You can’t always prevent arrhythmias. Regular checkups with your doctor can help keep you from having more heart rhythm problems. Be sure they know all the medications you’re taking. Some cold and cough medicines can trigger an arrhythmia, so talk to your doctor before using them.
They may also recommend some lifestyle changes:
• Eat a healthy diet. Get plenty of fruits and vegetables, fish, and plant-based proteins. Avoid saturated and trans fats.
• Keep cholesterol and blood pressure under control.
• Don’t smoke.
• Keep a healthy weight.
• Exercise regularly.
• Manage stress.
• Limit alcohol and caffeine.Show Less
Without treatment, an uneven heart rhythm could cause dangerous problems such as:
• Alzheimer’s disease and dementia. These cognitive disorders may happen because your brain doesn’t get enough blood over time.
• Heart failure. Your heart might not pump as well as it should after repeated arrhythmias.
• Stroke. Blood that lingers in your atria can clot. If a clot travels to your brain, it may cause a stroke.
• Cardiac arrest. V-fib could cause your heart to stop.
Safe Driving Concerns
If you have an arrhythmia, you could faint behind the wheel. This could put you, other motorists, pedestrians, and property at great risk.
To figure out whether you can drive safely, your doctor will consider:
• What type of arrhythmia you have;
• How serious yours is;
• The treatment you receive for it (if any);
• How often you have symptoms and how serious they are.
If you have no symptoms, and you haven't had any serious heart rhythm problems, you should be able to drive as you always have. If meds keep your arrhythmia under control, your doctor may give you the green light to drive, too.
In addition to meds to help manage your heart rhythm, you may have two other treatments. Both would keep you out of the driver's seat for a while:
Ablation: This treatment will usually restrict you to the passenger's seat for about a week. It may keep you there longer, depending on your medical history.
Implantable cardioverter-defibrillator: Usually after you get an ICD, you'll be asked not to drive for a week. If you got an ICD after fainting or surviving cardiac arrest, you may have to wait several months before you get back behind the wheel.
You can't drive commercially (as in a delivery truck or a taxi) at all if you have an ICD.Show Less
Treatment for arrhythmia is only necessary if the condition is increasing the risk of more severe arrhythmia or a complication, or if the symptoms are severe.
The various arrhythmias require different treatments.
1. Treatments for bradycardia
If bradycardia occurs due to an underlying condition, a doctor will need to treat that condition first. If they find no underlying problem, the doctor may advise implanting a pacemaker.
A pacemaker is a small device that a doctor places under the skin of the chest or abdomen to help control abnormal heart rhythms. Pacemakers use electrical pulses to prompt the heart to beat at a regular minimum rate.
Implantable cardioverter defibrillator (ICD)
Doctors mainly use ICDs to treat ventricular tachycardia and ventricular fibrillation, two life-threatening heart rhythms.
The ICD constantly tracks your heart rhythm. When it detects a very fast, unusual rhythm, it delivers an electric shock to the heart muscle to make it beat in a regular rhythm again. The ICD has two parts: the leads and a pulse generator. The leads are made up of wires and sensors that monitor the heart rhythm and deliver energy used for pacing or defibrillation. The generator houses the battery and a tiny computer. Energy is stored in the battery until it is needed. The computer receives information from the leads to determine how the heart is beating.
Your doctor programs the ICD to include one or all of the following functions:
• Anti-tachycardia pacing (ATP). A series of small electrical impulses to the heart muscle restores a regular rate and rhythm.
• Cardioversion. You may get a low-energy shock at the same time your heart beats to restore regular rhythm.
• Defibrillation. When your heartbeat is dangerously fast or uneven, your heart muscle gets a higher-energy shock to restore a regular rhythm.
• Anti-bradycardia pacing. Many ICDs give backup pacing to keep the heart rhythm if it slows too much.
There are different types of ICDs, including:
• Single-chamber ICD. A lead is attached to the right ventricle. If required, energy is delivered to the ventricle to restore a normal heart rhythm.
• Dual-chamber ICD. Leads are attached in the right atrium and the right ventricle. Energy can be delivered to the right atrium and then to the right ventricle, helping your heart to be paced in a normal sequence.
• Biventricular ICD. Leads are attached in the right atrium, the right ventricle, and the coronary sinus adjacent to the left ventricle. This technique helps the heart beat in a more efficient way and is specifically used for patients with heart failure.
Your doctor will determine which type of ICD is best for you. Before you have your ICD implanted, ask your doctor what medications you can take. Your doctor may ask you to stop taking certain medications before the procedure. You will receive specific instructions.
After it’s implanted, you might not notice a low-energy shock. Or it may feel like a flutter in your chest. The high-energy shock lasts just a second, but it can hurt. Some people say it feels like being hit with a baseball bat or being kicked by a horse. Most people feel it more in their back than their chest. If you feel a shock, sit or lie down because you may pass out.
Talk to your doctor about what to do if you ever get shocked. If you do get shocked, call your doctor immediately.
Think of this procedure as rewiring to fix an electrical problem in your heart.
Your doctor will insert a catheter through your leg. It delivers high-frequency electrical energy to a small area inside your heart that causes an unusual rhythm. This energy "disconnects" the pathway of the unusual rhythm.
Doctors use ablation to treat most PSVTs, atrial flutter, atrial fibrillation, and some atrial and ventricular tachycardia.
Heart surgery for arrhythmias
The maze procedure is a type of surgery to correct atrial fibrillation. Your surgeon makes a series, or "maze," of cuts in your heart's upper chambers. The goal is to keep your heart's electrical impulses only on certain pathways. Some people need a pacemaker afterward.
Your doctor might recommend other procedures, such as a coronary bypass, to treat other forms of heart disease.
2. Treatments for tachycardia
There are several treatments for tachycardia:
Vagal maneuvers: Specific movements and exercises that a person can carry out at home might stop some types of arrhythmia that start above the lower half of the heart.
Medications: These will not cure an arrhythmia but are usually effective in reducing the number of tachycardia episodes. Some medications also promote electrical conduction through the heart.
Cardioversion: The doctor may use an electric shock or medication to reset the heart to its regular Cardioversion: The doctor may use an electric shock or medication to reset the heart to its regular rhythm.
Ablation therapy: A surgeon inserts one or more catheters into the inner heart. They place the catheters in areas of the heart that they suspect may be the source of the arrhythmia. The surgeon will then use them to destroy small sections of damaged tissue, which often corrects the arrhythmia.
Implantable cardioverter-defibrillator (ICD): A surgeon implants this near the left collarbone. The device then monitors the heart rhythm. If it detects an unusually fast rate, it stimulates the heart to return to its normal speed.
Maze procedure: During the maze procedure, a surgeon makes a series of surgical incisions in the heart. These then heal into scars and form blocks that guide the electrical impulses, helping the heart to beat efficiently.
Ventricular aneurysm surgery: Sometimes, an aneurysm, or bulge, in a blood vessel that leads to the heart can cause arrhythmia. If other treatments are not effective, a surgeon may have to remove the aneurysm.
Coronary bypass surgery: A surgeon grafts arteries or veins from elsewhere in the body onto the coronary arteries. This helps the circulation bypass any regions that have become narrow and improves the blood supply to the heart muscle.Show Less
To diagnose an arrhythmia or find its cause, doctors use tests including:
• EKG. An electrocardiogram records the electrical activity of your heart. You wear small electrode patches on your chest, arms, and legs for the quick, painless test, which you take in your doctor's office.
• Holter monitor. This is a portable EKG (also called an "ambulatory electrocardiogram" or an ECG) about the size of a postcard or digital camera that you'll use for 1 to 2 days or up to 2 weeks. The test measures the movement of electrical signals or waves through your heart. These signals tell your heart to contract (squeeze) and pump blood. You'll have electrodes taped to your skin. It's painless, although some people have mild skin irritation from the tape used to attach the electrodes to the chest. You can do everything but shower or bathe while wearing the electrodes. After the test period, you'll go back to see your doctor. They'll download the information.
• Event monitor. If your symptoms don't happen often, your doctor may suggest that you wear one of these, usually for about a month. When you push a button, it records and stores your heart's electrical activity for a few minutes. Try to get a reading when you notice symptoms. Your doctor will interpret the results.
• Implantable loop recorder. Your doctor puts this under your skin, where it constantly records your heart’s electrical activity. It can send information to your doctor’s office.
• Stress test. There are different kinds of stress tests. The goal is to check how much stress your heart can manage before having a rhythm problem or not getting enough blood. For the most common type of stress test, you'll walk on a treadmill or pedal a stationary bike while you get an EKG and have your heart rate and blood pressure monitored. Technicians slowly raise the intensity level of your exercise.
• Echocardiogram. This test uses ultrasound to check your heart muscle and valves.
• Cardiac catheterization. Your doctor will insert a long, thin tube, called a catheter, into a blood vessel in your arm or leg. They’ll guide it to your heart with help from a special X-ray machine. Then, they’ll inject dye through the catheter to help make X-ray videos of your heart valves, coronary arteries, and chambers.
• Electrophysiology study. This test records your heart's electrical activities and pathways. It can help find out what's causing heart rhythm problems and find the best treatment for you. During the test, your doctor will safely trigger your unusual heart rhythm. Then, they may give you medications to see which one controls it best or to see what procedure or device you need to treat it.
• Head-up tilt table test. Doctors use this test to find out what's causing fainting spells. It measures the difference in heart rate and blood pressure when you're standing up and lying down. You'll get this test in a lab. You'll lie on a stretcher, tilted at different angles, while you get an EKG and specialists check your blood pressure and oxygen level. This shows if symptoms of passing out are due to your electrical system, nervous system, or vascular system.Show Less
Arrhythmias are divided up by the place where they happen. If they start in the ventricles, or lower chambers of your heart, they’re called ventricular. When they begin in the atria or upper chambers, they’re called supraventricular.
Doctors also group them by how they affect your resting heart rate. Bradycardia is a heart rate of fewer than 60 beats per minute. Tachycardia is more than 100 beats per minute.
Supraventricular arrhythmias include:
• Premature atrial contractions. These are early extra beats. They’re harmless and generally don't need treatment.
• Atrial fibrillation (AFib). The upper chambers of your heart contract in an unusual way. Your heart might beat more than 400 times a minute.
• Atrial flutter. This is usually more organized and regular than atrial fibrillation. It happens most often in people who have heart disease and in the first week after heart surgery. It frequently changes to atrial fibrillation.
• Paroxysmal supraventricular tachycardia (PSVT). This is a rapid heart rate, typically with a regular rhythm. It begins and ends suddenly.
• Accessory pathway tachycardia. You can have a rapid heart rate because of an extra pathway between your heart's upper and lower chambers. Think of it as an extra road on your way home, as well as your usual route. When that happens in your heart, it can cause a fast rhythm.
• AV nodal reentrant tachycardia (AVNRT). This is caused by an extra pathway through a part of your heart called the AV node. It can cause heart palpitations, fainting, or heart failure.
Ventricular arrhythmias include:
• Premature ventricular contractions (PVCs). These are among the most common arrhythmias. They're the "skipped heartbeat" that many of us feel sometimes.
• Ventricular tachycardia (V-tach). This is a rapid heart rhythm starting from the heart's lower chambers. Because your heart is beating too fast, it can't fill with enough blood. This can be a serious arrhythmia, especially in people who have heart disease, and it may be linked to other symptoms.
• Ventricular fibrillation (V-fib). This happens when your heart's lower chambers quiver and can't contract or pump blood to the rest of your body. It’s a medical emergency that must be treated with CPR and defibrillation as soon as possible.
• Long QT syndrome. Your heart’s lower chambers take too long to contract and release. This may cause dangerous rhythm problems and death.
Another type of arrhythmia, bradyarrhythmia, is a slow rhythm because of disease in your heart's electrical system or because of medication. It may make you pass out or feel like you will. Types of bradyarrhythmia include:
• Sinus node dysfunction. This is caused by an issue with your heart's sinus node, its natural pacemaker.
• Heart block. There’s a delay or a block of the electrical impulse as it travels from your heart's sinus node to its lower chambers.Show Less
• Age. The chances go up as you get older.
• 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. Especially a bad one, like air pollution, can make an arrhythmia more likely.
• Inherited genetic anomalies;
• Underlying heart problems;
• Hypothyroidism or hyperthyroidism;
• Some prescription medications and over-the-counter drugs;
• Uncontrolled diabetes;
• Obstructive sleep apnea;
• Electrolyte imbalances;
• Heavy and regular alcohol consumption;
• Excessive caffeine intake;
• Illegal drugs.
While some of these are unavoidable, a person can take a few steps to reduce their risk of arrhythmia.
These actions include staying active, avoiding the regular use of alcohol or illegal drugs, and limiting caffeine intake.Show Less
You could have arrhythmia even if your heart is healthy. Or it could happen because of:
• 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;
• Substance use disorder;
• Drinking too much coffee;
• Heart disease, such as congestive heart failure;
• High blood pressure;
• Hyperthyroidism, or an overactive thyroid gland;
• Scarring of the heart, often due to a heart attack;
• Certain dietary and herbal supplements;
• Some medications;
• Structural changes in the heart.
Any interruption to the electrical impulses that stimulate heart contractions may result in arrhythmia.
A person with good heart health will hardly ever experience long-term arrhythmia unless they have an external trigger, such as a substance use disorder or an electric shock.
However, an underlying heart problem can mean that electrical impulses do not travel through the heart correctly. This increases the risk of arrhythmia.Show Less
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;
• Shortness of breath;
• Chest pain or tightness;
• Weakness or fatigue (feeling very tired);
• Blurry vision;
Arrhythmia might not cause noticeable symptoms. However, a doctor may detect an arrhythmia during a routine examination or after requesting an electrocardiogram (EKG).
Even if an individual notices symptoms, it does not necessarily mean that they have a severe arrhythmia.
Some people with life-threatening arrhythmias may have no symptoms, while others with symptoms may have a light arrhythmia.
Symptoms depend on the type of arrhythmia, as follows:
1. Symptoms of tachycardia
Symptoms of a rapid heartbeat include:
• fainting or nearly fainting;
• fluttering in the chest;
• chest pain;
• sudden weakness.
2. Symptoms of bradycardia
Bradycardia can cause the following symptoms:
• angina, or chest pain;
• trouble concentrating;
• finding exercise more difficult than usual;
• shortness of breath;
• fainting or nearly fainting;
• profuse sweating.
3. Symptoms of A-fib
When A-fib symptoms occur, they often have a rapid onset and may involve:
• fainting or nearly fainting;
• weakness.Show Less
An arrhythmia is an irregular heartbeat. It means your heart is out of its usual rhythm.
It may feel like your heart skipped a beat, added a beat, or is "fluttering." It might feel like it’s beating too fast (which doctors call tachycardia) or too slow (called bradycardia). Or you might not notice anything.
Arrhythmias can be an emergency, or they could be harmless. If you feel something unusual happening with your heartbeat, get medical help right away, so doctors can find out why it's happening and what you need to do about it.
There are several categories of arrhythmia, including:
• bradycardia, or a slow heartbeat;
• tachycardia, or a fast heartbeat;
• irregular heartbeat, also known as a flutter or fibrillation;
• early heartbeat, or a premature contraction.
Most arrhythmias are not severe and do not cause complications. Some, however, can increase the risk of stroke or cardiac arrest.
A normal heartbeat:
Doctors identify a healthy heartbeat by counting the number of times the heart beats every minute (bpm) during rest. This is known as the resting heart rate.
The range for a healthy resting heart rate varies between individuals, but the American Heart Association (AHA) suggests that it is usually between 60 and 100 bpm.
The fitter a person is, the lower their resting heart rate becomes. Olympic athletes, for example, have a resting heart rate of less than 60 bpm, because their hearts are highly efficient.
The heart should beat with a regular rhythm, consisting of double “ba-bum” beats with even spaces in between each.
One of these beats is the heart contracting to provide oxygen to blood that has already circulated, and the other involves the heart pushing oxygenated blood around the body.
A person can measure the heart rate using their pulse. This is a point at which they can feel the heartbeat through the skin. The best locations on the body for this are:
• the wrists;
• the insides of the elbows;
• the side of the neck;
• the top of the foot.Show Less