By: Linh Tran, Medically reviewed by: Dr. Duyen Le.
What is arrhythmia?
An arrhythmia is a problem with the rate or rhythm of your heartbeat. Under this condition, your heart beats too quickly, too slowly, or with an irregular pattern.
Heart arrhythmia may feel like a fluttering or racing heart. Some may be harmless, but some can be serious or even life-threatening. During an arrhythmia, the heart may not be able to pump sufficient blood throughout the body, resulting in organs damage or failure.
How common is arrhythmia?
Arrhythmia can affect patients at any age. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.
Collapse and sudden cardiac arrest (in extreme case)
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.
What causes arrhythmia?
An arrhythmia can occur if the electrical signals that control the heartbeat are delayed or blocked. This can happen if the special nerve cells that produce electrical signals do not function properly or if the electrical signals are unable to travel to the heart properly.
An arrhythmia also can occur if another part of the heart starts to produce electrical signals. This adds to the signals from the special nerve cells and disrupts the normal heartbeat.
Some common causes of arrhythmia include:
A heart attack
Scarring of heart tissue from a prior heart attack
Changes to your heart’s structure, such as from cardiomyopathy
Blocked arteries in your heart (coronary artery disease)
High blood pressure
Overactive thyroid gland (hyperthyroidism)
Underactive thyroid gland (hypothyroidism)
Drinking too much alcohol or caffeine
Certain medications and supplements
What increases my risk for arrhythmia?
There are many risk factors for arrhythmia, such as:
History of cardiovascular-related condition or previous heart surgery such as heart attack, heart failure, leaking or narrowed heart valves, congenital heart defects.
High blood pressure: this condition increases your risk of developing coronary artery disease. It may also cause the walls of your left ventricle to become stiff and thick, affecting how electrical impulses travel through your heart.
Drugs and supplements: certain over-the-counter cough and cold medicines and certain prescription drugs may contribute to arrhythmia development.
Diabetes: your risk of developing coronary artery disease and high blood pressure greatly increases with uncontrolled diabetes.
Obstructive sleep anea: this disorder, in which your breathing is interrupted during sleep, can increase your risk of bradycardia, atrial fibrillation, and other arrhythmia.
Electrolyte imbalance: Electrolytes — such as potassium, sodium, calcium and magnesium — help triggers and conduct the electrical impulses in your heart. Electrolyte levels imbalance can affect your heart’s electrical impulses and contribute to arrhythmia development.
Drinking too much alcohol can affect the electrical impulses in your heart and can increase the chance of developing atrial fibrillation.
Caffeine or nicotine use: Caffeine, nicotine, and other stimulants can cause your heart to beat faster and may contribute to the development of more serious arrhythmia. Illegal drugs, such as amphetamines and cocaine, may profoundly affect the heart and lead to many types of arrhythmia or to sudden death due to ventricular fibrillation.
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is arrhythmia diagnosed?
To diagnose a heart arrhythmia, your doctor will review your symptoms and your medical history and conduct a physical examination. Your doctor may ask about — or test for — conditions that may trigger your arrhythmia, such as heart disease or a problem with your thyroid gland. Your doctor may also perform heart-monitoring tests specific to arrhythmia. These may include:
Electrocardiogram (ECG): an ECG measures the timing and duration of each electrical phase in your heartbeat to understand the electrical activity of your heart.
Holter monitor: this portable ECG device can be worn for a day or more to record your heart’s activity as you go about your routine.
Event monitor: this is for sporadic arrhythmia diagnosis. The portable device will be kept and pressed to measure heart activity when the patient experiences the symptoms. This allows your doctor check your heart rhythm at the time of your symptoms.
Echocardiogram: this process is to produce images of your heart’s size, structure and motion.
Implantable loop recorder: this device detects abnormal heart rhythms and is implanted under the skin in the chest area.
If your doctor does not find an arrhythmia during those tests, he or she may try to trigger your arrhythmia with other tests, which may include:
Stress test. Some heart problems are easier to diagnose when your heart is working hard and beating fast. During stress testing, you exercise to make your heart work hard and beat fast while heart tests are done. If you can’t exercise, you may be given medicine to make your heart work hard and beat fast to stimulate exercise condition.
Tilt table test. Your doctor may recommend this test if you’ve had fainting spells. You lie on a table that moves from a lying down to an upright position. The change in position may cause you to faint. Your doctor watches your symptoms, heart rate, EKG reading, and blood pressure throughout the test
Electrophysiological testing and mapping. In this test, doctors thread thin, flexible tubes (catheters) tipped with electrodes through your blood vessels to a variety of spots within your heart. Once in place, the electrodes can map the spread of electrical impulses through your heart.
In addition, your cardiologist can use the electrodes to stimulate your heart to beat at rates that may trigger — or halt — an arrhythmia. This allows your doctor to see the location of the arrhythmia and what may be causing it.
How is arrhythmia treated?
To treat arrhythmia, these are some type of techniques.
Vagal maneuvers: you may be able to stop an arrhythmia that begins above the lower half of your heart (supraventricular tachycardia) by using particular maneuvers that include holding your breath and straining, dunking your face in ice water, or coughing. These maneuvers affect the nervous system that controls your heartbeat (vagus nerves), often causing your heart rate to slow. However, vagal maneuvers don’t work for all types of arrhythmia.
For many types of tachycardia, you may be prescribed medication to control your heart rate or restore a normal heart rhythm. It’s very important to take any anti-arrhythmic medication exactly as directed by your doctor in order to minimize complications. If you have atrial fibrillation, your doctor may prescribe blood-thinning medications to help keep dangerous blood clots from forming.
If you have a certain type of arrhythmia, such as atrial fibrillation, your doctor may use cardioversion, which can be conducted as a procedure or by using medications. In the procedure, a shock is delivered to your heart through paddles or patches on your chest. The current affects the electrical impulses in your heart and can restore a normal rhythm.
Catheter ablation. In this procedure, your doctor threads one or more catheters through your blood vessels to your heart. Electrodes at the catheter tips can use heat, extreme cold or radiofrequency energy to damage (ablate) a small spot of heart tissue and create an electrical block along the pathway that’s causing your arrhythmia.
Treatment for heart arrhythmia also may involve use of an implantable device:
A pacemaker is an implantable device that helps control abnormal heart rhythms. A small device is placed under the skin near the collarbone in a minor surgical procedure. An insulated wire extends from the device to the heart, where it’s permanently anchored. If a pacemaker detects a heart rate that’s abnormal, it emits electrical impulses that stimulate your heart to beat at a normal rate.
Implantable cardioverter-defibrillator (ICD). Your doctor may recommend this device if you’re at high risk of developing a dangerously fast or irregular heartbeat in the lower half of your heart (ventricular tachycardia or ventricular fibrillation). If you have had the sudden cardiac arrest or have certain heart conditions that increase your risk of sudden cardiac arrest, your doctor may also recommend an ICD. An ICD is a battery-powered unit that’s implanted under the skin near the collarbone — similar to a pacemaker. One or more electrode-tipped wires from the ICD run through veins to the heart. The ICD continuously monitors your heart rhythm. If it detects an abnormal heart rhythm, it sends out low- or high-energy shocks to reset the heart to a normal rhythm. An ICD doesn’t prevent an abnormal heart rhythm from occurring, but it treats it if it occurs.
In some cases, surgery may be the recommended treatment for heart arrhythmia:
Maze procedure. In the maze procedure, a surgeon makes a series of surgical incisions in the heart tissue in the upper half of your heart (atria) to create a pattern or maze of scar tissue. Because scar tissue doesn’t conduct electricity, it interferes with stray electrical impulses that cause some types of arrhythmia.
The procedure is effective, but because it requires surgery, it’s usually reserved for people who don’t respond to other treatments or for those who are having heart surgery for other reasons.
Coronary bypass surgery. If you have severe coronary artery disease in addition to arrhythmias, your doctor may perform coronary bypass surgery. This procedure may improve the blood flow to your heart.
Lifestyle changes & Home remedies
What are some lifestyle changes or home remedies that can help me manage arrhythmia?
Research is ongoing regarding the effectiveness of several forms of complementary and alternative medical therapies for arrhythmia.
Some types of complementary and alternative therapies may be helpful to reduce stress, such as:
Some studies have shown that acupuncture may help reduce irregular heart rates in certain arrhythmia, but further research is needed.
The role of omega-3 fatty acids, a nutrient found mostly in fish, in the prevention and treatment of arrhythmia is not yet well studied, but it seems that this substance may be helpful in preventing and treating some arrhythmia.
If you have any questions, please consult with your doctor to better understand the best solution for you.