A heart arrhythmia is an irregular heartbeat. Heart rhythm problems (heart arrhythmias) occur when the electrical signals that coordinate the heart's beats don't work properly. The faulty signaling causes the heart to beat too fast (tachycardia), too slow (bradycardia) or irregularly.
Heart arrhythmias may feel like a fluttering or racing heart and may be harmless. However, some heart arrhythmias may cause bothersome — sometimes even life-threatening — signs and symptoms.Heart arrhythmias may feel like a fluttering or racing heart and may be harmless. However, some heart arrhythmias may cause bothersome — sometimes even life-threatening — signs and symptoms.
In general, heart arrhythmias are grouped by the speed of the heart rate. For example:
Tachycardia is a fast heart. The resting heart rate is greater than 100 beats a minute.
Bradycardia is a slow heartbeat. The resting heart rate is less than 60 beats a minute.
Atrial fibrillation (A-fib). Chaotic heart signaling causes a rapid, uncoordinated heart rate. The condition may be temporary, but some A-fib episodes may not stop unless treated. A-fib is associated with serious complications such as stroke.
Atrial flutter. Atrial flutter is similar to A-fib, but heartbeats are more organized. Atrial flutter is also linked to stroke.
Supraventricular tachycardia. Supraventricular tachycardia is a broad term that includes arrhythmias that start above the lower heart chambers (ventricles). Supraventricular tachycardia causes episodes of a pounding heartbeat (palpitations) that begin and end abruptly.
Ventricular fibrillation. This type of arrhythmia occurs when rapid, chaotic electrical signals cause the lower heart chambers (ventricles) to quiver instead of contacting in a coordinated way that pumps blood to the rest of the body. This serious problem can lead to death if a normal heart rhythm isn't restored within minutes. Most people who have ventricular fibrillation have an underlying heart disease or have experienced serious trauma.
Ventricular tachycardia. This rapid, regular heart rate starts with faulty electrical signals in the lower heart chambers (ventricles). The rapid heart rate doesn't allow the ventricles to properly fill with blood. As a result, the heart can't pump enough blood to the body. Ventricular tachycardia may not cause serious problems in people with an otherwise healthy heart. In those with heart disease, ventricular tachycardia can be a medical emergency that requires immediate medical treatment.
Although a heart rate below 60 beats a minute while at rest is considered bradycardia, a low resting heart rate doesn't always signal a problem. If you're physically fit, your heart may still be able to pump enough blood to the body with fewer than 60 beats a minute at rest.If you have a slow heart rate and your heart isn't pumping enough blood, you may have a type of bradycardia. Types of bradycardias include:
Sick sinus syndrome. The sinus node is responsible for setting the pace of the heart. If it doesn't work properly, the heart rate may alternate between too slow (bradycardia) and too fast (tachycardia). Sick sinus syndrome can be caused by scarring near the sinus node that's slowing, disrupting or blocking the travel of impulses. Sick sinus syndrome is most common among older adults.
Conduction block. A block of the heart's electrical pathways can cause the signals that trigger the heartbeats to slow down or stop. Some blocks may cause no signs or symptoms, and others may cause skipped beats or bradycardia.
Premature heartbeats are extra beats that occur one at a time, sometimes in patterns that alternate with the normal heart beat. The extra beats may come from the top chamber of the heart (premature atrial contractions) or the bottom chamber (premature ventricular contractions).A premature heartbeat may feel like your heart skipped a beat. These extra beats are generally not concerning, and they seldom mean you have a more serious condition. Still, a premature beat can trigger a longer-lasting arrhythmia, especially in people with heart disease. Occasionally, very frequent premature beats that last for several years may lead to a weak heart.Premature heartbeats may occur when resting. Sometimes premature heartbeats are caused by stress, strenuous exercise or stimulants, such as caffeine or nicotine.
Arrhythmias can be caused by:
1. Coronary artery disease..
2. Irritable tissue in the heart (due to genetic or acquired causes).
3. High blood pressure.
4. Changes in the heart muscle (cardiomyopathy).
5. Heart valve problems.
6. Electrolyte imbalances in your blood, such as sodium or potassium imbalances.
7. Injury from a heart attack.
8. The healing process after heart surgery.
9. Other medical conditions.
An arrhythmia may be “silent” and not cause any symptoms. A doctor can find an irregular heartbeat during an examination by taking your pulse, listening to your heart or performing diagnostic tests. If symptoms occur, they may include:
1. A feeling of skipped heartbeat or that your heart is “running away,” fluttering or doing "flip-flops.
2. Pounding in your chest.
3. Dizziness or feeling lightheaded.
4. Shortness of breath.
5. Chest discomfort.
6. Weakness or fatigue (feeling very tired).
6. Weakening of the heart muscle or low ejection fraction.
Lifestyle changes to reduce the risk of heart disease may help prevent heart arrhythmias. A heart-healthy lifestyle includes:
1. Using medications as directed and telling your doctor about all the medicines you take, including those bought without a prescription
2. Reducing stress, as intense stress and anger can cause heart rhythm problems.
3. Limiting or avoiding caffeine and alcohol
4. Not smoking.
5. Maintaining a healthy weight
6. Staying physically active
7. Eating a heart-healthy diet
If you feel like your heart is beating too fast or too slowly, or it's skipping a beat, make an appointment to see a doctor. Seek immediate medical help if you have shortness of breath, weakness, dizziness, lightheadedness, fainting or near fainting, and chest pain or discomfort.A type of arrhythmia called ventricular fibrillation can cause a dramatic drop in blood pressure. Collapse can occur within seconds and soon the person's breathing and pulse will stop. If this occurs, See a doctor immediately.
Treatment depends on the type and severity of your arrhythmia. In some cases, no treatment is necessary. Treatment options include medications, lifestyle changes, invasive therapies, electrical devices or surgery.
A variety of drugs are available to treat arrhythmias. Because everyone is different, it may take trials of several medications and doses to find the one that works best for you. Several types of drugs are used :
Anti-arrhythmic drugs are drugs used to convert the arrhythmia to sinus rhythm (normal rhythm) or to prevent an arrhythmia.
Heart-rate control drugs are drugs used to control the heart rate.
Anticoagulant or antiplatelet therapy are drugs, such as warfarin (a blood thinner) or aspirin, that reduce the risk of clots forming or having strokes.
Medications used to treat related conditions that may be causing an abnormal heart rhythm.
Complications depend on the type of arrhythmia. In general, complications of heart arrhythmias may include stroke, sudden death and heart failure.Heart arrhythmias are associated with an increased risk of blood clots. If a clot breaks loose, it can travel from the heart to the brain, causing a stroke. Blood thinners can lower the risk of stroke related to atrial fibrillation and other arrhythmias. Your doctor will determine if a blood-thinning medication is right for you.If an arrhythmia is causing heart failure symptoms, methods to control the heart rate may improve heart function.
Things that may increase the risk of heart arrhythmias include:
1. Coronary artery disease, other heart problems and previous heart surgery. Narrowed heart arteries, a heart attack, abnormal heart valves, prior heart surgery, heart failure, cardiomyopathy and other heart damage are risk factors for almost any kind of arrhythmia.
2. High blood pressure. This condition increases the risk of developing coronary artery disease. It may also cause the walls of the left lower heart chamber (left ventricle) to become stiff and thick, which can change how electrical signals travel through the heart.
3. Congenital heart disease. Being born with a heart condition may affect the heart's rhythm.
4. Thyroid disease. Having an overactive or underactive thyroid gland can raise the risk of irregular heartbeats.
5. Obstructive sleep apnea. This condition causes pauses in breathing during sleep. It can lead to a slow heartbeat (bradycardia) and irregular heartbeats, including atrial fibrillation.
6. Electrolyte imbalance. Substances in the blood called electrolytes — such as potassium, sodium, calcium and magnesium — help trigger and send electrical impulses in the heart. An imbalance in electrolytes — for example, if they are too low or too high — can interfere with heart signaling and lead to irregular heartbeats.
7. Certain drugs and supplements. Some prescription drugs and certain cough and cold medications bought without a prescription can cause arrhythmias.
8. Excessive alcohol. Drinking too much alcohol can affect the electrical impulses in your heart and can increase the chance of developing atrial fibrillation.
9. Caffeine, nicotine or illegal drug use. Caffeine, nicotine and other stimulants can cause your heart to beat faster and may lead to the development of more-serious arrhythmias. Illegal drugs, such as amphetamines and cocaine, may greatly affect the heart and cause many types of arrhythmias or sudden death due to ventricular fibrillation.
You’ll need to visit your doctor for regular follow-up visits to:Make sure your arrhythmia is controlled.Properly adjust your medications.Evaluate the function of any implanted devices.Make sure you’re staying healthy and not having other medical problems.Your provider will tell you how often you should visit. Call your doctor in between visits if your symptoms become more frequent or severe.You should also make sure that your family and friends know how to recognize your symptoms. They should also learn how to start CPR if that ever becomes necessary.
If you have an arrhythmia, or even if you don’t, you might find it useful to know how to take your pulse. Your pulse indicates your heart rate or the number of times your heart beats in one minute. Pulse rates vary from person to person. Your pulse is slower when you are at rest and increases when you exercise since more oxygen-rich blood is needed by the body during exercise.
You can tell how fast your heart is beating by feeling your pulse. You can feel your pulse on your wrist or neck. Place the tips of your index and middle fingers on the inner wrist of your other arm, just below the base of your thumb. Or, place the tips of your index and middle fingers on your lower neck, on either side of your windpipe. Press lightly with your fingers until you feel the blood pulsing beneath your fingers. You may need to move your fingers around slightly up or down until you feel the pulsing.You can count the number of beats in 10 seconds and multiply by six to determine your heart rate in beats per minute. A normal heart rate, at rest, is 50 to 100 beats per minute.