Arrhythmia is a condition in which the heart beats with an irregular or abnormal rhythm. It occurs when the electrical impulses that regulate your heartbeats don’t work properly, making your heart beat too fast (tachycardia), too slow (bradycardia) or irregularly. Some arrhythmias may be harmless, while others may be life-threatening.
Symptoms of heart arrhythmia
Some arrhythmias are “silent,” causing no symptoms, while others cause symptoms that may be brief, long-lasting or sudden and intense.
Symptoms may include:
- Palpitations, or skipping a beat
- Fluttering feeling in chest or neck
- Racing heart sensation
- Dizziness or lightheadedness
- Fainting or almost fainting
- Shortness of breath
- Chest pain
- Suddenly rapid, chaotic heartbeat
Chest pain or pressure could be a sign of a heart attack and is a medical emergency.
Causes of heart arrhythmia
Arrhythmias can occur at any age. Some arrhythmias pose no danger, while others can lead to congestive heart failure, serious heart problems and/or stroke.
Potential causes of heart arrhythmias include:
Diagnosing heart arrhythmia
To determine if you have a heart rhythm condition, your doctor will ask about your symptoms, medical history and family history. Your doctor will perform a physical exam, listening to your heart, taking your pulse and looking for any signs of heart problems.
The electrical activity of your heart will be checked with one or more of the following:
- Electrocardiogram (ECG or EKG)
- Holter monitor
- Exercise stress test
- Electrophysiology (EP) study
To look for problems of the heart structure, the doctor may also order blood tests and urine tests, and imaging tests such as:
- Nuclear scanning
- Coronary angiography
Treatments for heart arrhythmias
Treatments vary based on the specific condition but may include one or more of the following:
- Medications – antiarrhythmics, calcium channel blockers, beta blockers, anticoagulants
- Medical procedures – cardioversion and cardiac ablation
- Devices – pacemaker and implantable cardioverter defibrillator (ICD)
- Cardiac monitoring
Types of heart arrhythmias
Different types of arrhythmias can occur in different chambers of the heart.
Supraventricular/atrial arrhythmias (begin in the atria, the upper chambers of the heart)
- Atrial fibrillation (AFib) – the most common arrhythmia, affecting at least 2.7 million Americans. AFib is characterized by a fast, irregular heartbeat. It can lead to blood clots, stroke, heart failure and other heart-related complications. Treatment is recommended to reduce the risk of stroke. If medication is not tolerated or is ineffective, cardiac ablation may be the next step in treatment.
- Atrial or supraventricular tachycardia (SVT) – a rapid heart rate that starts in the upper chambers of the heart. SVT keeps the heart’s chambers from filling completely between contractions, compromising blood flow to the rest of the body. It is the most common type of arrhythmia in babies and children. Treatment may include medications, cardioversion and cardiac ablation.
- Sick sinus syndrome (SSS) – group of symptoms indicating the heart’s natural electrical “trigger”—the sinoatrial node where the electrical signal begins—is not working properly. The heartbeat can switch back and forth between too slow and too fast. A pacemaker may eventually be needed to manage the heart rate.
Ventricular arrhythmias (begin in the ventricles, the lower chambers of the heart)
- Ventricular tachycardia (VT) – occurs when abnormal electrical signals in the ventricles cause the heart to beat faster than normal and out of sync with the atria. This condition hinders blood flow to your body because the ventricles contract before they completely fill with blood. Treatment can include medications, defibrillation, cardiac ablation or cardioversion.
- Ventricular fibrillation (VF) – occurs suddenly and without warning and stops all heart function. This condition causes sudden cardiac death, also known as cardiac arrest. The only effective treatment is defibrillation, and it must be performed quickly to save the patient's life.
- Heart block – occurs when electrical signals created in the upper chambers don’t reach the lower chambers, causing the heart to beat too slowly. Treatment is not recommended for patients without symptoms. For patients experiencing symptoms, treatment may include medication and a pacemaker.
- Wolff-Parkinson-White (WPW) Syndrome – rare, congenital (present at birth) heart abnormality, characterized by rapid heartbeat, caused by an extra electrical pathway between the heart’s upper and lower chambers. The condition is typically treated with physical maneuvers (called vagal maneuvers), medication, cardioversion or cardiac ablation.
- Ectopic Heartbeat (also known as premature heartbeat) – occurs when the heart either skips a beat or adds an extra beat. Ectopic heartbeats are usually not a cause for concern and may occur for no known reason.
Managing risk factors for heart arrhythmias
Some arrhythmias increase your risk of heart attack, cardiac arrest and stroke. To help reduce your risk of developing an arrhythmia:
- Manage blood pressure and cholesterol levels
- Maintain a healthy weight
- Eat a heart-healthy diet
- Don’t smoke
- Stay active
Heart arrhythmia specialists
The cardiologists and electrophysiologists affiliated with Houston Heart are specialists at diagnosing and treating all types of heart rhythm disorders.
To learn more, schedule an appointment.