Learn the fundamentals of this condition’s symptoms, diagnosis, and treatment to help you manage heart arrhythmias.
An arrhythmia is characterized by an irregular heartbeat, which includes additional or skipped beats, a higher or slower heart rate than usual, or both. It’s possible that your irregular heartbeats are harmless variations.
Certain arrhythmias, however, raise the chance of cardiovascular diseases, including heart failure or stroke. If left undiagnosed or untreated, a small percentage of arrhythmias can be fatal.
Heart implant devices may be necessary for patients with the highest risk of arrhythmias. Nonetheless, medicine or catheterization can be used to treat the majority of arrhythmia types. You can live a normal life if you receive the right care and take regular measures.
Heart Arrhythmias
Arrhythmia: What Is It?
Typically, there are two categories for heart arrhythmias. The first is by the frequency of heartbeats. Bradyarrhythmias are sluggish heartbeats. A heart rate of less than 60 beats per minute is often regarded as sluggish. Tachyarrhythmia is a rapid heartbeat, typically exceeding 100 beats per minute.
Arrhythmias can also be categorized according to where in the heart they start. Atria, the upper chambers of the heart, or other cardiac structures can experience supraventricular arrhythmias.
Among arrhythmias, atrial fibrillation is one of the most prevalent. The Centers for Disease Control and Prevention estimate that up to 6 million Americans suffer from AFib. The risk is higher for older adults: AFib affects over 9% of all those 65 and older, compared to roughly 2% of adults under 65 who are affected.
Heart Arrhythmias
Heartbeat Basics
“The heart is a muscle, and it’s a muscular pump,” says Dr. Joseph H. Levine, director of the Arrhythmia & Pacemaker Center at St. Francis Hospital in Long Island, New York. “Like any mechanical pump, electrical signals turn it on and off. In the heart, the electrical signals are built into the heart muscle itself. Every heart cell has the ability to have electrical activity that tells the individual cell to contract. The overall electrical system in the heart allows the contractions to be synchronous and organized.”
The natural pacemaker of the heart is the sinus node, which leads into the right atrium. The main electrical “wiring” of the heart is the atrioventricular node between the atria and ventricles.
The His-Purkinje system is responsible for rapid ventricular conduction. “This is specialized cardiac tissue that allows for very fast activity, so that all heart cells can simultaneously be activated to allow contractions to be synchronous,” Levine says.
When the heart doesn’t contract in an efficient, synchronized way, arrhythmia results.
Heart Arrhythmias
Signs and Symptoms of Heart Arrhythmias
Depending on your arrhythmia type or heart risk, you may experience the following symptoms:
Slow Heart Rhythm
- Fatigue.
- Syncope (fainting).
- Dizziness.
Fast Heart Rhythm
- Palpitations, or the sensation of a hammering or rapidly beating heart.
- Feeling dizzy or experiencing syncope.
- Breathlessness when exerting oneself.
- Feeling of anxiety.
- Chest discomfort.
- One of the main risks of atrial fibrillation is stroke. According to Levine, individuals with AFib are at increased risk for stroke regardless of whether they exhibit modest, incapacitating symptoms or none at all. Sometimes a patient is admitted to the hospital after suffering a stroke before AFib is identified.
Heart Arrhythmias
Causes of Heart Arrhythmias
Arrhythmias can be caused by cardiac or vascular illnesses such as coronary artery disease, excessive blood pressure, cardiomyopathy, or abnormalities in the heart muscle, and problems with the heart valves.
Arrhythmias in childhood or adulthood can result from congenital heart diseases, which are cardiac issues like tetralogy of Fallot or atrial septal defect that people are born with.
One of the more severe forms of rapid arrhythmias can result from scar tissue in the heart, such as following a heart attack. “Tachycardia circuits can develop,” says Dr. Vivek Reddy, who is the director of Mount Sinai Health System’s cardiac arrhythmia service in New York City. “Ventricular tachycardia is dangerous—it’s actually the rhythm that leads to most cardiac arrests.”
In many cases, the cause of arrhythmia is unknown. One common misconception is that all arrhythmias are abnormal, Levine notes. For instance, a wearable fitness device may pick up a benign irregular heartbeat with no clear cause and no need for treatment.
Premature ventricular contractions are early, extra heartbeats that start in the ventricles. PVCs are quite common and usually considered harmless unless people also have risk factors such as heart disease or heart failure. Premature atrial contractions, or PACS, are similar but start in the atria of the heart.
The cause may be external. “It turns out that caffeine causes a lot of arrhythmias,” Levine says. “Red wine causes a lot of arrhythmias. Alcohol excess causes a lot of arrhythmias, and the alcohol excess is called ‘holiday heart syndrome.’ You go on holiday and the next day you’re in the emergency room with arrhythmia.” For some people, limiting caffeine and alcohol may be enough to prevent future episodes.
Heart Arrhythmias
Diagnosis of Heart Arrhythmias
To make an arrhythmia diagnosis, cardiologists ask patients about their medical history, perform a physical exam and order certain tests based on specific symptoms.
Tests to Diagnose Heart Arrhythmia
- An electrocardiogram is the primary diagnostic test. A 12-lead EKG is standard, Koplan says.
- A continuous wearable monitor, like a Holter monitor, is a small device that you wear around the clock for a day or two to catch arrhythmias that come and go. Wearable monitors can catch paroxysmal or nonsustained arrhythmias that an EKG may not pick up.
- Treadmill tests can help diagnose exercise-related arrhythmias.
- Echocardiograms are noninvasive, ultrasound tests of the heart.
- Electrophysiology studies are done under local anesthesia, with cardiac catheters threaded into large blood vessels to the heart to determine the arrhythmia’s source.
Heart Arrhythmias
Treatments of Heart Arrhythmias
If you have an arrhythmia that requires treatment, your cardiologist will explain your options and describe the risks and benefits for each one. Depending on your specific diagnosis, choices may include medications, catheter-based procedures, or implanted heart devices such as pacemakers and internal defibrillators.
- Medications for Arrhythmia
- Surgical Procedures for Arrhythmia
- Implanted Heart Devices
Who Should You See for Arrhythmia?
Ask if a cardiology clinic offers the entire range of procedures and has substantial experience in every field before getting treatment there, suggests Levine. According to him, inquire about their success and complication rates, which ought to be higher than the national norm.
“If a person just has a skipped heartbeat, they might start with a cardiologist,” Levine explains. “If you’re getting palpitations and you’re passing out—fainting is a big symptom of arrhythmia—if you had a heart attack and you’re passing out; if you have an abnormal EKG that you’ve known about, those people should just go to an arrhythmia center, period.”
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Disclaimer: The opinions and suggestions expressed in this article are solely those of the individual analysts. These are not the opinions of HNN. For more, please consult with your doctor
