An arrhythmia is a problem with your heartbeat’s rhythm and/or rate. Some arrhythmias are nothing to worry about, others should be monitored, and some need to be addressed immediately.
Causes
The heart has four chambers. The top two are atria, and the lower two are ventricles. For your heart to work properly, the chambers must contract in an organized manner. This process is controlled by electrical signals generated by the sinus node, which is located in the heart’s right atrium. When the sinus node malfunctions, or the signals it generates are slowed or blocked as they travel through the heart, arrhythmias can occur.
Arrhythmias can also be caused by:
• Other heart problems
• Using substances such as caffeine, alcohol, and nicotine
• Anxiety and physical or mental stress
• Obesity and the conditions that it may cause, such as sleep apnea, diabetes, and high blood pressure
• An imbalance of fluids, hormones, or electrolytes in the blood
Symptoms
Arrhythmias don’t always produce symptoms. Their symptoms are often mild and can mirror the symptoms of other conditions. They include:
• Anxiety (which can be a cause, as well as a symptom, of arrhythmia)
• Sweating
• Weakness or fatigue
• Dizziness or light-headedness
• Fainting or nearly fainting
• Shortness of breath
• Chest discomfort
• Palpitations, which can feel like (and actually can be) your heart racing and/or skipping a beat
Diagnosing arrhythmias
Doctors can use many tools to diagnose arrhythmias:
• Electrocardiograms (EKGs or ECGs) are graphs of your heart’s electrical activity.
• Holter monitors are devices you wear that can produce EKGs of 48 hours or more. They allow doctors to see what you’re doing when arrhythmias occur.
• Stress tests measure how your heart responds to exercise.
• Tilt-table tests enable doctors to see whether feeling faint or lightheaded is due to arrhythmia.
Types of arrhythmias
Arrythmias are categorized by where they originate and the kind of heartbeat abnormality they involve.
Arrhythmias that originate in the ventricles are called ventricular arrhythmias. Arrhythmia that originate above the ventricles are classified as supraventricular arrhythmias. Most supraventricular arrhythmias originate in the atria and are called atrial arrhythmias.
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Arrythmias in which the heart beats faster than normal are called tachycardias. Arrhythmias in which the heart beats slower than normal are called bradycardias.
Arrhythmias that require treatment as soon as possible:
• Atrial fibrillations, or a-fibs, are common tachycardias. They involve rapid, uncoordinated heartbeats caused by the heart producing chaotic electrical signals. A-fibs may be temporary, but they increase the risk of stroke.
• Ventricular tachycardias are irregular electrical signals that result in a rapid heartbeat, which may prevent the heart from pumping enough blood to the rest of the body, causing light-headedness.
• Ventricular fibrillations are caused by the heart’s lower chambers contracting in a very rapid and uncoordinated manner, so that the heart fails to pump blood to the rest of the body.
These three types of arrhythmias are all medical emergencies that require immediate attention.
Treatments
There are a wide range of treatments for arrhythmias. In some cases, reducing stress, drinking less coffee or alcohol, or quitting smoking may be all that’s needed. Arrhythmias resulting from obesity and/or other conditions can be dealt with by treating those conditions.
Arrhythmias also can be treated by medicines such as:
• Beta blockers, which make the heart less responsive to adrenaline
• Calcium channel blockers, which slow down the heart’s electrical signals as they travel from the atria to the ventricles
• Antiarrhythmics, which alter electrical activity in heart cells
• Anticoagulants, also known as blood thinners, which are prescribed for arrhythmias that could cause blood clots or strokes
Procedures and devices used to treat arrhythmias include:
• Cardioverters, in which deliver a quick electrical shock to the heart through two large, sticky pads placed on the patient’s chest and back
• Pacemakers, which are implanted devices that monitor the heart and send mild electrical signals to correct its beat when necessary
• Implantable defibrillators, which are similar to pacemakers
• Catheter ablation, in which a tube called a catheter is inserted into a blood vessel, guided to the heart, and used to correct the causes of irregular heartbeats
Heart surgery is typically only used to treat arrhythmias when medicines and minimally invasive procedures won’t work; the patient’s heart is unusually shaped; or the patient has another heart condition that’s causing them.
The heart of the matter
Arrhythmias can be difficult to identify because their symptoms can be mild and/or may be symptoms of other conditions. That’s why, if you have recurring, severe, or prolonged arrhythmia symptoms, you should see a doctor. You may not be experiencing harmful arrhythmias, or any arrhythmia at all, but it’s always better to be safe than sorry.