Medically reviewed by Rafle Fernandez, MDMedically reviewed by Rafle Fernandez, MD
An abnormal heart rhythm, or arrhythmia (also referred to as an irregular heartbeat), is a condition in which your heart beats too fast (at more than 100 beats per minute, or BPM), too slowly (at less than 60 BPM), or irregularly.
Your heart relies on its own electrical system to pump blood throughout your body, delivering oxygen and nutrients to every organ and cell. When this system is disrupted, it results in an abnormal heart rhythm, which can cause various symptoms or, in some cases, no symptoms at all.
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Types of Abnormal Heart Rhythms
Tachycardia
Tachycardia is a heart rate that’s too fast—a resting heart rate of over 100 BPM. The normal range for heart rates is between 60 and 100 BPM. When your heart rate is too fast, it prevents the chambers inside the heart from filling up with blood in between beats. If this happens too frequently, it can negatively affect blood flow.
Bradycardia
Bradycardia is a slow heartbeat of less than 60 BPM. Children, older adults, and athletes may have slow resting heart rates that do not require medical attention. Concerning causes of bradycardia include problems with the heart’s electrical signal, such as sick sinus syndrome. In this disorder, the sinus node (the heart’s natural pacemaker) does not trigger every heartbeat.
Atrial Fibrillation
Atrial fibrillation (A-fib) occurs when the heart’s upper chambers (the atria) beat irregularly, making it difficult for the heart to pump blood out. Leftover blood pools in the atria, leading to clots and increasing the risk of stroke and heart failure.
Atrial Flutter
Atrial flutter occurs when the heart’s electrical signals fire too fast, causing a rapid heart rate that can increase to over 300 BPM. The pattern can be regular or irregular.
Ventricular Fibrillation
Ventricular fibrillation occurs when electrical signals cause the heart’s ventricles (lower chambers that help pump blood) to convulse instead of pumping. If not enough blood and oxygen move through the body, cardiac arrest can happen quickly.
Premature Contractions
Premature contractions occur when your heart does an extra beat. It can feel like a skipped beat. Premature contractions can sometimes happen in normal-functioning hearts. If you feel it happening often, see a healthcare provider.
What Does It Feel Like?
Abnormal heart rhythms do not always cause noticeable symptoms. Sometimes, they cause symptoms that are too mild to notice. When they do cause noticeable symptoms, they could include the following:
What Causes Abnormal Heart Rhythm?
High Blood Pressure
Having uncontrolled high blood pressure (hypertension) for a long time is a risk factor for an abnormal heart rhythm. High blood pressure occurs when the force of the blood moving through your arteries is very high, damaging your heart and increasing your chance of developing an abnormal heart rhythm.
Coronary Heart Disease
Coronary heart disease happens when the arteries leading to and from your heart harden from a buildup of cholesterol and plaque. Less blood flows through the arteries, making your heart work much harder. Over time, the heart muscle weakens, causing abnormal heart rhythms.
Heart Conditions or Damage to the Heart
A heart arrhythmia can arise from a heart condition present at birth or damage to the heart from long-term disease. Heart disease or damage can affect the heart’s electrical system, leading to an irregular heartbeat.
Medications
Paradoxically, some antiarrhythmic drugs designed to treat abnormal heart rhythms can sometimes induce them. This phenomenon is known as proarrhythmia. Drugs such as Pacerone (amiodarone), Tambocor (flecainide), and Verelan (verapamil) (used to control angina or high blood pressure) alter the electronic activity of the heart to treat arrhythmic conditions but can also cause new or more severe abnormal heart rhythms.
Some antidepressants, antipsychotics, and antibiotics can cause arrhythmia by prolonging the QT interval, the time it takes for your heart to contract and refill with blood before beating again. This disruption happens by interrupting potassium flow to heart cells, which is necessary for healthy cardiac function.
Anxiety or Emotional Distress
Emotional stress and anxiety can trigger arrhythmias by activating the body’s sympathetic nervous system, increasing your heart rate, and disrupting your heart’s regular electrical activity. When you experience stress, your body releases hormones like adrenaline, which can cause abnormal heart rhythms. Chronic stress can contribute to ongoing inflammation, which damages artery linings and causes coronary plaque buildup.
Illness or Fever
An elevated body temperature can increase your heart’s electrical activity, potentially leading to an abnormal heart rhythm. Fevers can cause electrolyte imbalances and increase sympathetic nervous system activity, increasing the risk for arrhythmia.
The risk factors for abnormal heart rhythms include:
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Congenital (at birth) heart defects
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Drinking too much alcohol, taking illicit drugs, or smoking
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Heart disease
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Increased age
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Levels of potassium, magnesium, or calcium that are too high or too low
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Taking medications that cause arrhythmia
How Do You Know If You Have an Abnormal Heart Rhythm?
Diagnosing abnormal heart rhythms involves several methods. The most common is a physical examination and an electrocardiogram (ECG or EKG), which shows a snapshot of the heart’s electrical activity. Other diagnostic tests include:
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Stress test: This exercise test involves walking or running on a treadmill or stationary bike while monitoring your heart rate. If an abnormal heart rhythm is detected, your healthcare provider can evaluate it in real time.
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Cardiac event monitor: This test is for people with abnormal heart rhythms that occur and return to normal quickly. Monitors come as bracelets, finger clips, or patches worn under the arm for four to eight weeks.
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Holter monitor: This device is a small, portable electrocardiogram recorder. Your provider might ask you to log your symptoms and activities. They can compare the monitor’s data to your self-reported data.
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Electrophysiology test: This procedure is done under local anesthesia. Temporary electrode catheters are inserted through the peripheral veins into the heart. The catheters record the electrical signals, charting the path of electrical impulses during each heartbeat.
Treatment Options
Medications
A healthcare provider may prescribe you one or more of the following medications to help manage an abnormal heart rhythm:
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Antiarrhythmic drugs: Normalize the heartbeat from being too fast or too slow
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Calcium channel blockers: Disrupt the movement of calcium into the heart and blood vessels, decreasing the burden on the heart to help control your heart rate
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Beta-blockers: Block the effects of adrenaline to slow your heart rate
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Anticoagulants (blood thinners): Make it more challenging for blood to clot
Surgical Procedures
Some people may require surgical procedures to treat an abnormal heart rhythm:
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Cardioversion: A procedure that uses external electric shocks to return the heart to a normal rhythm.
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Catheter ablation: A procedure that stops abnormal electric signals from moving into your heart.
Implants
In some instances, you may require ongoing support, in which case a healthcare provider will recommend an implanted device, such as the following:
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Pacemaker: These devices can be temporary or permanent implants that help your heart chambers beat in unison to pump blood more efficiently or send electrical impulses to your heart so it can maintain a normal rhythm.
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Implantable cardioverter defibrillator (ICD): A type of defibrillation device that a healthcare provider surgically places in your body. Healthcare providers mainly use ICDs for people who are at high risk for a life-threatening arrhythmia event.
Is an Irregular Heartbeat Serious?
The long-term outlook for people with irregular heartbeats varies depending on the condition’s type, severity, and effectiveness of the treatment. Medications, lifestyle changes, implants, or procedures can give many people an excellent quality of life.
But for some who have conditions that are resistant to treatment or are undiagnosed, the risk of complications such as stroke, heart failure, or cardiac arrest is high. It is crucial to have regular follow-ups with your healthcare provider to monitor treatment.
How to Prevent It
In addition to medications, implants, and surgical procedures as treatment options, lifestyle changes are also necessary to manage or prevent abnormal heart rhythms. They include:
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Eating heart-healthy foods
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Maintaining a healthy weight
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Managing chronic conditions (diabetes, high blood pressure)
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Managing stress triggers
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Quitting smoking
Summary
Abnormal heart rhythms, or arrhythmia (also called irregular heartbeats), occur when the heart beats too fast, too slow, or irregularly, disrupting its normal function. They can be asymptomatic or cause noticeable symptoms, such as palpitations, dizziness, or shortness of breath.
With proper treatment and management, most people with arrhythmia can lead full, active lives. If you experience symptoms of an abnormal heart rhythm, seek immediate medical attention.
Read the original article on Verywell Health.
