What Is Arrhythmia?

Overview

We’ve all heard the term ‘arrhythmia’ at some point in our lives. Though it might sound quite technical, it’s essential to know the details associated with it for our own well-being. 

Arrhythmia is marked by an abnormal heartbeat. The heartbeat might be too fast, too slow or irregular. 

Our heart rate fluctuates based on the activities we do, when we move around or exercise our heart rate tends to increase and when we go back to rest our heart rate tends to decrease, this is normal and there is nothing to worry about it. What should not be ignored is when your heart rate does not match the activity you are doing, for example, experiencing the feeling of a racing heart while at rest. If this occurs repeatedly and for an extended period of time it might be an indicator of a more serious underlying condition.

This article will take you through the types, causes, signs and symptoms, management and treatment, diagnosis, risk factors, and complications associated with arrhythmia.

Types of arrhythmia

Arrhythmia can be classified into different types based on the heart rate and which part of the heart it occurs in.

Based on the heart rate, arrhythmia can be classified into:

• Bradycardia: resting heart rate is slower than 60 beats per minute
• Tachycardia: resting heart rate is faster than 100 beats per minute
• Premature or extra heartbeat: Signal to beat comes too early. This can feel like your heart skipped a beat

Based on the part of the heart that is affected, arrhythmia can be classified into:

• Supraventricular arrhythmia: Occurs in the atria (upper chamber of the heart). They are further classified into atrial fibrillation, atrial flutter, and paroxysmal supraventricular tachycardia (PSVT)
• Ventricular arrhythmias: Occurs in the ventricles (lower chamber of the heart). They the most common and dangerous arrhythmias seen in routine clinical practice and require immediate medical attention.¹

Causes of arrhythmia

Arrhythmia is often caused when there is a problem with the electrical signals within the heart. These electrical signals determine the pace of your heartbeat and when there is a problem with these electrical signals it leads to irregular heartbeats. Problems with the electrical signals can occur when the nerve cells that generate and carry electrical impulses malfunction or when electrical messages do not pass normally through the heart. Various regions of the heart are capable of generating their own electrical signals, these signals may interfere with the usual impulses allowing the heart to function, disturbing the normal rhythm.

Signs and symptoms of arrhythmia

Some indications and symptoms of cardiac arrhythmias include loss of consciousness, and more severe symptoms appear in the context of structural heart illness, such as sustained monomorphic ventricular tachycardia (VT) in the normal heart and numerous left ventricular dysfunctions. 

Some notable symptoms of heart arrhythmia include dizziness, palpitations, rapid heartbeat, a sense of weakness and discomfort in the chest. 

If you experience rapid heartbeats (Tachycardias) they are often accompanied by chest pain or discomfort, diaphoresis, neck fullness,  a vasovagal reaction with syncope, or nausea. In the absence of structural heart defects, isolated or occasional premature beats may suggest premature atrial contractions or premature ventricular contractions, which are benign.² 

 If you are experiencing these symptoms speak with your doctor. Sometimes arrhythmia can be “silent” causing no symptoms.

Management and treatment for arrhythmia

Once the healthcare professional has confirmed that you have an arrhythmia, the next step is to identify whether it is a consequence of your heart’s normal activity or if there is an underlying disease or structural abnormality associated with it. Additionally, your doctor will decide if your arrhythmia is clinically significant meaning if it can cause symptoms or raise your risk of developing more severe arrhythmias or consequences from arrhythmias in the future. A treatment plan will be created if your arrhythmia is atypical and clinically serious.

Arrhythmia patients should ideally receive treatment with the intention of restoring sinus (typical) rhythm to the heart, or in the absence of that, stabilising heart rate.³ A number of resources are required for the delivery of comprehensive arrhythmia care. These involve intricate hospital systems, implantable technology, and qualified medical personnel.⁴

Diagnosis of arrhythmia

Electrocardiograms (ECGs), record the electrical impulses and show your heart's rhythm, they are the most reliable tool for diagnosing arrhythmias. You might need to have your heart further monitored if the ECG shows no signs of disease. Electrocardiographic signals from Holter monitors can also be continuously recorded for up to 24 hours. This gives the doctor a more in-depth look at the electrical activity of the heart over a longer period of time. People whose arrhythmias are thought to be brought on by exercise can be diagnosed with a stress test or an exercise stress test. Other tests like blood tests, imaging tests like CT scans or MRI, tilt table tests or electrophysiology study (EPS) might be performed. 

Risk factors

Arrhythmia may develop in the body due to various underlying causes. Some of them are listed below:

• Lifestyle
• Age
• Family history
• Medications
• Air pollution⁵
• Diseases related to the heart and blood vessels
• Obesity
• Viral infections like influenza or COVID-19
• Lung diseases
• Kidney diseases
• Electrolyte imbalance in the body may include low levels of potassium, calcium, or magnesium

Complications

Arrhythmias can harm the heart, the brain, or other organs if they are not addressed properly and quickly. They can, in turn, cause heart failure, cardiac arrest, or a fatal stroke. When a person experiences cardiac arrest, their heart stops beating suddenly and unexpectedly. If this condition is not treated right away, they may die.

FAQs

How can I prevent arrhythmia?

Arrhythmia can be prevented by maintaining a healthy lifestyle. Lower your blood pressure and cholesterol level, maintain your weight at the optimum range, consume heart-healthy foods, steer clear of vaping and smoking, and enjoy consistent exercise.

How common is arrhythmia?

Atrial fibrillation (AF) is the most common cardiac arrhythmia and is estimated that at least 33.5 million people worldwide are diagnosed with it.⁶ In the UK, around 2 million people have arrhythmias or other heart rhythm issues. If an irregular cardiac rhythm is correctly detected, the majority of affected individuals can lead normal lives.

When should I see a doctor?

A doctor should be visited if you feel like your heartbeat does not match the activity you are doing (when it beats too quickly, too slowly, or skips a beat). If you experience chest pain or discomfort, shortness of breath, weakness, lightheadedness, dizziness, or near-fainting, seek emergency medical attention.

Summary

Arrhythmia is a problem where the heartbeat is not normal. The heartbeat is either too fast or too slow or it skips a beat and does not match the activity you are doing. Having an arrhythmia might make you fearful, anxious, depressed, and stressed out. Share your feelings with the medical staff. Speaking with a trained counsellor might also be beneficial. Healthy lifestyle changes can be included in your daily routine to manage the disease well. Constant support from your healthcare professional is very essential and you should not hesitate to seek help in whatever ways you feel is important for your well-being. The most essential regimen that should be followed is to make your everyday life stress-free as it has a strong correlation with being healthy.