Arrhythmia

Many factors can affect your heart’s rhythm, such as having had a heart attack, smoking,congenital heart defects, and stress. Some substances or medicines may also cause arrhythmias.

Symptoms of arrhythmias include

• Fast or slow heart beat
• Skipping beats
• Lightheadedness or dizziness
• Chest pain
• Shortness of breath
• Sweating

Your doctor can run tests to find out if you have an arrhythmia. Treatment to restore a normal heart rhythm may include medicines, an implantable cardioverter-defibrillator (ICD) or pacemaker, or sometimes surgery.

Risk Factors

Arrhythmias are very common in older adults. Atrial fibrillation, a common type of arrhythmia that can cause problems, affects millions of people, and the number is rising.

Most serious arrhythmias affect people older than 60. This is because older adults are more likely to have heart disease and other health problems that can lead to arrhythmias.

Older adults also tend to be more sensitive to the side effects of medicines, some of which can cause arrhythmias. Some medicines used to treat arrhythmias can even cause arrhythmias as a side effect.

Paroxysmal Arrhythmias are more common in people who have diseases or conditions that weaken the heart, such as:

• Heart attack
• Heart failure or cardiomyopathy, which weakens the heart and changes the way electrical signals move through the heart
• Heart tissue that’s too thick or stiff or that hasn’t formed normally
• Leaking or narrowed heart valves, which make the heart work too hard and can lead to heart failure
• Congenital heart defects that affect the heart’s structure or function

Other conditions also can raise the risk for arrhythmias, such as:

• High blood pressure
• Infections that damage the heart muscle or the sac around the heart
• Diabetes, which increases the risk of high blood pressure and coronary heart disease
• Sleep apnea, which can stress the heart because the heart doesn’t get enough oxygen
• An overactive or underactive thyroid gland (too much or too little thyroid hormone in the body)

Several other risk factors also can raise your risk for arrhythmias. Examples include heart surgery, certain drugs or an imbalance of chemicals or other substances in the bloodstream.

Causes

An arrhythmia can occur if the electrical signals that control the heartbeat are delayed or blocked. This can happen if the special nerve cells that produce electrical signals don’t work properly. It also can happen if the electrical signals don’t travel normally through the heart.

An arrhythmia also can occur if another part of the heart starts to produce electrical signals. This adds to the signals from the special nerve cells and disrupts the normal heartbeat.

Smoking, heavy alcohol use, use of some drugs, use of some prescription or over-the-counter medicines, or too much caffeine or nicotine can lead to arrhythmias in some people.

Strong emotional stress or anger can make the heart work harder, raise blood pressure, and release stress hormones. Sometimes these reactions can lead to arrhythmias.

A heart attack or other condition that damages the heart’s electrical system also can cause arrhythmias. Examples of such conditions include high blood pressure, coronary heart disease, heart failure, an overactive or underactive thyroid gland, and rheumatic heart disease.

Congenital heart defects can cause some arrhythmias, such as Wolff-Parkinson-White syndrome. Sometimes the cause of arrhythmias is unknown.

Symptoms

Many arrhythmias cause no signs or symptoms. When signs or symptoms are present, the most common ones are:

• Palpitations (feelings that your heart is skipping a beat, fluttering, or beating too hard or fast)
• A slow heartbeat
• An irregular heartbeat
• Feeling pauses between heartbeats

More serious signs and symptoms include:

• Anxiety
• Weakness, dizziness, and light-headedness
• Fainting or nearly fainting
• Sweating
• Shortness of breath
• Chest pain

Diagnosis

Arrhythmias can be hard to diagnose, especially the types that only cause symptoms every once in a while. Doctors diagnose arrhythmias based on medical and family histories, a physical exam, and the results from tests and procedures.

To diagnose an arrhythmia, your doctor may ask you to describe your symptoms. He or she may ask whether you feel fluttering in your chest and whether you feel dizzy or light-headed.

Your doctor also may ask whether you have other health problems, such as a history of heart disease, high blood pressure, diabetes, or thyroid problems.

Your doctor will likely want to know what medicines you’re taking, including over-the-counter medicines and supplements.

Your doctor may ask about your health habits, such as physical activity, smoking, or using alcohol or drugsHe or she also may want to know whether you’ve had emotional stress or anger.

During a physical exam, your doctor may:

• Listen to the rate and rhythm of your heartbeat
• Listen to your heart for a heart murmur
• Check your pulse to find out how fast your heart is beating
• Check for swelling in your legs or feet, which could be a sign of an enlarged heart or heart failure
• Look for signs of other diseases, such as thyroid disease, that could be causing the problem

An EKG is a simple, painless test that detects and records the heart’s electrical activity. It’s the most common test used to diagnose arrhythmias.

Treatment

Common arrhythmia treatments include medicines, medical procedures, and surgery. Your doctor may recommend treatment if your arrhythmia causes serious symptoms, such as dizziness, chest pain, or fainting.

Your doctor also may recommend treatment if the arrhythmia increases your risk for problems such as heart failure, stroke, or sudden cardiac arrest.

Medicines can slow down a heart that’s beating too fast. They also can change an abnormal heart rhythm to a normal, steady rhythm. Medicines that do this are called antiarrhythmics. Currently, no medicine can reliably speed up a slow heart rate. Abnormally slow heart rates are treated with pacemakers.

Medicines also can control an underlying medical condition that might be causing an arrhythmia, such as heart disease or a thyroid condition.

Some arrhythmias are treated with pacemakers. A pacemaker is a small device that’s placed under the skin of your chest or abdomen to help control abnormal heart rhythms. Pacemakers have sensors that detect the heart’s electrical activity. When the device senses an abnormal heart rhythm, it sends electrical pulses to prompt the heart to beat at a normal rate.

Some arrhythmias are treated with a jolt of electricity to the heart. This type of treatment is called cardioversion or defibrillation, depending on which type of arrhythmia is being treated.

Doctors treat some arrhythmias with surgery. This may occur if surgery is already being done for another reason, such as repair of a heart valve.

Recovery

Many arrhythmias are harmless. It’s common to have an occasional extra heartbeat or mild palpitations. People who have harmless arrhythmias can live healthy lives. They usually don’t need treatment for their arrhythmias.

Even people who have serious arrhythmias often can be successfully treated and lead normal lives.