• Heart Disease

Heart Arrhythmia: Understanding Irregular Heartbeat Symptoms

Heart arrhythmias can affect people of all ages, but the condition is more prevalent among adults than children.

The Centers for Disease Control and Prevention (CDC) states that atrial fibrillation — or AFib — is the most common type of heart arrhythmia. The condition affects an estimated 12.1 million people in the U.S.

Most heart arrhythmias are harmless and do not require any treatment.

What is a Heart Arrhythmia?

A heart arrhythmia refers to an abnormal or irregular heart rhythm.

To understand why an irregular heart rhythm is potentially dangerous, you must understand how the heart’s electrical system functions.

Electricity and the heart: How does it work?

There is an electrical ‘highway’ in the heart that allows electrical instructions to be carried throughout the heart muscle.

This electricity must flow in a coordinated pattern from the two top chambers of the heart — called the atria — to the lower chambers, called the ventricles.

The heart’s natural pacemaker — known as the sinoatrial or SA node — produces the electricity in the heart.

These electrical impulses make the heart’s four chambers work in a coordinated manner to receive oxygen-poor blood from the body, and then direct it to the lungs in order to send oxygen-rich blood to all organs in the body.

Electricity is what makes the heart function. If you don’t have electricity flowing through the heart, it won’t contract — in other words, it won’t be able to pump blood throughout the body.

Why is the coordination of the heart’s electrical activity so important?

If the electricity in the heart did not flow in one direction in a coordinated manner, random parts of the heart would contract at any given time and not allow blood to flow where it should.

To illustrate this, imagine trying to get the last bit of toothpaste from a tube.

You wouldn’t start pushing at the top of the tube and force the toothpaste downward to get the last bit out at the top — your toothpaste would then just collect at the bottom of the tube.

Similarly, the heart needs to efficiently pump blood toward the exits of the various chambers.

So the heart must start contracting in a specific area of the heart and its valves then help direct blood flow within the heart to ensure it only moves where it is meant to in the most efficient way.

Any abnormal electrical activity in the heart can affect its ability to receive oxygen-poor blood from the body and then pump oxygen-rich blood back to the parts of the body that need it.

When this happens, organ damage can occur due to poor circulation.

Is Heart Arrhythmia a Serious Condition?

While some heart arrhythmias won’t necessarily require treatment, it can be a serious condition that causes severe symptoms and health complications. The heart needs a normal electrical system and optimally functioning parts to pump blood effectively. If the flow of blood is impacted due to an abnormal heart rhythm, it can lead to impaired blood flow to the brain and other parts of the body that need blood to survive. Some arrhythmias are so dangerous that if they’re not corrected within minutes, death will follow.

What are the Causes of Heart Arrhythmia?

Heart arrhythmias can be caused by several conditions or factors. It’s important to know what can cause heart arrhythmia — especially fatal arrhythmias.

Causes of fatal arrhythmias

• Hypoxia: Suffocation or the body’s starvation of oxygen. For example, from drowning.

• Hypovolaemia: When the body has an extremely low amount of fluid. For example, due to blood loss, severe blood infections, heart failure, or severe dehydration.

• Hypothermia: This refers to extreme cold that makes body temperature drop below 95 degrees Fahrenheit. The colder the patient gets, the higher the risk of fatal arrhythmia.

• Hypoglycemia: Low blood glucose levels.

Abnormal potassium: Either low or high potassium levels can cause fatal arrhythmias.

• Direct injury to the heart: For example, a stab wound.

• Tamponade: Fluid around the heart that prevents the heart from pumping.

• Tension pneumothorax: When air enters into the chest cavity and accumulates to such a degree that it pushes organs around inside the chest and impairs their functioning.

Other causes of arrhythmia

• Electrolyte abnormalities

• Heart attacks

• Birth defects affecting the heart

• Drug use or poisoning

• Severe lung disease

• Medications such as antihypertensives

• Thyroid abnormalities

What are the Symptoms of Heart Arrhythmia?

Some people with arrhythmia will experience no symptoms at all, while others may experience severe symptoms, including:

• Heart palpitations

• Shortness of breath

• Fatigue or weakness

• Chest pain

• Dizziness

• Fainting

• Stroke and its symptoms (common with atrial fibrillation)

• Death, if it’s a fatal arrhythmia

How is an Arrhythmia Diagnosed?

Your healthcare provider may do an electrocardiogram (EKG) which measures the electrical activity of the heart.

During the procedure, small sticky pads with wires are placed on the chest. The electrical activity of the heart is then displayed on a monitor and interpreted by a healthcare professional.

What are the Types of Heart Arrhythmias?

A normal heart rhythm is known as a sinus rhythm because it originates from the part of the heart known as the sinoatrial node or the heart’s natural pacemaker.

If a rhythm is too slow it is called bradycardia, and if it is too fast it is called tachycardia. Below we go into detail about slow, fast, and fatal arrhythmias:

Slow heart rhythm: Lower than 60 beats per minute

There are two types of slow heart rhythms that can occur:

Sinus bradycardia

This heart rate is slower than average, but the heart rhythm is still normal. This is said to be the hallmark of an athlete’s heart. But it can also be caused by several health conditions, such as hypothyroidism and heart disease.

There are also certain medications such as narcotics and antihypertensives that can cause sinus bradycardia.

An electrolyte imbalance — that occurs when certain mineral levels in your blood are too low or too high — can also cause sinus bradycardia.

Blockage or failure of the SA node

If the SA node pacemaker of the heart is not functioning normally, backup pacemakers take over to prevent a person from dying.

These pacemakers are not as effective or fast as the SA node, since they result in slower, less effective beats, but they ensure the patient’s survival.

These pacemakers can either be the AV node or even the ventricles themselves. When these backup pacemakers kick in, it’s called a junctional escape rhythm.

Some conditions that can cause the SA node to stop functioning include heart attacks (which may destroy either the pacemaker itself or the highway leading from it), drug use, and electrolyte abnormalities.

Fast heart rhythm: Higher than 100 beats per minute

There are three types of fast heart rhythms that can occur:

Sinus tachycardia

This faster heart rhythm is a normal increase in the heart rate and is typically harmless. It occurs due to factors like stress, anxiety, fever, or exercise — especially in unfit persons.

Atrial fibrillation (AFib or AF)

In this case, the atria send abnormal extra impulses in addition to the pacemaker’s signals. This results in small contractions of the atria in various areas of these chambers.

Blood does not flow properly and may cause small clots, which could lead to a stroke.

Atrial flutter

Atrial flutter is caused by abnormal electrical circuits inside the atria. People with atrial flutter have chambers that contract faster than normal and in an uncoordinated way.

Those with atrial flutter may develop AFib, too.

Potentially fatal arrhythmias

The following arrhythmias may be lethal and require emergency medical attention.

Ventricular fibrillation

Similar to atrial fibrillation, the ventricles send abnormal extra impulses in various directions which prevent the blood from flowing in the right direction.

This is disastrous as no blood — or very little blood — can get to the brain or other areas of the body. If CPR is not immediately started, death is inevitable.

Pulseless ventricular tachycardia (VT or v-tach)

The ventricles pump very fast and do not give the heart a chance to fill with blood. This causes poor contractions that are out of sync with the atria. Very little blood ends up leaving the heart to get to the brain.

Death is likely if CPR and defibrillation are not done.

Asystole or pulseless electrical activity (PEA)

This occurs when the heart stops beating entirely. It is commonly known as “flat-lining” and it is fatal if CPR is not immediately initiated.

The treatment depends on the cause. Contrary to what TV shows and movies would have us believe, defibrillation does not help with flat-lining.

How Do I Treat an Arrhythmia?

Arrhythmias are treated depending on their causes. A healthcare provider will advise you on your specific treatment plan.

Emergency treatment: Fatal arrhythmias

If someone is in cardiac arrest and has no pulse, the cause might be a potentially fatal arrhythmia, immediately contact an ambulance service.

Emergency personnel may instruct you to begin CPR. If you are not trained to do so, they usually guide you through the process.

If cardiac arrest occurs in a public setting, such as a shopping mall or workplace, the facility might have a portable AED (automated external defibrillator) stored on-site for emergency use.

When placed on a person’s chest, the AED will guide you through the process and decide whether someone is in cardiac arrest and needs to be shocked or not. The prompts of the AED simply need to be followed until emergency services arrive.

Treatments for heart arrhythmia

Emergency medications

These drugs are used by medical personnel only and mostly given intravenously:

• Lidocaine

• Adrenaline (or epinephrine)

• Adenosine

• Verapamil

• Beta-blockers

Healthy lifestyle changes

Regular exercise, a heart-healthy diet, and stress management will improve cardiovascular health but it’s not a cure for arrhythmia.

However, stopping illicit drug use, caffeine use, and smoking can improve an arrhythmia.

Medications and therapies

You’ll need to consult with your doctor to learn whether any of the following treatments might help you:

• Antihypertensive medications

• Blood thinners, such as warfarin

• Anti-arrhythmic drugs, such as digoxin and amiodarone

• Ablation: Involves destruction of the heart tissue that causes abnormal heart rhythms

• Valsalva maneuver: Involves blowing out air through the nose while it is pinched closed. It can help lower fast heart rhythms in some cases.

• Anti-coagulation: Thinning of the blood to prevent strokes associated with atrial fibrillation

• Cardioversion: A medical procedure that is aimed at correcting heart rhythms with specific drugs (chemical cardioversion) or low-energy shocks

Implanted devices

During emergencies, an external pacemaker can be placed on the chest. Artificial pacemakers may also be implanted surgically if the heart rhythm is slow and can’t be corrected with medication.

Where Can I Learn More About Heart Arrhythmias?

If you are concerned about your health status or think you might have a heart arrhythmia, LifeMD can help.

We provide online access to doctors and valuable resources about heart health. Visit our portal and book your appointment to get started.

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