An arrhythmia is an abnormal heart rhythm or heartbeat. It may feel like a fluttering or racing of the heart.
There are two basic types of arrhythmias:
- Bradycardia The heartbeat is too slow, resulting in a heart rate of less than 60 beats per minute
- Tachycardia The heartbeat is too fast, resulting in a heart rate greater than 100 beats per minute
Some arrhythmias are harmless and may have no noticeable symptoms.
Signs and Symptoms of Arrhythmia
Many arrhythmias don’t have any symptoms.
If they do, common signs and symptoms of an arrhythmia may include:
- Palpitations (may feel like fluttering in your chest, like your heart is skipping a beat, or like it is beating too hard or too fast)
- Feeling pauses between heartbeats or an irregular pattern
- Fatigue, weakness, light-headedness
- A slow heartbeat
Some arrhythmias are medical emergencies. During an arrhythmia, the heart may not be able to pump enough blood to the body and may stop working.
If you experience the following symptoms, call 911:
- Significant weakness, dizziness, or light-headedness
- Shortness of breath
- Chest pain
- Blurred vision
Causes and Risk Factors of Arrhythmias
Arrhythmias happen when the electrical signals that control your heartbeat don’t work properly.
This can happen if the specialized heart cells that send the electrical signals are damaged or if the electrical signals don’t travel properly through the heart.
A normal heartbeat can also be disrupted if the heart produces too many electrical signals.
Sometimes the cause of an arrhythmia is unknown.
Arrhythmias are common in older adults, who are more likely to have heart disease, high blood pressure, and other health conditions that can cause arrhythmias.
Some medications can also cause arrhythmias as a side effect, including tricyclic antidepressants (TCAs), antihistamines, and beta-blockers.
Additionally, illegal drugs, such as cocaine, methamphetamines, and stimulants like caffeine and nicotine can cause arrhythmias.
Common risk factors for arrhythmias include:
- Heart attack
- Heart failure or cardiomyopathy
- Abnormal heart valves
- Congenital (present at birth) heart defects
- High blood pressure
- Sleep apnea
- Thyroid problems
- Extreme emotional stress or anger
How Is Arrhythmia Diagnosed?
A number of tests and devices are used to detect an arrhythmia.
Diagnosis usually requires recording the heart’s electrical activity using an electrocardiogram, or ECG.
A Holter monitor — a portable, 24- or 48-hour ECG — may also be used if your doctor wants to see your heartbeat over a longer period.
During an ECG, small patches or stickers called electrodes are stuck to several spots on your chest and body.
These electrodes will generate a picture of your heart’s electrical activity so doctors can see where any irregularities may occur.
An echocardiogram — a type of ultrasound that uses sound waves to produce images of your heart — may also be used to diagnose heart problems that can lead to arrhythmias.
Stress tests, which use physical exertion (such as running on a treadmill) or drugs to simulate exercise, can trigger an arrhythmia and help a doctor make an accurate diagnosis.
Cardiac catheterization, a procedure in which a tiny tube is threaded through a vein or artery and into the heart, can help your doctor measure pressures in the heart or evaluate for potential blockage of the coronary arteries.
Duration of Arrhythmia
The frequency and duration of arrhythmia depends on the cause. For example, when an arrhythmia is caused by a treatable condition, like an overactive thyroid, the irregular heartbeat may go away when the thyroid problem is treated.
Treatment and Medication Options for Arrhythmia
Arrhythmias can be treated with lifestyle modification, medications, or medical procedures/surgery.
Medications can slow down a heartbeat that is too fast. They can also be used to even out or stabilize an abnormal heart rhythm.
Drugs used to treat arrhythmias include:
- Adenosine slows a racing heart by slowing its electrical signals.
- Atropine temporarily treats a slow heart rate.
- Beta-blockers work by slowing the heart rate and decreasing the effects of adrenaline on the heart, thereby lowering blood pressure.
- Anticoagulants, or blood thinners, work by making it more difficult for blood to clot. These medications do not dissolve existing blood clots, but rather prevent new ones from forming or existing ones from growing bigger. Anticoagulants are commonly prescribed to people who are at risk of blood clots, such as those with atrial fibrillation.
- Calcium channel blockers, or “calcium antagonists,” interrupt the movement of calcium into the heart and can slow the heart rate.
- Digitalis helps slow the heart rate and can help the heart strengthen its contractions when its pumping function has been weakened.
Some arrhythmias, including heartbeats that are too slow, can be treated with a pacemaker.
Another option might be a minimally invasive surgical procedure known as a catheter ablation. In this approach, a surgeon uses a catheter to create small scars in the heart tissue where the arrhythmia is occurring. The goal is to purposely destroy the abnormal tissue that is causing irregular rhythms and restore proper function. Catheter ablation is often considered if medication options are not effective, notes the Cleveland Clinic.
Alternative and Complementary Therapies
Regardless of any medical interventions that are recommended for treating arrhythmia, your doctor may also advise common-sense lifestyle changes, including:
- A healthy, low-fat, low-sodium diet
- Regular exercise
- Smoking cessation
- Weight loss to avoid obesity
Additionally, some arrhythmias can be treated with simple home exercises called vagal maneuvers to help control heart rate.
Some vagal maneuvers include:
- Gagging or coughing
- Holding your breath and bearing down
- Putting your fingers on your eyelids and pressing down gently
- Dunking your face in ice water
Vagal maneuvers aren’t right for everyone, and they work only for certain types of arrhythmias.
Prevention of Arrhythmia
Not all cardiac arrhythmias can be prevented. Still, there are steps you can take to reduce risk factors.
You can reduce your risk of an arrhythmia caused by coronary artery disease by:
- Eating a heart-healthy diet rich in fruits and vegetables and avoiding saturated and trans fats
- Maintaining a healthy weight
- Getting regular exercise
- Controlling high blood pressure and cholesterol
- Quitting smoking
Complications of Arrhythmia
Complications of arrhythmias can include:
Stroke Arrhythmias such as atrial fibrillation are associated with an increased risk of blood clots, which, if broken loose, can travel from the heart to the brain and block blood flow. This is what causes a stroke. Medications called blood thinners can greatly reduce the risk of stroke. Your doctor will determine if this medication is right for you, depending on the type of arrhythmia you have and your blood clot risk.
Heart Failure Ongoing arrhythmias can lead to a decline in the ability of the heart’s lower chambers to pump blood properly. Heart failure as the result of an arrhythmia is more common in individuals who already have heart disease.
Research and Statistics: How Many People Have Arrhythmia?
Racial Disparity in Arrhythmia
Related Conditions and Causes of Arrhythmia
Certain conditions make arrhythmias more likely, including hyperthyroidism, or an overactive thyroid, and sleep apnea.
Resources We Love
Favorite Organizations for Essential Information About Arrhythmia
The AHA is the nation’s leading organization for heart health and heart-related disorders. Learn about symptoms, diagnosis, and monitoring of arrhythmia, as well as tips for prevention and treatment of a heart rhythm disorder.
UpBeat.org is a subsite of the Heart Rhythm Society, an international non-profit organization representing medical and science professionals from more than 70 countries who specialize in cardiac rhythm disorders. Get the facts on arrhythmias and search the organization’s database for a certified heart specialist near you.
CardioSmart is a patient engagement program from the American College of Cardiology (ACC) that provides information and resources on heart conditions. The ACC is committed to empowering patients to make better informed decisions about their health and has created “decision aids” to help those living with heart conditions like Afib navigate different treatment options.
Favorite Arrhythmia Support Group
Through this support network from the AHA, you can join a community of people with atrial fibrillation. Share your experiences and connect with others who are dealing with the same struggles of living with an arrhythmia.
Favorite Resource to Become an Advocate
Arrhythmia Alliance is a coalition of charities, patient groups, caregivers, and medical professionals with the mission to raise awareness and advance treatment and quality of life for people living with cardiac arrhythmias.
Additional reporting by Lindsey Konkel.