular fibrillation is a type of arrhythmia that can cause sudden cardiac death. This type of arrhythmia causes the lower chamber of the heart to quiver instead of pumping blood. When this occurs, your blood pressure will plummet, cutting off the blood supply to the brain and vital organs.

If someone collapses from suspected ventricular fibrillation, call 911 and begin CPR as soon as possible. Compress the heart at a rate of approximately 100 compressions a minute until help arrives.

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