What the heck is an arrhythmia and why should you care?


Your heart is amazing. It's a strong, muscular pump a little larger than your fist. Its only job is to pump blood continuously through your circulatory system.

Did you know?

  • Each day, the average heart beats about 100,000 times and pumps about 2,000 gallons of blood through the body.
  • In a 70-year lifetime, the average heart beats more than 2.5 billion times.

Wow. That's a lot of action and truly amazing when your heart is functioning well. However, if there's a muscular misstep, what happens?

If you have an abnormal heart rhythm, it's called an arrhythmia. It may feel like a fluttering in your chest or a brief pause. It may be so brief that it doesn't change your heart rate. Or it can cause the heart rate to be too slow or too fast. "Some arrhythmias don't cause any symptoms. Others can make you feel lightheaded or dizzy, and even if there are no symptoms, some arrhythmias may be dangerous potentially causing strokes," said Mark Seifert, MD, an HonorHealth Heart Group cardiologist and electrophysiologist.

Types of arrhythmias

The two major kinds of arrhythmias are:

  • Bradycardia: When your heart rate is too slow – defined as less than 60 beats per minute.
  • Tachycardia: When your heart rate is too fast – defined as more than 100 beats per minute at rest.

Other types of arrhythmias include:

  • Atrial fibrillation (aFib): When the upper chambers of your heart contract rapidly and irregularly.
  • Ventricular fibrillation: When the lower chambers of your heart have disorganized contraction.
  • Conduction disorders: When electrical impulses in your heart don't progress normally along a path.

When your heart doesn't beat properly, it can't pump blood effectively. When that happens, your lungs, brain and all your other organs can't work as they should. Without sufficient blood flow, organ damage begins to happen and/or the organ just shuts down totally.

Signs of an arrhythmia

When it's very brief, an arrhythmia can have almost no symptoms. When arrhythmias are severe or last long enough to affect how well your heart works, your heart may not be able to pump enough blood through your circulatory system. "This can cause you to feel tired, lightheaded or may make you pass out. Some can even cause death," Dr. Seifert said.

Expected changes in heart rate occur during physical activity, stress, excitement and sleep. The prevalence of atrial and ventricular arrhythmias tends to increase with age, even when there's no clear sign of heart disease.

Heart disease that you may have as an after-effect from a muscle-damaging heart attack or other events is the most important factor making you prone to arrhythmias. Scarring or abnormal tissue deposits can cause either bradycardia or tachycardia. If you have heart disease, your cardiologist is likely monitoring your heart rhythm with regular EKGs. But arrhythmias that happen infrequently may not be detected. Also, not all arrhythmias cause clear-cut symptoms, so be sure to tell your doctor about any unusual symptoms such as fainting, difficulty breathing, fatigue, or a thumping feeling in your chest.

Smoking cigarettes, drinking alcohol and using recreational drugs can provoke arrhythmias. So can various prescription cardiac medications. Even drugs used to treat arrhythmias may cause another arrhythmia.

How are arrhythmias treated?

Before treatment, your doctor will need to know where in your heart the arrhythmia starts and if it's abnormal. An EKG, which creates a graphic record of the heart's electrical impulses, is often used to diagnose arrhythmias. Additional ways to find where arrhythmias start are by:

  • Using a Holter monitor, a portable device that you wear non-stop for 24 to 48 hours to record your heart's electrical activity.
  • Taking an exercise stress test that measures heart activity as you walk on a treadmill or ride a stationary bike.
  • Having a tilt table test. Your blood pressure and heart rate are measured as you lie on a table that's slowly tilted up.
  • Undergoing electrophysiological studies that map your heart's electrical system.

Treatments may include:

Source: American Heart Association (www.heart.org)

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