Abnormal heart rhythms or arrhythmias

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Overview

A heart arrhythmia (uh-RITH-me-uh) is an irregular heartbeat. Heart rhythm problems (heart arrhythmias) occur when the electrical signals that coordinate the heart's beats don't work properly. The faulty signaling causes the heart to beat too fast (tachycardia), too slow (bradycardia) or irregularly.


Heart arrhythmias may feel like a fluttering or racing heart and may be harmless. However, some heart arrhythmias may cause bothersome — sometimes even life-threatening — signs and symptoms.


However, sometimes it's normal for a person to have a fast or slow heart rate. For example, the heart rate may increase with exercise or slow down during sleep.


Heart arrhythmia treatment may include medications, catheter procedures, implanted devices or surgery to control or eliminate fast, slow or irregular heartbeats. A heart-healthy lifestyle can help prevent heart damage that can trigger certain heart arrhythmias.


Types

In general, heart arrhythmias are grouped by the speed of the heart rate. For example:


Tachycardia (tak-ih-KAHR-dee-uh) is a fast heart. The resting heart rate is greater than 100 beats a minute.

Bradycardia (brad-e-KAHR-dee-uh) is a slow heartbeat. The resting heart rate is less than 60 beats a minute.

Fast heartbeat (tachycardia)

Types of tachycardias include:


Atrial fibrillation (A-fib). Chaotic heart signaling causes a rapid, uncoordinated heart rate. The condition may be temporary, but some A-fib episodes may not stop unless treated. A-fib is associated with serious complications such as stroke.

Atrial flutter. Atrial flutter is similar to A-fib, but heartbeats are more organized. Atrial flutter is also linked to stroke.

Supraventricular tachycardia. Supraventricular tachycardia is a broad term that includes arrhythmias that start above the lower heart chambers (ventricles). Supraventricular tachycardia causes episodes of a pounding heartbeat (palpitations) that begin and end abruptly.

Ventricular fibrillation. This type of arrhythmia occurs when rapid, chaotic electrical signals cause the lower heart chambers (ventricles) to quiver instead of contacting in a coordinated way that pumps blood to the rest of the body. This serious problem can lead to death if a normal heart rhythm isn't restored within minutes. Most people who have ventricular fibrillation have an underlying heart disease or have experienced serious trauma.

Ventricular tachycardia. This rapid, regular heart rate starts with faulty electrical signals in the lower heart chambers (ventricles). The rapid heart rate doesn't allow the ventricles to properly fill with blood. As a result, the heart can't pump enough blood to the body. Ventricular tachycardia may not cause serious problems in people with an otherwise healthy heart. In those with heart disease, ventricular tachycardia can be a medical emergency that requires immediate medical treatment.

Slow heartbeat (bradycardia)

Although a heart rate below 60 beats a minute while at rest is considered bradycardia, a low resting heart rate doesn't always signal a problem. If you're physically fit, your heart may still be able to pump enough blood to the body with fewer than 60 beats a minute at rest.


If you have a slow heart rate and your heart isn't pumping enough blood, you may have a type of bradycardia. Types of bradycardias include:


Sick sinus syndrome. The sinus node is responsible for setting the pace of the heart. If it doesn't work properly, the heart rate may alternate between too slow (bradycardia) and too fast (tachycardia). Sick sinus syndrome can be caused by scarring near the sinus node that's slowing, disrupting or blocking the travel of impulses. Sick sinus syndrome is most common among older adults.

Conduction block. A block of the heart's electrical pathways can cause the signals that trigger the heartbeats to slow down or stop. Some blocks may cause no signs or symptoms, and others may cause skipped beats or bradycardia.

Premature heartbeats

Premature heartbeats are extra beats that occur one at a time, sometimes in patterns that alternate with the normal heart beat. The extra beats may come from the top chamber of the heart (premature atrial contractions) or the bottom chamber (premature ventricular contractions).


A premature heartbeat may feel like your heart skipped a beat. These extra beats are generally not concerning, and they seldom mean you have a more serious condition. Still, a premature beat can trigger a longer-lasting arrhythmia, especially in people with heart disease. Occasionally, very frequent premature beats that last for several years may lead to a weak heart.


Premature heartbeats may occur when resting. Sometimes premature heartbeats are caused by stress, strenuous exercise or stimulants, such as caffeine or nicotine.


Symptoms

An arrhythmia can be silent, meaning you don't notice any symptoms. Your doctor may spot an uneven heartbeat during a physical exam.


If you have symptoms, they may include:



Palpitations (a feeling of skipped heartbeats, fluttering, or "flip-flops")

Pounding in your chest

Dizziness or feeling lightheaded

Fainting

Shortness of breath

Chest pain or tightness

Weakness or fatigue (feeling very tired)

Anxiety

Blurry vision

Sweating


Causes

You could have an arrhythmia even if your heart is healthy. Or it could happen because of:


Heart disease

The wrong balance of electrolytes (such as sodium or potassium) in your blood

Heart injury or changes such as reduced blood flow or stiff heart tissue

Healing process after heart surgery

Infection or fever

Certain medications

Problems with the electrical signals in your heart

Strong emotions, stress, or surprise

Things in your daily life like alcohol, tobacco, caffeine, or exercise


Risk factors

Things that may make you more likely to have an arrhythmia include your:


Age. The chances go up as you get older.

Genes. Your odds might be higher if a close relative has had an arrhythmia. Some types of heart disease can also run in families.

Lifestyle. Alcohol, tobacco, and recreational drugs can raise your risk.

Medical conditions.High blood pressure, diabetes, low blood sugar, obesity, sleep apnea, and autoimmune disorders are among the conditions that may cause heart rhythm problems.

Environment. Things in the world around you, like air pollution, can make an arrhythmia more likely.


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Complications

Complications depend on the type of arrhythmia. In general, complications of heart arrhythmias may include stroke, sudden death and heart failure. Heart arrhythmias are associated with an increased risk of blood clots. If a clot breaks loose, it can travel from the heart to the brain, causing a stroke.

Prevention

An arrhythmia has several possible causes. It may be congenital, or present at birth. It may develop due to environmental factors, such as emotional or mental stress. Lifestyle choices such as smoking, drinking, and use of illegal drugs can increase your chances of developing an arrhythmia. An arrhythmia can also occur due to another condition, such as coronary artery disease, congestive heart failure, or diabetes.


You may not be able to prevent the development of an arrhythmia. However, if you have an arrhythmia, you can take steps to prevent future symptoms and reduce the chances that your arrhythmia will get worse.


Understanding your arrhythmia

The first step is to understand your arrhythmia. Start by answering the following questions with the help of your doctor:


What causes your arrhythmia? Is it brought on by an external factor such as stress or smoking? Or is it the result of another disease?

Where in your heart does the arrhythmia begin?

Does your heart beat too fast, too slow, or irregularly?

What makes your symptoms worse?

What makes your symptoms better?

Understanding your arrhythmia will help you make choices that help you avoid symptoms. It also helps you communicate your needs to:


your family members

your friends

your doctor

other healthcare providers


Prevention measures

Avoid triggers

Your doctor can help you determine things that trigger your symptoms, or times when your symptoms become worse. These may be stressful situations at work, home, or school. Personal relationships or conflicts can be triggers as well. Triggers can also be substances such as caffeine, nicotine, and alcohol.


Medications you take for another condition might be causing arrhythmia. Discuss this possibility with your doctor. Ask them whether you should change any medications you’re taking or reduce the dose. You shouldn’t try to do this on your own. Doing so may make things worse.


If you’re able to avoid these triggers or deal with them in a certain way, you may be able to reduce or eliminate your symptoms.


Adopt a healthy lifestyle

Exercise increases your heart’s strength and stamina. It also decreases your chances of having heart issues in the future.


The following can increase your heart rate:


nicotine

caffeine

certain illegal drugs

certain over-the-counter medicines

alcohol

Avoiding these substances and eventually cutting them out of your life altogether may reduce the symptoms of arrhythmia and the number of episodes. It can also reduce your chances of developing other health issues, such as heart disease and cancer, in the future.


Have a plan of action

You should have a plan designed for your specific needs if your arrhythmia or symptoms need medical attention. This may mean taking medication as soon as you begin feeling symptoms, or using a well-rehearsed exercise or maneuver to help get your heart back into rhythm. Work with your doctor to make sure you’re giving yourself the best opportunity to recover from the symptoms in a healthy way.


Try omega-3 fatty acids

Study resultsTrusted Source show that omega-3 fatty acids may reduce the risk of sudden cardiac death. You can find omega-3 fatty acids in cold-water, fatty fish such as salmon, mackerel, sardines, and herring. The American Heart AssociationTrusted Source recommends eating fish containing omega-3 fatty acids two times per week. You can also increase your intake by taking a nutritional supplement, such as fish oil.