Dr. M.J. Bazos MD,
What is an
An arrhythmia is a change in the rhythm of your
heartbeat. When the heart beats too fast, it's called tachycardia. When it beats
too slow, it's called bradycardia. An arrhythmia can also mean that your heart
beats irregularly (skips a beat or has an extra beat). At some time or another,
most people have felt their heart race or skip a beat. These occasional changes
can be brought on by strong emotions or exercise. They usually are not a cause
for alarm. Arrhythmias that occur more often or cause symptoms (see the box
below) may be more serious and need to be discussed with your doctor.
What are the symptoms of arrhythmia?
Call your doctor if you have any of these
symptoms, especially if you have heart disease or have had a heart
- Palpitations or rapid thumping in your chest
- Feeling tired or light-headed
- Passing out
- Shortness of breath
- Chest pain
What causes an
The heart has 4 chambers. The walls of the heart
contract to push blood through the chambers. The contractions are controlled by
an electrical signal that begins in the heart's natural "pacemaker" (called the
sinoatrial node). The rate of the contractions is influenced by nerve impulses
and hormones in the blood. A problem in any of these can cause an arrhythmia.
Minor arrhythmias may be caused by excessive
alcohol use, smoking, caffeine, stress or exercise. The most common cause of
arrhythmias is heart disease, particularly coronary artery disease, abnormal
heart valve function and heart failure. However, arrhythmias can occur for no
Is an arrhythmia
In most people, arrhythmias are minor and are
not dangerous. A small number of people, however, have arrhythmias that are
dangerous and require treatment. Arrhythmias are also more serious if you have
other heart problems. In general, arrhythmias that start in the lower chambers
of the heart (called the ventricles) are more serious than those that start in
the upper chambers (called the atria). Your doctor will talk with you about the
type of arrhythmia you have and whether you need treatment.
How do I know if I have an
Your doctor will ask if you have any of the
symptoms listed in the box on page 1. Your doctor may also do some tests. One of
these tests is an electrocardiogram, also called ECG or EKG. During this test,
your doctor will have you lie down so your heart can be monitored.
Your doctor may also ask you to walk on a
treadmill while he or she monitors your heart, or may want to monitor your heart
while you do your daily activities. One way to do this is for you to wear a
Holter monitor for 24 hours. If your doctor wants to monitor your heart for more
than 24 hours, he or she might recommend an event-recorder, which you wear for a
couple of days or longer. Other tests, called electrophysiologic studies, may
also give your doctor information about your heart.
What are some of the types of
- Atrial fibrillation. The heart
beats too fast and irregularly. This type of arrhythmia requires treatment and
can increase your risk of stroke.
- Paroxysmal atrial tachycardia. The heart
has episodes when it beats fast, but regularly. This type of arrhythmia may be
unpleasant but is usually not dangerous.
- Ectopic beats. The heart has an extra
beat. Treatment usually is not needed unless you have several extra beats in a
row and/or other problems with your heart (such as heart disease or congential
- Ventricular tachycardia and ventricular
fibrillation. The heart beats too fast and may not pump enough blood. These
types of arrhythmias are very dangerous and need immediate treatment.
Treatment depends on the type of arrhythmia you
have. Some mild arrhythmias require no treatment. Other arrhythmias can be
treated with medicines. If another health problem is causing the arrhythmia,
treatment is aimed at taking care of that problem. In more serious cases, other
treatments are available:
- An artificial pacemaker. An electronic
device placed under the skin on the chest. It helps the heart maintain a regular
beat, especially when the heart beats too slowly.
- Cardiac defibrillation (very brief electric
shock). Can be used to stop an abnormal rhythm and restore a normal one.
- Surgery. Can correct certain types of
arrhythmias. For example, arrhythmias caused by coronary artery disease may be
controlled by bypass surgery. When an arrhythmia is caused by a certain area of
the heart, sometimes that part of the heart can be destroyed or removed.