Heart rhythm problems (heart arrhythmias) occur when the electrical impulses in your heart that coordinate your heartbeats don't work properly, causing your heart to beat too fast, too slow or irregularly.
Heart arrhythmias (uh-RITH-me-uhs) are often harmless. Most people have occasional, irregular heartbeats that may feel like a fluttering or racing heart. However, some heart arrhythmias may cause bothersome — sometimes even life-threatening — signs and symptoms.
Heart arrhythmia treatment can often control or eliminate irregular heartbeats. In addition, because troublesome heart arrhythmias are often made worse — or are even caused — by a weak or damaged heart, you may be able to reduce your arrhythmia risk by adopting a heart-healthy lifestyle.
Arrhythmias may not cause any signs or symptoms. In fact, your doctor might find you have an arrhythmia before you do, during a routine examination.
Some people do have noticeable arrhythmia symptoms, which may include:
Noticeable signs and symptoms don't always indicate a serious problem. Some people who feel arrhythmias don't have a serious problem, while others who have life-threatening arrhythmias have no symptoms at all.
When to see a doctor
Ventricular fibrillation (VF) is one type of arrhythmia that is deadly. It occurs when the heart beats with rapid, erratic electrical impulses. This causes pumping chambers in your heart (the ventricles) to quiver uselessly, instead of pumping blood. Without an effective heartbeat, blood pressure plummets, cutting off blood supply to your vital organs. A person with ventricular fibrillation will collapse within seconds and soon won't be breathing or have a pulse. If this occurs, follow these steps:
Portable defibrillators, which can deliver an electric shock that may restart heartbeats, are available in an increasing number of places, such as in airplanes, police cars and shopping malls. They can even be purchased for your home. Portable defibrillators come with built-in instructions for their use. They're programmed to allow a shock only when appropriate.
Many things can lead to, or cause, an arrhythmia, including:
What's a normal heartbeat?
Your heart is divided into four hollow chambers. The chambers on each half of your heart form two adjoining pumps, with an upper chamber (atrium) and a lower chamber (ventricle).
During a heartbeat, the atria contract and fill the relaxed ventricles with blood. This contraction starts when the sinus node — a small group of cells in your right atrium — sends an electrical impulse causing your right and left atria to contract.
The impulse then travels to the center of your heart, to the atrioventricular node that lies on the pathway between your atria and your ventricles. From here, the impulse exits the atrioventricular node and travels through your ventricles, causing them to contract and pump blood throughout your body.
In a healthy heart, this process usually goes smoothly, resulting in a normal resting heart rate of 60 to 100 beats a minute. Athletes at rest commonly have a heart rate less than 60 beats a minute because their hearts are so efficient.
Types of arrhythmias
Not all tachycardias or bradycardias mean you have heart disease. For example, during exercise it's normal to develop tachycardia as the heart speeds up to provide your tissues with more oxygen-rich blood.
Tachycardias in the atria
Tachycardias in the ventricles
Bradycardia — a slow heartbeat
Although you may feel an occasional premature beat, it seldom means you have a more serious problem. Still, a premature beat can trigger a longer lasting arrhythmia — especially in people with heart disease. Premature heartbeats are commonly caused by stimulants, such as caffeine from coffee, tea and soft drinks; over-the-counter cold remedies containing pseudoephedrine; and some asthma medications.
Electrical signals fire from multiple locations in the atria, causing abnormal quivering of the atria (1). The atrioventricular node — your heart's natural pacemaker — is unable to ...
Atrial flutter is similar to atrial fibrillation but characterized by more-organized and more-rhythmic electrical impulses. ...
Wolff-Parkinson-White syndrome is the name for episodes of fast heart rate caused by an extra electrical pathway between the atria and the ventricles. The fast heart rate often occurs because the ...
Ventricular tachycardia — caused by abnormal electrical impulses originating in the ventricles — is a fast, regular beating of the heart. ...
During ventricular fibrillation, your ventricles quiver uselessly instead of pumping blood. ...
Certain factors may increase your risk of developing an arrhythmia. These include:
Certain arrhythmias may increase your risk of developing conditions such as:
Preparing for your appointment
If you think you may have a heart arrhythmia, make an appointment with your family doctor. If a heart arrhythmia is found early, your treatment may be easier and more effective. Eventually, however, you may be referred to a heart specialist (cardiologist).
If your heart arrhythmia persists for more than a few minutes or is accompanied by fainting, shortness of breath, or chest pain, seek emergency medical help immediately.
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important, in case time runs out. For heart arrhythmias, some basic questions to ask your doctor include:
What to expect from your doctor
Tests and diagnosis
To diagnose a heart arrhythmia, 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 arrhythmias. These may include:
If your doctor doesn't find an arrhythmia during those tests, he or she may try to trigger your arrhythmia with other tests, which may include:
Treatments and drugs
If you have an arrhythmia, treatment may or may not be necessary. Usually it's required only if the arrhythmia is causing significant symptoms or if it's putting you at risk of a more serious arrhythmia or arrhythmia complication.
Treating slow heartbeats
Treating fast heartbeats
Cardiac catheter ablation
In catheter ablation, catheters are threaded through the blood vessels to the inner heart, and electrodes at the catheter tips transmit energy to destroy a small spot of heart tissue. ...
A dual chamber pacemaker paces the atrium and ventricle. A biventricular pacemaker paces both ventricles. An implantable cardioverter-defibrillator can function as a pacemaker would. In addition, if ...
Lifestyle and home remedies
Many arrhythmias can be blamed on underlying heart disease, so your doctor may suggest that, in addition to other treatments, you make lifestyle changes that will keep your heart as healthy as possible. Making healthy lifestyle changes can also help prevent heart arrhythmias from developing in the first place.
These lifestyle changes may include:
Last Updated: 2011-02-11
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