An arrhythmia is a disorder of the heart that affects the rate or rhythm at which the heart beats; basically the way the electricity works.
It happens when electrical impulses that direct and regulate heartbeats don’t function properly. This causes the heart to beat:
- too fast (tachycardia)
- too slow (bradycardia)
- too early (premature contraction)
- too erratically (fibrillation)
The prevalence of arrhythmia is between
It may feel like your heart is racing or fluttering. Or you may not feel different at all.
Arrhythmias can be common and usually harmless, but some can be problematic. When an arrhythmia interferes with blood flow to your body, it can damage your:
- other vital organs
If they’re not treated, arrhythmias may be life threatening.
Arrhythmia vs. dysrhythmia
Dysrhythmia is another name for arrhythmia. While there’s a slight medical distinction between the two, both are often used interchangeably to refer to an irregular heartbeat.
Arrhythmias are named and categorized based on three factors:
- rate, whether it’s too slow or too fast
- origin, whether it’s in the ventricles or the atria
In a properly beating heart, electrical impulses follow precise pathways through the heart. These signals coordinate the activity of the heart muscle so that blood pumps in and out of the heart.
Any interruption in these pathways or impulses can cause the heart to beat abnormally, leading to arrhythmia. These can start in the sinus node, the ventricles (the heart’s lower chambers), or the atria (the upper chambers).
Categories of arrhythmia can include:
- bradycardia, in which the heart rate is too slow
- tachycardia, in which the heart rate is too fast
- ventricular arrhythmia, which begins in the ventricles
- supraventricular arrhythmia, which begins above the ventricles
- premature heartbeat, in which the heart has an extra beat
Bradycardia occurs when your heart rate slows to under 60 beats per minute.
Conditions that cause a slow heart rate can include:
- heart block
- sick sinus syndrome
Sinus arrhythmia is one type of sick sinus syndrome, a group of disorders related to the sinus node. This condition can be present from birth or develop as the result of another condition, such as congenital heart disease or sleep apnea.
Tachycardia occurs when your heart rate speeds up to more than 100 beats per minute.
This rapid heartbeat can affect the way your heart pumps blood. Your ventricles may not be able to fill with the necessary amount of blood to pump to the rest of your body.
Typically, if this condition lasts only a few minutes, it may not be serious. However, you may need immediate medical attention if it lasts longer than 30 minutes or is accompanied by chest pain.
Ventricular arrhythmias begins in the ventricles, or the lower chambers, of the heart.
Types of ventricular arrhythmias can include:
- ventricular tachycardia
- ventricular fibrillation
- premature ventricular beats (PVCs), which are extra heartbeats that begin in the ventricles
- Torsades de Pointes, which is an uncommon but specific type of ventricular tachycardia that can be life threatening
Both ventricular tachycardia and ventricular fibrillation may need to be treated immediately, especially if you have other heart conditions.
Ventricular tachycardia (VT) typically occurs in people who have had heart disease or heart-related issues, like coronary artery disease or a prior heart attack, but can occur in those with structurally normal hearts. It can cause a heart rate of 100 beats per minute or higher with the rhythm originating in the bottom chamber of the heart.
VT is dangerous when it lasts longer than a few seconds. It may also lead to more serious ventricular arrhythmias, such as ventricular fibrillation.
Ventricular fibrillation (VF) involves sudden, rapid, irregular, and chaotic heartbeats in the ventricle. These erratic electrical impulses, sometimes triggered by a heart attack, cause your heart’s ventricles to quiver.
When you have this kind of arrhythmia, your ventricles can’t pump blood into your body, and your heart rate drops quickly. This can cause sudden cardiac arrest and death without immediate treatment.
Supraventricular arrhythmias, or atrial arrhythmias
Atrial arrhythmias, also known as supraventricular arrhythmias, begin in the atrium or upper chamber of the heart above the ventricles.
Supraventricular tachycardia (SVT) includes different forms of arrhythmias that begin above the ventricles. SVTs are usually identified by a burst of rapid heartbeats that may begin and end suddenly. They can cause a sudden rapid heartbeat of over 100 beats per minute that typically lasts a few minutes but that may last longer, including up to several hours, according to the UK National Health Service (NHS).
Types of supraventricular arrhythmia can include:
- atrial fibrillation
- atrial flutter
- atrial tachycardia
- atrioventricular nodal reentrant tachycardia (AVNRT)
- atrioventricular reeentrant tachycardia
- supraventricular tachycardia
- paroxysmal supraventricular tachycardia (PSVT)
- Wolff-Parkinson-White syndrome
If you have atrial fibrillation, also known as AF or AFib, your atria beat very rapidly, as fast as 400 beats per minute. The atria move so quickly that they aren’t able to contract completely. Instead, they quiver — or fibrillate — and the ventricular rate is usually fast as well.
Your risk of developing AF increases past age 65 and if you have other medical conditions. If left untreated, AF can lead to more serious conditions, such as stroke.
In atrial flutter (AFl), the heart beats more rhythmic and constant than in atrial fibrillation. You may not feel any symptoms with either type of arrhythmia.
Atrial flutter occurs most often in people with heart disease, though it’s less common than AF. It also can often show up in the first weeks after heart surgery. Like AF, atrial flutter can be life threatening.
A premature heartbeat can also sometimes lead to arrhythmia if you have another heart condition.
Premature heartbeats feel like your heart has skipped a beat. In reality, your normal heart rhythm has likely been interrupted by a too-soon beat, and you’re experiencing the beat after that early beat.
The sinus node uses electrical impulses to help regulate your heartbeat’s rhythm. A sinus arrhythmia is a rhythm variation of the normal sinus rhythm. It is most often seen in children and young, healthy adults and, can
It happens sometimes when breathing stimulates the vagus nerve — a nerve that shares information from the organs with the brain. This can result in beat-to-beat differences in the resting heart rate.
When not associated with breathing, sinus arrhythmia can indicate an underlying condition.
Scarring near the sinus node from heart disease or a heart attack may slow down or block the electrical impulses as they travel through the heart. This can cause arrhythmia and other cardiovascular disorders.
Sinus arrhythmia is a common condition in many people. However, it may cause heart complications for some.
You may not have any symptoms of an arrhythmia. However, common signs can include:
- feeling like your heart skipped a beat
- a fluttering feeling in your neck or chest
- rapid heartbeat
- slow or irregular heartbeat
Talk to your doctor about your symptoms so they can effectively diagnose and treat your arrhythmia. You may also develop more serious symptoms from your heart not working properly, including:
- chest pain or tightness
- difficulty breathing
- irregular pulse
- dizziness or lightheadedness
- fainting, or almost fainting
- heart palpitations
- low blood pressure
Seek medical care right away if you experience any of these symptoms. Find out more about arrhythmia symptoms and when to seek care.
What does arrhythmia feel like?
Sometimes, arrhythmia is asymptomatic. You may not feel anything at all.
Arrhythmia may also feel like your heart is beating irregularly, too fast, or too slow. You may feel a fluttering feeling in your chest.
Arrhythmias can have medical, physical, emotional, or genetic causes. The cause may also be unknown.
Antibiotics and other medications can trigger arrhythmia in some people. These may include medications that treat:
- high blood pressure
Changes in blood flow or physical alterations to the heart, such as scarring, can also cause arrhythmia. Other medical conditions may also be the source. They can include:
- high blood pressure
- thyroid disorder
- sleep apnea
- electrolyte imbalance, such as from low levels of calcium, potassium, or magnesium
Other physical or lifestyle factors can also cause arrhythmia in some cases. These can include:
Having certain risk factors may increase the chances of developing arrhythmias. However, not all people who have these risk factors develop irregular heart rhythms.
Some risk factors for arrhythmia are related to medical conditions. Others may be related to genetics, certain behaviors, or medications.
Conditions that may increase your risk for developing arrhythmia can include:
- coronary artery disease
- heart valve disease
- heart attack or heart failure
- cardiomyopathy (heart muscle diseases)
- endocarditis (heart inflammation)
- high blood pressure
- sleep apnea
- chronic lung disease
- overactive or underactive thyroid gland
- kidney disease
- eating disorders that cause an electrolyte imbalance or malnutrition
Other common risk factors for arrhythmia can include:
- older age
- certain medications, especially stimulants and antihistamines, some of which can be purchased over the counter
- air pollution
- family history of arrhythmia
- street drugs, particularly cocaine or amphetamines
Making certain lifestyle changes, such as reducing your consumption of caffeine, alcohol, and drugs, may reduce your risk of developing arrhythmia.
Doctors may use a variety of tests to diagnose arrhythmia. These tests may also help determine why you are experiencing an irregular heartbeat. This information can help guide your treatment.
The following tests may be used to help a doctor reach a diagnosis:
- your medical and family history
- a physical exam
- a range of tests to diagnose arrhythmias, including an electrocardiogram (ECG)
- a Holter monitor, a wearable ECG device that can be worn at home or during daily activities
In addition to an ECG, a doctor may also use a chest X-ray or echocardiogram to check:
- the size and shape of your heart
- the condition of the valves that help regulate the flow of blood through your heart
A doctor may also use additional tests to check for arrhythmias. These can include:
- Stress test. A stress test allows a doctor to monitor your heartbeat while you exercise to see if exertion causes an arrhythmia. They can also use medication to increase your heart rate for the test if you have trouble exercising.
- Sleep study. A sleep study can show whether sleep apnea is the source of your arrhythmia.
- Tilt table test. A tilt table test may be used if your arrhythmia has caused you to faint in the past. The doctor will check your heart rate and blood pressure as you lie on a table that’s tilted between different positions.
- Electrophysiological testing. A doctor will insert thin electrode catheters through your veins to different areas on your heart to map electrical signals during electrophysiological testing. The electrodes cause different parts of the heart to contract, which may help the doctor diagnose an arrhythmia and suggest treatment.
- Blood tests. A doctor may also order blood tests to check the levels of substances, such as magnesium, calcium, and thyroid hormones, that may affect arrhythmia.
An electrocardiogram, also called an ECG or EKG, is frequently used to diagnose arrhythmia. The doctor attaches electrodes to your chest, arms, or legs that measure and graph your heart’s electrical activity.
ECG measurements reveal if the electrical activity is unusually fast, slow, or irregular. The test can also show if your heart is enlarged or has poor blood flow.
A doctor may take an ECG while you’re resting or while you’re exercising on a stationary bicycle or treadmill. A portable monitor can also take ECGs to look for irregularities over a longer period of time.
ECGs involve little or no risk.
Since arrhythmias can be irregular and may not occur while you’re at the doctor’s office, a doctor may have you use a heart monitor at home to help diagnose the conditions.
Types of heart monitors can include:
- Holter monitor. A Holter monitor is a portable monitor that records your heart’s rhythm over the course of 1 or 2 days but can be up to 14 days.
- Event recorders. Event recorders are handheld monitors that can be used to record your heartbeat when you feel an irregularity.
- Implantable loop recorder. A doctor may implant a loop recorder under your skin to continuously monitor your heartbeat and record infrequent arrhythmias.
Arrhythmias sometimes don’t need specific treatment, but it’s important to have your arrhythmia medically evaluated.
A doctor will evaluate whether your arrhythmia may cause more serious symptoms or other conditions when deciding on treatment options.
It’s important to exercise, maintain a healthy diet, and manage your blood pressure and cholesterol levels when you have an arrhythmia. This can lower your risk for complications like a heart attack or stroke.
If you experience a fast heart rate without any other symptoms, a doctor may suggest that you try vagal maneuvers. They can prompt your vagus nerve to slow your heart rate. Vagal maneuvers can include:
- soaking your face with cold water
- holding your breath while straining
Other treatments for arrhythmia may include medication and surgery.
A doctor may give you medication to help you manage your arrhythmia and prevent complications like a heart attack.
Most of the medications come in pill form, but some may come in intranasal or intravenous form for use during an emergency.
The medication they prescribe depends on the type of arrhythmia as well as other conditions you may have. Common medication types include:
- Calcium channel blockers. Calcium channel blockers, which can include amlodipine (Norvasc) and diltiazem (Cardizem CD), help lower your blood pressure and heart rate. They can be used long term.
- Beta-blockers. Beta-blockers slow your heart rate to treat tachycardia. Beta-blockers may include acebutolol (Sectral), metoprolol (Lopressor, Toprol XL), and other medications.
- Antiarrhythmic drugs. Antiarrhythmic drugs can treat tachycardia and premature heartbeats. They can include amiodarone (Pacerone, Nexterone), propafenone (Rythmol SR), flecainide (Tambocor), and more. However, they may cause the problematic side effect of proarrhythmia, which can potentially worsen your arrhythmia or cause a new arrhythmia.
- Anticoagulants. Anticoagulants help prevent blood clots, which can result from atrial fibrillation. Blood-thinning medications include warfarin (Coumadin, Jantoven), rivaroxaban (Xarelto), and more. A side effect may be excessive or internal bleeding.
Make sure to take medications as prescribed. Let your doctor know about side effects, especially any new arrhythmias or worsening of your existing arrhythmia.
If medication or other treatments aren’t enough to help your arrhythmia, you may need a minor procedure or surgery. Several procedures and implantable devices may help treat arrhythmia:
- Catheter ablation: During catheter ablation, a cardiologist threads flexible tubes called catheters through your blood vessels to the correct area of your heart. An electrode at the end of one of the catheters releases radiofrequency waves, heat, or cold temperatures to create a small scar. The scar tissue blocks the electrical waves that cause arrhythmias.
- Pacemaker: A doctor can implant a pacemaker during minor surgery. After making a small cut near your shoulder, they guide small wires through your veins and place them in your heart. The wires connect to a small battery-powered generator implanted near your collarbone. If the generator detects an abnormal heart rhythm, it can send an electrical pulse through the wire to help regulate it.
- Implantable cardioverter defibrillator (ICD): An ICD is similar to a pacemaker and may be implanted near your collarbone, breastbone, or ribs. It may help if your arrhythmias are life threatening or put you at risk of cardiac arrest. An ICD can send electric shocks to your heart to correct its rhythm or restart your heart if it stops beating.
Surgery can also treat serious types of arrhythmias, such as atrial fibrillation.
In the maze procedure, your surgeon makes small cuts on the upper half of your heart to create scar tissue. The scars block electrical activity that can cause irregular heart rhythms.
Home remedies for arrhythmia
Making lifestyle changes at home, including getting regular exercise and eating healthy foods, can help improve your heart health and help you manage arrhythmia.
Other complementary treatments may help arrhythmia, though more research is needed. According to a
Acupuncture may also be an effective treatment for arrhythmia, according to a 2017 research review. However, the review noted that current research is limited.
Two research reviews published in 2017 suggested that magnesium and vitamin C supplements may reduce or prevent atrial fibrillation after heart surgery.
Still, there isn’t enough evidence to recommend supplements for arrhythmias.
Discuss any alternative treatments for arrhythmia, especially supplements, with a doctor.
Different types of arrhythmias, especially when untreated, may lead to life threatening conditions. These complications include:
- heart failure
- cardiac arrest
- arrhythmias that get worse or cause other symptoms
Arrhythmias can develop from a variety of causes, some of which you may not be able to prevent. Still, you can work to avoid triggering your arrhythmia or making it worse.
First, it’s important to understand the cause of your arrhythmia so you can avoid behaviors and substances that may trigger the condition.
Arrhythmia triggers that can be prevented may include:
Talk to your doctor if you think any medications are causing your arrhythmia. Don’t stop or change your medication on your own.
Certain healthy practices can also help manage and prevent arrhythmia. These practices can include:
- following a heart-healthy diet with reduced salt and fat
- quitting smoking
- exercising regularly
- maintaining a healthy BMI
- reducing stress
- limiting alcohol
- maintain healthy blood pressure and cholesterol levels
Develop a plan with your doctor to help manage your arrhythmia, including steps you can take when you have symptoms.
Arrhythmia can occur without symptoms or side effects.
Arrhythmia can occur as part of an inherited or other health condition. Some types of arrhythmia may be more serious and potentially life threatening. The outlook depends on the type and severity of the arrhythmia along with your other health conditions.
If you think you may have an arrhythmia, consult with a doctor for diagnosis and treatment. More serious arrhythmias may be treated with medication or surgery. Most people with arrhythmia can live a normal life.
Heart arrhythmias are common and many people experience them. Sometimes, they may occur without other symptoms and leave no lasting effects.
It’s also normal to have an increased heart rate during exercise, when your heart is working hard to provide your tissues with oxygen-rich blood so you don’t get tired too quickly.
However, some types of arrhythmias can be severe and require medical attention. It’s important to get diagnosed to determine the best plan for treatment.