About Arrhythmias

Electrical impulses cause the normal heart to beat about 60 to 100 times a minute while at rest. These impulses come from a natural pacemaker called the sinus node. It's in the right upper heart chamber. Electrical impulses travel throughout the upper heart chambers (the atria) before reaching the bottom muscle chambers (the ventricles) through an electrical connection called the AV node. Each impulse causes the heart muscle to contract. This causes the blood to flow through the heart and out to the tissues and organs of your body.

An arrhythmia is a change from the normal speed or pattern of these electrical impulses. This can cause the heart to beat too fast (tachycardia), too slow (bradycardia), or in an unsteady pattern (irregular rhythm).

Symptoms of arrhythmias

Different people experience arrhythmias differently. And different arrhythmias can cause different symptoms. Sometimes you may not have symptoms, but just notice a change in your pulse. Symptoms can include:

  • Fluttering feeling in the chest

  • Shortness of breath

  • Chest pain or pressure

  • Neck fullness

  • Lightheadedness or dizziness

  • Fainting or almost fainting

  • Palpitations. This is the sense that your heart is fluttering or beating fast or hard or irregularly.

  • Tiredness, fatigue, or weakness

  • Cardiac arrest, and death, in serious arrhythmias

Causes of arrhythmias

Arrhythmias are most often caused by heart disease, such as:

  • Coronary artery disease ("blocked arteries")

  • Heart valve disease

  • Enlarged heart

  • High blood pressure

  • Heart failure

Other causes of arrhythmia include:

  • Certain medicines, such as asthma inhalers and decongestants

  • Some herbal supplements

  • Cardiac stimulant drugs and medicines. These include cocaine, amphetamine, and diet pills, and certain decongestant cold medicines, caffeine, and nicotine.

  • Heavy use of alcohol

  • Anxiety and panic disorder

  • Thyroid disease

  • Anemia

  • Diabetes

  • Sleep apnea

  • Obesity

  • Heart disease since birth (congenital)

  • Heart diseases passed down through families

  • Electrolyte imbalance. Electrolytes are substances that help regulate normal heartbeat. High or low levels of certain electrolytes such as potassium or magnesium may affect the heartbeat and lead to arrhythmia.

  • Older age

Arrhythmias can often be prevented. The cause and type of arrhythmia determines the best treatment. Sometimes your healthcare provider may want to keep track of your heart rate over a 24-hour period or longer. This can help find the cause of your arrhythmia and find the best treatment. This can be done with a Holter monitor. This is a portable electrocardiogram (ECG) recording device attached to your chest. Or you may get an event monitor. You can place this monitor over the skin in front of your heart. It records heart rhythms. You can carry this with you as you go about your daily activities during the monitoring period. You may also have an implantable loop recorder. This can monitor the heart rhythm for up to 3 years. This tiny device is placed underneath the skin over the heart.

Home care

These guidelines will help you care for yourself at home:

  • Stay away from heart stimulants. These include cocaine, amphetamine, diet pills, certain decongestant cold medicines, caffeine, and nicotine.

  • Stop smoking if you smoke. Contact your healthcare provider or a local stop-smoking program for help.

  • Tell your healthcare provider about any prescription, over the counter, or herbal medicines you take. These may be affecting your heart rhythm.

Follow-up care

Follow up with your healthcare provider, or as advised. If a Holter monitor has been advised, contact the cardiologist you have been referred to as soon as you can to pick up the device. Other outpatient tests may also be arranged for you at that time.

Call 911

This is the fastest and safest way to get to the emergency department. The paramedics can also start treatment on the way to the hospital, if needed.

Don't wait until your symptoms are severe to call 911. Other reasons to call 911 besides chest pain include:

  • Chest pain radiating to the shoulder, arm, neck, or back

  • Shortness of breath

  • Feeling lightheaded, faint, or dizzy

  • Unexplained fainting

  • Rapid heartbeat

  • Slower than usual heart rate compared to your normal

  • Very irregular heartbeat

  • Chest pain (angina) with weakness, dizziness, heavy sweating, nausea, or vomiting

  • Extreme drowsiness, or confusion

  • Weakness of an arm or leg or one side of the face

  • Trouble with speech or vision

When to get medical advice

Remember, things are not always like they are on TV. Sometimes it is not so obvious. You may only feel weak or just "not right." If it is not clear or if you have any doubt, call for advice.

  • Seek help for chest pain, or if something feels different from usual, even if your symptoms are mild.

  • Don't drive yourself. Have someone else drive. If no one can drive you, call 911.

  • If your healthcare provider has given you medicines to take when you have symptoms, take them, but don't delay getting help while trying to find them.

© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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