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Arrhythmia

Woman with a man with hand on chest

What is an arrhythmia?

An arrhythmia is a heartbeat that is too fast, too slow or irregular. It occurs when the electrical signals that stimulate our heart to beat are disrupted. There are many different types of arrhythmia.

When your heart is healthy, a steady, electrical signal that originates in the Sino Atrial node in the right upper part of your heart keeps your heart at a regular beat, usually between 60 and 100 beats per minute. This is called sinus rhythm. An arrhythmia is any disturbance in this sinus rhythm.

Most arrhythmias are harmless or not serious; however, others can predispose a person to a stroke or cardiac arrest.

What are the symptoms of an arrhythmia?

Some arrhythmias cause no symptoms and are only diagnosed during a routine physical examination or an investigation for an unrelated reason.

Noticeable arrhythmia symptoms may include:

  • A feeling like your heart is racing
  • A slow heartbeat
  • Palpitations, or a fluttering in your chest
  • Dizziness
  • Breathlessness
  • Chest pain
  • Sweating
  • Fainting or almost fainting.

What causes an arrhythmia?

Since there are many different types of arrhythmia, there are also many reasons why arrhythmias occur.

Some common reasons include:

  • Certain medications and supplements
  • Coronary artery disease
  • Current or prior heart attack
  • Diabetes
  • Drug or substance abuse
  • Excess caffeine
  • Genetics
  • High blood pressure
  • Metabolic disturbances
  • Overindulgence in alcohol
  • Sleep apnea
  • Smoking
  • Stress
  • Structural problems within the heart
  • Thyroid problems (an over or underactive thyroid).

How are arrhythmias diagnosed?

If you have any symptoms of an arrhythmia see your doctor. Your doctor with review your medical and medication history and conduct a physical examination. Tests may be conducted that will determine if you have any underlying conditions that may be causing your arrhythmia.

Other tests may include:

  • An electrocardiogram: Sensors are placed on your chest that detects the electrical activity of your heart
  • A Holter monitor: This is a portable ECG which measures your heart rhythm over 24 hours or longer
  • An event monitor: For people who have sporadic arrhythmias, a button can be pushed which records the electrical activity of the heart when they have symptoms
  • Echocardiogram: A handheld device is placed on your chest which records your hearts size structure and motion through sound waves
  • Implantable loop recorder: A device is implanted under your skin which detects abnormal heart rhythms.

Other tests may include a stress test, tilt table testing or electrophysiological testing.

Your arrhythmia will be diagnosed according to how the heart is beating, for example:

  • Too slow: bradycardia
  • Too fast: tachycardia
  • Irregular: fibrillation or flutter
  • Too early: premature contraction.

How is an arrhythmia treated?

Treatment depends on the type of arrhythmia, how severe the symptoms are, and if the underlying condition is putting the person at risk of a more serious arrhythmia or a complication.

Treatments may include:

  • Ablation therapy
  • Cardioversion
  • Coronary bypass surgery
  • ICD (implantable cardioverter-defibrillator)
  • Maze procedure
  • Medications
  • Pacemakers
  • Surgery
  • Vagal maneuvers
  • Ventricular aneurysm surgery.