An arrhythmia (ah-RITH-me-ah) is a problem with the
rate or rhythm of the heartbeat. During an arrhythmia, the heart can beat too
fast, too slow, or with an irregular rhythm.
A heartbeat that is too fast is called tachycardia
(TAK-ih-KAR-de-ah). A heartbeat that is too slow is called bradycardia
(bray-de-KAR-de-ah).
Most arrhythmias are harmless, but some can be
serious or even life threatening. When the heart rate is too fast, too slow, or
irregular, the heart may not be able to pump enough blood to the body. Lack of
blood flow can damage the brain, heart, and other organs.
Understanding the Heart's Electrical System
To understand arrhythmias, it helps to understand
the heart's internal electrical system. The heart's electrical system controls
the rate and rhythm of the heartbeat.
With each heartbeat, an electrical signal spreads
from the top of the heart to the bottom. As the signal travels, it causes the
heart to contract and pump blood. The process repeats with each new
heartbeat.
Each electrical signal begins in a group of cells
called the sinus node or sinoatrial (SA) node. The SA node is located in the
right atrium (AY-tree-um), which is the upper right chamber of the heart. In a
healthy adult heart at rest, the SA node fires off an electrical signal to
begin a new heartbeat 60 to 100 times a minute.
From the SA node, the electrical signal travels
through special pathways in the right and left atria. This causes the atria to
contract and pump blood into the heart's two lower chambers, the ventricles
(VEN-trih-kuls).
The electrical signal then moves down to a group of
cells called the atrioventricular (AV) node, located between the atria and the
ventricles. Here, the signal slows down just a little, allowing the ventricles
time to finish filling with blood.
The electrical signal then leaves the AV node and
travels along a pathway called the bundle of His. This pathway divides into a
right bundle branch and a left bundle branch. The signal goes down these
branches to the ventricles, causing them to contract and pump blood out to the
lungs and the rest of the body.
The ventricles then relax, and the heartbeat process
starts all over again in the SA node.
A problem with any part of this process can cause an
arrhythmia. For example, in
atrial
fibrillation, a common type of arrhythmia, electrical signals travel
through the atria in a fast and disorganized way. This causes the atria to
quiver instead of contract.
For more information on the heart's electrical
system and detailed animations, go to the Diseases and Conditions Index
How
the Heart Works article.
Outlook
There are many types of arrhythmia. Most arrhythmias
are harmless, but some are not. The outlook for a person who has an arrhythmia
depends on the type and severity of the arrhythmia.
Even serious arrhythmias often can be successfully
treated. Most people who have arrhythmias are able to live normal, healthy
lives.
Types of Arrhythmia
The four main types of arrhythmia are premature
(extra) beats, supraventricular arrhythmias, ventricular arrhythmias, and
bradyarrhythmias (bray-de-ah-RITH-me-ahs).
Premature (Extra) Beats
Premature beats are the most common type of
arrhythmia. They're harmless most of the time and often don't cause any
symptoms.
When symptoms do occur, they usually feel like
fluttering in the chest or a feeling of a skipped beat. Most of the time,
premature beats need no treatment, especially in healthy people.
Premature beats that occur in the atria are called
premature atrial contractions, or PACs. Premature beats that occur in the
ventricles are called premature ventricular contractions, or PVCs.
In most cases, premature beats occur naturally, not
due to any heart disease. But certain heart diseases can cause premature beats.
They also can happen because of stress, too much exercise, or too much caffeine
or nicotine.
Supraventricular Arrhythmias
Supraventricular arrhythmias are tachycardias (fast
heart rates) that start in the atria or the atrioventricular (AV) node. The AV
node is a group of cells located between the atria and the ventricles.
Types of supraventricular arrhythmias include
atrial
fibrillation (AF), atrial flutter, paroxysmal supraventricular tachycardia
(PSVT), and Wolff-Parkinson-White (WPW) syndrome.
Atrial Fibrillation
AF is the most common type of serious arrhythmia.
It's a very fast and irregular contraction of the atria.
In AF, the heart's electrical signal doesn't begin
in the SA node. Instead, the signal begins in another part of the atria or in
the nearby pulmonary veins and is conducted abnormally.
When this happens, the electrical signal doesn't
travel through the normal pathways in the atria. Instead, it spreads throughout
the atria in a fast and disorganized manner.
This causes the walls of the atria to quiver very
fast (fibrillate) instead of beating normally. As a result, the atria aren't
able to pump blood into the ventricles the way they should.
The animation below shows atrial fibrillation. Click
the "start" button to play the animation. Written and spoken explanations are
provided with each frame. Use the buttons in the lower right corner to pause,
restart, or replay the animation, or use the scroll bar below the buttons to
move through the frames.
The animation shows how the heart's
electrical signal starts in a place in the right atrium other than the
sinoatrial node, causing the atria to beat very fast and irregularly.
In AF, electrical signals can travel through the
atria at a rate of more than 300 per minute. Some of these abnormal electrical
signals can travel to the ventricles, causing them to beat too fast and with an
irregular rhythm. AF usually isn't life threatening, but it can be dangerous
when it causes the ventricles to beat very fast.
The two most serious complications of chronic
(long-term) AF are
stroke and
heart
failure. Stroke can happen if a blood clot travels to an artery in the
brain, blocking off blood flow.
In AF, blood clots can form because some of the
blood "pools" in the fibrillating atria instead of flowing into the ventricles.
If a piece of a blood clot in the left atrium breaks off, it can travel to the
brain, causing a stroke. People who have AF often are treated with
blood-thinning medicines to lower their risk for blood clots.
Heart failure is when the heart can't pump enough
blood to meet the body's needs. AF can cause heart failure if the ventricles
beat too fast and don't have enough time to fill with blood to pump out to the
body. Heart failure causes fatigue (tiredness), leg swelling, and shortness of
breath.
AF and other supraventricular arrhythmias can occur
for no apparent reason. But most of the time, an underlying condition that
damages the heart muscle and its ability to conduct electrical impulses causes
AF. These conditions include
high
blood pressure,
coronary
heart disease (also called coronary artery disease), heart failure, and
rheumatic heart disease.
Other conditions also can lead to AF, including an
overactive thyroid gland (too much thyroid hormone produced) and heavy alcohol
use. AF also becomes more common as people get older.
Atrial Flutter
Atrial flutter is similar to AF, but instead of the
electrical signals spreading through the atria in a fast and irregular rhythm,
they travel in a fast and regular rhythm.
Atrial flutter is much less common than AF, but it
has similar symptoms and complications.
Paroxysmal Supraventricular Tachycardia
PSVT is a very fast heart rate that begins and ends
suddenly. PSVT occurs due to problems with the electrical connection between
the atria and the ventricles.
In PSVT, electrical signals that begin in the atria
and travel to the ventricles can reenter the atria, causing extra heartbeats.
This type of arrhythmia usually isn't dangerous and tends to occur in young
people. It can happen during vigorous exercise.
A special type of PSVT is called
Wolff-Parkinson-White syndrome. WPW syndrome is a condition in which the
heart's electrical signals travel along an extra pathway from the atria to the
ventricles.
This extra pathway disrupts the timing of the
heart's electrical signals and can cause the ventricles to beat very fast. This
type of arrhythmia can be life threatening.
The animation below shows Wolff-Parkinson-White
syndrome. Click the "start" button to play the animation. Written and spoken
explanations are provided with each frame. Use the buttons in the lower right
corner to pause, restart, or replay the animation, or use the scroll bar below
the buttons to move through the frames.
The animation shows how an extra,
abnormal electrical pathway in the heart disrupts the normal timing of the
heart's electrical signal, causing the atria and ventricles to beat too fast.
Ventricular Arrhythmias
These arrhythmias start in the ventricles. They can
be very dangerous and usually need medical attention right away.
Ventricular arrhythmias include ventricular
tachycardia and ventricular fibrillation (v-fib). Coronary heart
disease,
heart
attack, weakened heart muscle, and other problems can cause ventricular
arrhythmias.
Ventricular Tachycardia
Ventricular tachycardia is a fast, regular beating
of the ventricles that may last for only a few seconds or for much longer.
A few beats of ventricular tachycardia often don't
cause problems. However, episodes that last for more than a few seconds can be
dangerous. Ventricular tachycardia can turn into other, more dangerous
arrhythmias, such as v-fib.
Ventricular Fibrillation
V-fib occurs when disorganized electrical signals
make the ventricles quiver instead of pump normally. Without the ventricles
pumping blood out to the body, you'll lose consciousness within seconds and die
within minutes if not treated.
To prevent death, the condition must be treated
right away with an electric shock to the heart called defibrillation
(de-fib-ri-LA-shun).
V-fib may happen during or after a heart attack or
in someone whose heart is already weak because of another condition. Health
experts think that most of the
sudden
cardiac deaths that occur every year (about 335,000) are due to v-fib.
The animation below shows ventricular fibrillation.
Click the "start" button to play the animation. Written and spoken explanations
are provided with each frame. Use the buttons in the lower right corner to
pause, restart, or replay the animation, or use the scroll bar below the
buttons to move through the frames.
The animation shows how disorganized
electrical signals in the heart's ventricles can cause them to pump abnormally
and quiver.
Torsades de pointes (torsades) is a type of v-fib
that causes a unique pattern on an
EKG
(electrocardiogram). Certain medicines or imbalanced amounts of potassium,
calcium, or magnesium in the bloodstream can cause this condition.
People who have
long
QT syndrome are at higher risk for torsades. People who have this condition
need to be careful about taking certain antibiotics, heart medicines, and
over-the-counter medicines.
Bradyarrhythmias
Bradyarrhythmias are arrhythmias in which the heart
rate is slower than normal. If the heart rate is too slow, not enough blood
reaches the brain. This can cause you to lose consciousness.
In adults, a heart rate slower than 60 beats per
minute is considered a bradyarrhythmia. Some people normally have slow heart
rates, especially people who are very physically fit. For them, a heartbeat
slower than 60 beats per minute isn't dangerous and doesn't cause symptoms. But
in other people, bradyarrhythmia can be due to a serious disease or other
condition.
Bradyarrhythmias can be caused by:
Heart attack
Conditions that harm or change the heart's
electrical activity, such as an underactive thyroid gland or aging
An imbalance of chemicals or other substances,
such as potassium, in the blood
Some medicines, such as beta blockers
Bradyarrhythmias also can happen as a result of
severe bundle branch block. Bundle branch block is a condition in which an
electrical signal traveling down either or both of the bundle branches is
delayed or blocked.
When this happens, the ventricles don't contract at
exactly the same time, as they should. As a result, the heart has to work
harder to pump blood to the body. The cause of bundle branch block often is an
existing heart condition.
Arrhythmias in Children
A child's heart rate normally decreases as he or she
gets older. A newborn's heart beats between 95 to 160 times a minute. A
1-year-old's heart beats between 90 to 150 times a minute, and a 6- to
8-year-old's heart beats between 60 to 110 times a minute.
A baby or child's heart can beat faster or slower
than normal for many reasons. Like adults, when children are active, their
hearts will beat faster. When they're sleeping, their hearts will beat slower.
Their heart rates can speed up and slow down as they breathe in and out. All of
these changes are normal.
Some children are born with heart defects that cause
arrhythmias. In other children, arrhythmias can develop later in childhood.
Doctors use the same tests to diagnose arrhythmias in children and adults.
Treatments for children who have arrhythmias include
medicines, defibrillation (electric shock), surgically implanted devices that
control the heartbeat, and other procedures that fix abnormal electrical
signals in the heart.
Other Names for Arrhythmia
Dysrhythmia
What Causes an 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 don't work properly, or if
electrical signals don't travel normally through the heart.
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.
Smoking, heavy alcohol use, use of certain drugs
(such as cocaine or amphetamines), use of certain prescription or
over-the-counter medicines, or too much caffeine or nicotine can lead to
arrhythmias in some people.
Strong emotional stress or anger can make the heart
work harder, raise blood pressure, and release stress hormones. In some people,
these reactions can lead to arrhythmias.
A
heart
attack or an underlying condition that damages the heart's electrical
system also can cause arrhythmias. Examples of such conditions include
high
blood pressure,
coronary
heart disease,
heart
failure, overactive or underactive thyroid gland (too much or too little
thyroid hormone produced), and rheumatic heart disease.
In some arrhythmias, such as Wolff-Parkinson-White
syndrome, the underlying heart defect that causes the arrhythmia is congenital
(present at birth). Sometimes, the cause of an arrhythmia can't be
found.
Who Is At Risk for an Arrhythmia?
Millions of Americans have arrhythmias. They're
very common in older adults. About 2.2 million Americans have
atrial
fibrillation (a common type of arrhythmia that can cause problems).
Most serious arrhythmias affect people older than
60. This is because older adults are more likely to have heart disease and
other health problems that can lead to arrhythmias.
Older adults also tend to be more sensitive to the
side effects of medicines, some of which can cause arrhythmias. Some medicines
used to treat arrhythmias can even cause arrhythmias as a side effect.
Some types of arrhythmia happen more often in
children and young adults. Paroxysmal supraventricular tachycardias (PSVTs),
including Wolff-Parkinson-White syndrome, are more common in young people. PSVT
is a fast heart rate that begins and ends suddenly.
Major Risk Factors
Arrhythmias are more common in people who have
diseases or conditions that weaken the heart, such as:
Sleep apnea (when breathing becomes shallow or stops during sleep), which
can stress the heart because the heart doesn't get enough oxygen
An overactive or underactive thyroid gland (too
much or too little thyroid hormone in the body)
Also, several other risk factors can increase risk
for arrhythmias. Examples include
heart
surgery, certain drugs (such as cocaine or amphetamines), or an imbalance
of chemicals or other substances (such as potassium) in the bloodstream.
What Are the Signs and Symptoms of an
Arrhythmia?
Many arrhythmias cause no signs or symptoms. When
signs or symptoms are present, the most common ones are:
Palpitations
(feelings that your heart is skipping a beat, fluttering, or beating too hard
or fast)
A slow heartbeat
An irregular heartbeat
Feeling pauses between heartbeats
More serious signs and symptoms include:
Anxiety
Weakness, dizziness, and lightheadedness
Fainting or nearly fainting
Sweating
Shortness of breath
Chest pain
How Are Arrhythmias Diagnosed?
Arrhythmias can be hard to diagnose, especially the
types that only cause symptoms every once in a while. Doctors use several
methods to help diagnose arrhythmias, including medical and family histories,
physical exam, and diagnostic tests and procedures.
Specialists Involved
Doctors who specialize in the diagnosis and
treatment of heart diseases include:
Cardiologists. These doctors take care of adults
who have heart problems.
Pediatric cardiologists. These doctors take care
of babies, children, and youth who have heart problems.
Electrophysiologists. These doctors are
cardiologists or pediatric cardiologists who specialize in arrhythmias.
Medical and Family Histories
To diagnose an arrhythmia, your doctor may ask about
your signs and symptoms. He or she may ask about what symptoms you're having,
whether you feel fluttering in your chest, and whether you feel dizzy or
lightheaded.
Your doctor also may ask about other health problems
you have, such as a history of heart disease,
high
blood pressure, diabetes, or thyroid problems. He or she may ask about your
family' s medical history, including:
Does anyone in your family have a history of
arrhythmias?
Has anyone in your family ever had heart disease
or high blood pressure?
Has anyone in your family died suddenly?
Are there other illnesses or health problems in
your family?
Your doctor will likely want to know what medicines
you're taking, including over-the-counter medicines and vitamin or mineral or
nutritional supplements.
Your doctor may ask about your health habits, such
as physical activity, smoking, or using alcohol or drugs (for example,
cocaine). He or she also may want to know whether you've had episodes of strong
emotional stress or anger.
Physical Exam
Your doctor will listen to the rate and rhythm of
your heart and for a
heart
murmur (an extra or unusual sound heard during your heartbeat). He or she
also will:
Check your pulse to find out how fast your heart
is beating
Check for swelling in your legs or feet, which
could be a sign of an enlarged heart or
heart
failure
Look for signs of other diseases, such as thyroid
disease, that could be causing the problem
Diagnostic Tests and Procedures
EKG (Electrocardiogram)
An
EKG
is the most common test used to diagnose arrhythmias. An EKG is a simple test
that detects and records the heart's electrical activity.
The test shows how fast the heart is beating and its
rhythm (steady or irregular). It also records the strength and timing of
electrical signals as they pass through each part of the heart.
A standard EKG only records the heartbeat for a few
seconds. It won't detect arrhythmias that don't happen during the test.
To diagnose arrhythmias that come and go, your
doctor may have you wear a portable EKG monitor. The two most common types of
portable EKGs are
Holter
and event monitors.
Holter and Event Monitors
A Holter monitor records the heart's electrical
signals for a full 24- or 48-hour period. You wear one while you do your normal
daily activities. This allows the monitor to record your heart for a longer
time than a standard EKG.
An event monitor is similar to a Holter monitor. You
wear an event monitor while doing your normal activities. However, an event
monitor only records your heart's electrical activity at certain times while
you're wearing it.
For many event monitors, you push a button to start
the monitor when you feel symptoms. Other event monitors start automatically
when they sense abnormal heart rhythms.
Some event monitors are able to send data about your
heart's electrical activity to a central monitoring station. Technicians at the
station review the information and send it to your doctor. You also can use the
device to report any symptoms you're having.
You may wear an event monitor for 1 to 2 months, or
as long as it takes to get a recording of your heart during symptoms.
Other Tests
Other tests also are used to help diagnose
arrhythmias.
Blood tests.Blood
tests check the level of substances in the blood, such as potassium or
thyroid hormone, that can increase your chances of having an arrhythmia.
Chest x ray. A
chest
x ray is a painless test that creates pictures of the structures in your
chest, such as your heart and lungs. This test can show whether the heart is
enlarged.
(EK-o-kar-de-OG-ra-fee). This test
uses sound waves to create a moving picture of your heart.
Echocardiography
(echo) provides information about the size and shape of your heart and how well
your heart chambers and valves are working.
The test also can identify areas of poor blood flow
to the heart, areas of heart muscle that aren't contracting normally, and
previous injury to the heart muscle caused by poor blood flow.
There are several different types of echo, including
stress echo. This test is done both before and after a stress test (see below).
A stress echo usually is done to find out whether you have decreased blood flow
to your heart, a sign of
coronary
heart disease (CHD).
A transesophageal (tranz-ih-sof-uh-JEE-ul) echo, or
TEE, is a special type of echo that takes pictures of the back of the heart
through the esophagus (the passage leading from your mouth to your
stomach).
Stress test. Some heart problems
are easier to diagnose when your heart is working hard and beating fast. During
stress
testing, you exercise (or are given medicine if you're unable to exercise)
to make your heart work hard and beat fast while heart tests are done.
These tests may include
nuclear
heart scanning, echocardiography, and magnetic resonance imaging (MRI) and
positron emission tomography (PET) scanning of the heart.
Electrophysiology study (EPS). This
test is used to assess serious arrhythmias. During an EPS, a thin, flexible
wire is passed through a vein in your groin (upper thigh) or arm to your heart.
The wire records the heart's electrical signals.
Your doctor uses the wire to electrically stimulate
your heart and trigger an arrhythmia. This allows the doctor to see whether an
antiarrhythmia medicine can stop the problem.
Catheter ablation, a procedure used to fix some types of arrhythmia, may be
done during an EPS.
Tilt table testing. This test
sometimes is used to help find the cause of fainting spells. You lie on a table
that moves from a lying down to an upright position. The change in position can
cause you to faint.
Your doctor watches your symptoms, heart rate, EKG
reading, and blood pressure throughout the test. Your doctor also may give you
medicine and then check your response to the medicine.
Coronary angiography
(an-jee-OG-ra-fee).Coronary
angiography uses dye and special x rays to show the inside of your coronary
(heart) arteries.
During the test, a long, thin, flexible tube called
a catheter is put into a blood vessel in your arm, groin (upper thigh), or
neck.
The tube is then threaded into your coronary
arteries, and the dye is injected into your bloodstream. Special x rays are
taken while the dye is flowing through the coronary arteries.
The dye lets your doctor study the flow of blood
through your heart and blood vessels. This helps your doctor find blockages
that can cause a
heart
attack.
Implantable loop recorder. This
device detects abnormal heart rhythms. Minor surgery is used to place this
device under the skin in the chest area.
An implantable loop recorder helps doctors figure
out why a person may be having
palpitations
or fainting spells, especially when these symptoms dont happen very
often. The device can be used for as long as 12 to 24 months.
How Are Arrhythmias Treated?
Common arrhythmia treatments include medicines,
medical procedures, and surgery. Treatment is needed when an arrhythmia causes
serious symptoms, such as dizziness, chest pain, or fainting.
Medicines can be used to speed up a heart
thats beating too slow or slow down a heart thats beating too fast.
They also can be used to convert an abnormal heart rhythm to a normal, steady
rhythm. Medicines that do this are called antiarrhythmics.
Some of the medicines used to slow a fast heart
rate are beta blockers (such as metoprolol and atenolol), calcium channel
blockers (such as diltiazem and verapamil), and digoxin (digitalis). These
medicines often are used to slow the heart rate in people who have
atrial
fibrillation.
Some of the medicines used to restore an abnormal
heartbeat to a normal rhythm are amiodarone, sotalol, flecainide, propafenone,
dofetilide, ibutilide, quinidine, procainamide, and disopyramide. These
medicines often have side effects. Some of the side effects can make an
arrhythmia worse or even cause a different kind of arrhythmia.
People who have atrial fibrillation and some other
arrhythmias often are treated with anticoagulants, or blood thinners, to reduce
the risk of blood clots forming. Aspirin, warfarin (Coumadin®),
and heparin are commonly used blood thinners.
Medicines also can control an underlying medical
condition, such as heart disease or a thyroid condition, that might be causing
an arrhythmia.
Medical Procedures
Some arrhythmias are treated with a
pacemaker.
A pacemaker is a small device that's placed under the skin of your chest or
abdomen to help control abnormal heart rhythms.
This device uses electrical pulses to prompt the
heart to beat at a normal rate. Most pacemakers contain a sensor that activates
the device only when the heartbeat is abnormal.
Some arrhythmias are treated with a jolt of
electricity delivered to the heart. This type of treatment is called
cardioversion or defibrillation, depending on which type of arrhythmia is
being treated.
Some people who are at risk for ventricular
fibrillation are treated with a device called an
implantable
cardioverter defibrillator (ICD). Like a pacemaker, an ICD is a small
device thats placed under the skin in the chest. This device uses
electrical pulses or shocks to help control life-threatening arrhythmias.
An ICD continuously monitors the heartbeat. If it
senses a dangerous ventricular arrhythmia, it sends an electric shock to the
heart to restore a normal heartbeat.
A procedure called
catheter
ablation is sometimes used to treat certain types of arrhythmia when
medicines dont work.
During this procedure, a long, thin, flexible tube
is put into a blood vessel in your arm, groin (upper thigh), or neck. The tube
is guided to your heart through the blood vessel. A special machine sends
energy through the tube to your heart.
This energy finds and destroys small areas of heart
tissue where abnormal heartbeats may cause an arrhythmia to start. Catheter
ablation usually is done in a hospital as part of an electrophysiology
study.
Surgery
Sometimes, an arrhythmia is treated with surgery.
This often occurs when surgery is already being done for another reason, such
as repair of a heart valve.
One type of surgery for atrial fibrillation is
called "maze" surgery. In this operation, the surgeon makes small cuts or burns
in the atria that prevent the spread of disorganized electrical signals.
Vagal maneuvers are another arrhythmia treatment.
These simple exercises sometimes can stop or slow down certain types of
supraventricular arrhythmias. They do this by affecting the vagus nerve, which
helps control the heart rate.
Some vagal maneuvers include:
Gagging
Holding your breath and bearing down (Valsalva
maneuver)
Immersing your face in ice-cold water
Coughing
Putting your fingers on your eyelids and pressing
down gently
Vagal maneuvers aren't an appropriate treatment for
everyone. Discuss with your doctor whether vagal maneuvers are an option for
you.
Living With an Arrhythmia
Many arrhythmias are harmless. It's common to have
an occasional extra heartbeat and not even be aware of it, or to only have mild
palpitations.
People who have harmless arrhythmias can live healthy lives and usually don't
need treatment for their arrhythmias.
Even people who have serious arrhythmias often are
treated successfully and lead normal lives.
Ongoing Care
If you have an arrhythmia that requires treatment,
you should:
Keep all of your medical appointments. Always
bring all medicines you're taking to all of your doctor visits. This helps
ensure that all of your doctors know exactly what medicines you're taking,
which can help prevent medication errors.
Follow your doctor's instructions for taking
medicines. Check with your doctor before taking over-the-counter medicines,
nutritional supplements, or cold and allergy medicines.
Tell your doctor if you're having side effects
from your medicines. Side effects could include depression and palpitations.
These side effects often can be treated.
Tell your doctor if arrhythmia symptoms are
getting worse or if you have new symptoms.
Allow your doctor to check you regularly if
you're taking blood-thinning medicines.
If you have an arrhythmia, taking care of yourself
is important. If you feel dizzy or faint, you should lie down. Don't try to
walk or drive. Let your doctor know about these symptoms.
Ask your doctor whether vagal maneuvers are an
option for you. These exercises, which people who have certain arrhythmias can
do, may help stop a rapid heartbeat.
Learn how to take your pulse. Discuss with your
doctor what pulse rate is normal for you. Keep a record of changes in your
pulse rate and share this information with your doctor.
Lifestyle Changes
Many arrhythmias are caused by underlying heart
disease. Keep your heart healthy by following a healthy diet.
A healthy diet includes a variety of fruits,
vegetables, and whole grains. It also includes lean meats, poultry, fish,
beans, and fat-free or low-fat milk or milk products. A healthy diet is low in
saturated fat, trans fat, cholesterol, sodium (salt), and added
sugar.
A healthy lifestyle also includes doing physical
activity regularly, quitting smoking, maintaining a healthy weight, and keeping
your blood cholesterol and blood pressure at healthy levels.
Strong emotional stress or anger can lead to
arrhythmias. Try to manage stress and anger through activities such as yoga,
quiet time, meditation, and relaxation techniques. Getting support from friends
and family also can help you manage stress.
Your doctor may want you to avoid certain
substances if they make your heart beat too fast. These substances may include
alcohol and cold and cough medicines.
Key Points
An arrhythmia is a problem with the rate or
rhythm of the heartbeat. During an arrhythmia, the heart can beat too fast, too
slow, or with an irregular rhythm.
Most arrhythmias are harmless, but some can be
serious or even life threatening. When the heart rate is too fast, too slow, or
irregular, the heart may not be able to pump enough blood to the body. Lack of
blood flow can damage the brain, heart, and other organs.
To understand arrhythmias, it helps to understand
the heart's electrical system. With each heartbeat, an electrical signal
spreads from the top of the heart to the bottom. As the signal travels, it
causes the heart to contract and pump blood. A problem with any part of this
process can cause an arrhythmia.
The four main types of arrhythmia are premature
(extra) beats, supraventricular arrhythmias, ventricular arrhythmias, and
bradyarrhythmias.
An arrhythmia can occur if the electrical signals
that control the heartbeat are delayed or blocked, or if the heart produces
extra electrical signals. Other causes of arrhythmia include smoking, heavy
alcohol use, use of certain drugs and medicines, too much caffeine or nicotine,
strong emotional stress or anger, and underlying medical conditions. Sometimes
the cause of an arrhythmia can't be found.
Millions of Americans have arrhythmias. They're
very common in older adults, and most serious arrhythmias affect people older
than 60. Some types of arrhythmia, such as paroxysmal supraventricular
tachycardia, are more common in young people.
Most arrhythmias cause no signs or symptoms. When
signs and symptoms are present, the most common ones are
palpitations,
a slow heartbeat, an irregular heartbeat, and feeling pauses between
heartbeats.
Doctors use several methods to diagnose
arrhythmias, including medical and family histories, a physical exam, and
diagnostic tests and procedures.
Common arrhythmia treatments include medicines,
medical procedures, and surgery. Treatment is needed when an arrhythmia causes
serious symptoms, such as dizziness, chest pain, or fainting.
Many arrhythmias are harmless, and people who
have them can live healthy lives and usually don't need treatment. Even people
who have serious arrhythmias often are treated successfully and lead normal
lives.
If you have an arrhythmia that requires
treatment, it's important to get ongoing care. Keep all of your medical
appointments, take medicines as prescribed, and tell your doctor if you have
new or worsening symptoms.
Because many arrhythmias are caused by underlying
heart disease, it's important to keep your heart healthy. Follow a healthy
diet, get physical activity regularly, quit smoking, maintain a healthy weight,
and keep your blood cholesterol and blood pressure at healthy levels. Try to
manage stress and anger.