Arrhythmia

Many arrhythmias don’t have any symptoms.

If they do, common signs and symptoms of an arrhythmia may include:

• Palpitations (may feel like fluttering in your chest, like your heart is skipping a beat, or like it is beating too hard or too fast)
• Feeling pauses between heartbeats or an irregular pattern
• Fatigue, weakness, light-headedness
• A slow heartbeat

Some arrhythmias are medical emergencies. During an arrhythmia, the heart may not be able to pump enough blood to the body and may stop working.

If you experience the following symptoms, call 911:

• Significant weakness, dizziness, or light-headedness
• Fainting
• Shortness of breath
• Chest pain
• Blurred vision

Arrhythmias happen when the electrical signals that control your heartbeat don’t work properly.

This can happen if the specialized heart cells that send the electrical signals are damaged or if the electrical signals don’t travel properly through the heart.

A normal heartbeat can also be disrupted if the heart produces too many electrical signals.

Sometimes the cause of an arrhythmia is unknown.

Arrhythmias are common in older adults, who are more likely to have heart disease, high blood pressure, and other health conditions that can cause arrhythmias.

Some medications can also cause arrhythmias as a side effect, including tricyclic antidepressants (TCAs), antihistamines, and beta-blockers.

Additionally, illegal drugs, such as cocaine, methamphetamines, and stimulants like caffeine and nicotine can cause arrhythmias.

A number of tests and devices are used to detect an arrhythmia.

Diagnosis usually requires recording the heart’s electrical activity using an electrocardiogram, or ECG.

A Holter monitor — a portable, 24- or 48-hour ECG — may also be used if your doctor wants to see your heartbeat over a longer period.

During an ECG, small patches or stickers called electrodes are stuck to several spots on your chest and body.

These electrodes will generate a picture of your heart’s electrical activity so doctors can see where any irregularities may occur.

An echocardiogram — a type of ultrasound that uses sound waves to produce images of your heart — may also be used to diagnose heart problems that can lead to arrhythmias.

Stress tests, which use physical exertion (such as running on a treadmill) or drugs to simulate exercise, can trigger an arrhythmia and help a doctor make an accurate diagnosis.

Cardiac catheterization, a procedure in which a tiny tube is threaded through a vein or artery and into the heart, can help your doctor measure pressures in the heart or evaluate for potential blockage of the coronary arteries.

The frequency and duration of arrhythmia depends on the cause. For example, when an arrhythmia is caused by a treatable condition, like an overactive thyroid, the irregular heartbeat may go away when the thyroid problem is treated.

Arrhythmias can be treated with lifestyle modification, medications, or medical procedures/surgery.

Medication Options

Medications can slow down a heartbeat that is too fast. They can also be used to even out or stabilize an abnormal heart rhythm.

Drugs used to treat arrhythmias include:

• Adenosine slows a racing heart by slowing its electrical signals.
• Atropine temporarily treats a slow heart rate.
• Beta-blockers work by slowing the heart rate and decreasing the effects of adrenaline on the heart, thereby lowering blood pressure.
• Anticoagulants, or blood thinners, work by making it more difficult for blood to clot. These medications do not dissolve existing blood clots, but rather prevent new ones from forming or existing ones from growing bigger. Anticoagulants are commonly prescribed to people who are at risk of blood clots, such as those with atrial fibrillation.
• Calcium channel blockers, or “calcium antagonists,” interrupt the movement of calcium into the heart and can slow the heart rate.