Definition and Overview

The normal heart rate for a body at rest is between 60-100 beats per minute, which is sufficient to pump oxygen-rich blood throughout the entire body. However, if the body is in an active state, it consumes more oxygen. The heart then beats faster to compensate. If the heart beats faster or slower than usual, or if it seemingly misses a beat without any change to the state of the body, the condition is called arrhythmia.

Almost everybody has experienced arrhythmia at least once in their lives. In most cases, the condition doesn’t present any cause for concern. However, serious types of arrhythmia can cause many problems, such as heart failure or stroke. Several types of arrhythmia prevent the heart from supplying the different organs with oxygen-rich blood. This often results in damage or total failure of the organs.

To get a better picture of arrhythmia, one must understand what makes the heart beat. The heart has its own electrical system, which is responsible for sending impulses from the top of the heart to the bottom at a steady rate, or at a rate that the body needs blood.

The electrical impulse originates from the sinoatrial node located in the upper chambers of the heart, also called the right atrium. The impulse then triggers the cardiac muscle to contract and release.

If the electrical impulse is interrupted or fails to travel along the correct path (axon) down the heart, the contractions become irregular. The condition will then be referred to as one of the following arrhythmias:

  • Bradycardia – the heart beats slower than normal
  • Atrial fibrillation – the heart contracts irregularly at the upper chambers
  • Ventricular fibrillation – the heart contracts irregularly at the lower chambers
  • Premature contraction – heart beats occur too early
  • Tachycardia – the heart beats faster than normal


Arrhythmia can occur in anybody of any age. However, the condition is more common in those with heart problems.

Cause of Condition

Arrhythmias occur when the electrical signals produced by the sinoatrial node are blocked or don’t travel along the correct path. This can happen due to a variety of factors, such as heart attack, hypertension, coronary heart disease, abnormal thyroid hormone production, and other heart diseases.

Arrhythmias can also be a result of smoking, excessive alcohol consumption, illegal drugs, caffeine, or even over-the-counter or prescription medications. Some people may experience arrhythmia because of stressful situations, such as work-related stress.

People who are born with congenital disease are also at risk of arrhythmia.

Key Symptoms

In most cases, a person will feel the symptoms of arrhythmia, such as the heart seemingly skipping a beat or palpitating heavily. In some cases, the heart may seem to be beating too slowly or at irregular intervals.

Changes to the heart’s normal beating pattern can result in a feeling of weakness, anxiety, and dizziness. A person could faint, feel out of breath, sweat heavily, or experience chest pains.

As earlier stated, not all cases of arrhythmia are a cause for concern. However, if the condition occurs frequently or if the person has a known heart condition, it would be best to see a medical professional to have the condition diagnosed.

Who to See and Types of Treatment Available

Individuals who experience arrhythmia on a frequent basis, but are not aware of any heart problems, should see their family doctor. The initial consultation will involve a short interview about the symptoms being experienced, when the patient first noticed them, and a brief history of diseases in the family.

Meanwhile, those who were already been diagnosed with a heart problem and are being treated for such, must consult a cardiologist, who specializes in diagnosing and treating heart conditions.

Treatment for arrhythmia will depend on the severity of the condition. These can include medications or surgery. Some medications slow down an abnormally fast heart rate while others normalize irregular heart rhythms. Those with abnormally slow heart rates will need a pacemaker that is implanted into the chest. A pacemaker is a small device that detects abnormal heart rhythms and produces electrical impulses to restore normal heartbeats.

Another option is catheter ablation. This procedure involves inserting a small tube into the area of the heart that is causing arrhythmia. Electrical impulses are transmitted through the tube to destroy tissues that are causing the problem.

In some cases, surgery might be the only option. For instance, if a failing heart valve is causing arrhythmia, the valve will be repaired or replaced through a surgical procedure. If the doctor determines that the cause of arrhythmia is a coronary heart disease, a coronary artery bypass surgical procedure will be performed.

Not all types of arrhythmia require medical treatment. In some cases, the doctor may recommend exercises called vagal maneuvers, which include gagging, coughing, and holding the breath, among others. These exercises have been proven to slow down a fast heart rate.

References:

  • Olgin SE. Approach to the patient with suspected arrhythmia. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 62.

  • Tracy CM, Epstein AE, Darbar D, et al. 2012 ACCF/AHA/HRS Focused Update of the 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities. J Am Coll Cardiol. 2012;60(14):1297-1313.

  • Rubart M, Zipes DP. Genesis of cardiac arrhythmias, electrophysiologic considerations. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 35.

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