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Understanding Heart Arrhythmia: Causes, Symptoms, and Treatments

8 min read

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by Dr. Kurt Hong

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Heart arrhythmia, commonly known as arrhythmia, is an abnormality or irregularity of the heartbeat. 

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This abnormality in heart rhythm is characterized by heartbeats that are too fast or too slow, or by the heart missing a beat or beating at irregular rhythms. 

There are different types of arrhythmia. Some may require no specific treatments, while others may need medications to control the heart rate. Regardless of the type of arrhythmia, you should check in with your primary care doctor or cardiologist if the arrhythmia is new or symptomatic.

Irregular heartbeats in arrhythmia are mostly a concern for people with pre-existing heart disease (such as coronary heart disease or disease of the heart valves) or who are at high risk of cardiac disorders or complications, such as in patients with diabetes or a history of stroke.

In this article, we will discuss heart arrhythmia in detail, including the types, signs and symptoms, causes, and treatments. 

What Is Heart Arrhythmia? 

Heart arrhythmia is an irregularity of your heartbeat. Normally, our heart beats 60 to 100 times per minute. 

It is normal for the heartbeat to increase above this range during any physical activity or exertion and decrease when you are sleeping or resting. 

However, if you face frequent irregular or abnormal heartbeats, for example, if you miss a heartbeat too often or experience a frequent increase or decrease in heartbeat without any reason, it may be due to arrhythmia.

Types of Heart Arrhythmia 

There are four main types of arrhythmia, including: 

Atrial Fibrillation 

Atrial fibrillation, sometimes referred to as “AFib”, is the most common type of arrhythmia.

It is characterized by an irregular or abnormally fast heartbeat that is above 100 beats per minute. Patients can frequently experience heart palpitations and, in some severe cases, a sensation of shortness of breath.

The irregular or fast heartbeat in atrial fibrillation commonly occurs or starts from your upper heart chamber, called the atrium. When the atrium is not contracting properly, this can lead to an increased heart rate. Patients with atrial fibrillation should see their doctor about potential medications for heart rate control. Some patients with chronic atrial fibrillation may also need to be on blood thinner medications due to the increased risk of blood clots and stroke. 

Supraventricular Arrhythmia or Tachycardia 

Supraventricular arrhythmia, also known as supraventricular tachycardia, is an abnormally fast or rapid heartbeat that begins above the ventricles (“supra” ventricles) or the atria. 

Ventricles are the lower and more muscular chambers of our heart that pump blood out of the heart, while atria are the upper chambers of the heart that receive blood from the body or the lungs. Patients with supraventricular arrhythmia can also have a very fast heart rate, which, if not controlled, can lead to a drop in blood pressure. Most patients with this type of arrhythmia are under the care of a cardiologist and may need chronic medications, such as beta-blockers, to manage their heart rate.

Ventricular Arrhythmia 

As the name indicates, ventricular arrhythmia is an abnormal heartbeat that occurs in the ventricles.

An abnormal or irregular heartbeat means that your heart may beat too fast, too slow, or miss a beat. This type of arrhythmia can be life-threatening, and if patients are reporting associated symptoms such as a rapid drop in blood pressure, chest pain, or difficulty breathing, they usually will need to be evaluated in the emergency room.

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Bradyarrhythmia 

Bradycardia or bradyarrhythmia is a type of arrhythmia in which your heart beats too slowly (below 60 beats per minute), even during physical activity. This is more common as we age, and while many patients may be asymptomatic, if you are experiencing shortness of breath or fatigue with a slowed heart rate, it is important to check with your doctors.

Heart Arrhythmia Symptoms 

The common symptoms of heart arrhythmia include: 

  • Shortness of breath 
  • Dizziness 
  • Frequent sensations of missing heartbeats
  • Tiredness 
  • Chest pain
  • Fast or slow heartbeat 
  • Fainting 
  • Sweating 
  • Heart palpitations (fluttering, pounding, or racing heartbeat)

Heart Arrhythmia Causes 

The electrical signals of the heart control the rate of the heartbeat or how fast or slow your heart beats. 

If there is any problem or abnormality in the electrical signals that travel to the heart, it may cause arrhythmia. 

Our nerve cells produce electrical signals that control the heartbeat and other important functions of the body, like communication or transfer of information between cells, tissues, and organs within the body.

Any problem in the nerve cells or transmission of electrical signals to the heart may lead to arrhythmia. 

There are certain triggers or risk factors that may cause arrhythmia, including:

  • Primary heart conduction disorders
  • Pre-existing heart disease, like a history of heart attack, heart defects present at birth, heart inflammation, or cardiomyopathy
  • High blood pressure 
  • Advanced age
  • Sleep apnea
  • Blood sugar levels that are too high or too low 
  • Excessive physical activity or exertion 
  • Kidney or lung disease
  • Too much use of alcohol, tobacco, illegal drugs, or caffeine

Heart Arrhythmia Treatments 

There are different treatments for heart arrhythmia. Your doctor chooses the best treatment option depending on: 

  • The type and severity of your arrhythmia
  • Any pre-existing heart disease
  • The underlying cause of arrhythmia

The treatment of heart arrhythmia includes: 

Medications 

Antiarrhythmic drugs are given to prevent or treat arrhythmia. They may be given alone or in combination with other therapies, depending on the severity and type of arrhythmia you have.

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Pacemaker 

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A pacemaker is an artificial device that contains a battery. It generates and sends electrical signals to the heart to maintain a normal heartbeat. 

The pacemaker is implanted in the patient’s chest with the help of local anesthesia. It helps the heart beat at a normal rate and prevents your heart rate from going too fast or too slow.

ICD 

ICD, also known as implantable cardioverter defibrillator, is a device that monitors the heartbeat. 

Whenever your heartbeat gets irregular, rapid, or slow, the ICD generates a shock to normalize the heart rhythm as needed.

Surgery 

In rare cases, a surgical treatment may be needed to treat the underlying heart disease responsible for causing arrhythmia. This is sometimes an option for patients who do not respond to medications or have severe side effects from medications.

For example, valve surgery may be done to treat a leaky heart valve. On the other hand, a coronary artery bypass surgery is done to correct blockage of the coronary artery and restore normal blood flow to the heart. 

By addressing the underlying heart disease, the irregular heartbeat slowly normalizes.

Surgeries are also done to treat atrial fibrillation by blocking abnormal electrical signals and allowing normal flow of electrical signals to the heart.

Lifestyle Changes 

Addressing the risk factors and possible causes of arrhythmia by certain lifestyle changes can also help normalize the heartbeat. 

The following lifestyle changes are recommended to help correct arrhythmia:

  • Limiting alcohol, tobacco, and caffeine intake
  • Limiting sodium intake
  • Controlling blood pressure and blood sugar.
  • Maintaining a healthy weight.
  • Maintaining a healthy exercise regimen

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