MediFind
Condition

Arrhythmias

Condition 101

What is the definition of Arrhythmias?

An arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregularly.

An arrhythmia can be harmless, a sign of other heart problems, or an immediate danger to your health.

What are the alternative names for Arrhythmias?

Abnormal heart rhythms; Bradycardia; Tachycardia; Fibrillation

What are the causes for Arrhythmias?

Normally, your heart works as a pump that brings blood to the lungs and the rest of the body.

To help this happen, your heart has an electrical system that makes sure it contracts (squeezes) in an orderly way.

  • The electrical impulse that signals your heart to contract begins in an area of the heart called the sinoatrial node (also called the sinus node or SA node). This is your heart’s natural pacemaker.
  • The signal leaves the SA node and travels through the heart along a set electrical pathway.
  • Different nerve messages signal your heart to beat slower or faster.

Arrhythmias are caused by problems with the heart's electrical conduction system.

  • Abnormal (extra) signals may occur.
  • Electrical signals may be blocked or slowed.
  • Electrical signals travel in new or different pathways through the heart.

Some common causes of abnormal heartbeats are:

  • Abnormal levels of potassium or other substances in the body
  • Heart attack, or a damaged heart muscle from a past heart attack
  • Heart disease that is present at birth (congenital)
  • Heart failure or an enlarged heart
  • Overactive thyroid gland

Arrhythmias may also be caused by some substances or drugs, including:

  • Alcohol, caffeine, or stimulant drugs
  • Heart or blood pressure medicines
  • Cigarette smoking (nicotine)
  • Drugs that mimic the activity of your nervous system
  • Medicines used for depression or psychosis

Sometimes medicines used to treat one type of arrhythmia will cause another type of abnormal heart rhythm.

Some of the more common abnormal heart rhythms are:

  • Atrial fibrillation or flutter
  • Atrioventricular nodal reentry tachycardia (AVNRT)
  • Heart block or atrioventricular block
  • Multifocal atrial tachycardia
  • Paroxysmal supraventricular tachycardia
  • Sick sinus syndrome
  • Ventricular fibrillation or ventricular tachycardia
  • Wolff-Parkinson-White syndrome

What are the symptoms for Arrhythmias?

When you have an arrhythmia, your heartbeat may be:

  • Too slow (bradycardia)
  • Too quick (tachycardia)
  • Irregular, uneven, possibly with extra or skipped beats

An arrhythmia may be present all of the time or it may come and go. You may or may not feel symptoms when the arrhythmia is present. Or, you may only notice symptoms when you are more active.

Symptoms can be very mild, or they may be severe or even life threatening.

Common symptoms that may occur when the arrhythmia is present include:

  • Chest pain
  • Fainting
  • Lightheadedness, dizziness
  • Paleness
  • Palpitations (feeling your heart beat fast or irregularly)
  • Shortness of breath
  • Sweating

What are the current treatments for Arrhythmias?

When an arrhythmia is serious, you may need urgent treatment to restore a normal rhythm. This may include:

  • Electrical "shock" therapy (defibrillation or cardioversion)
  • Implanting a short-term heart pacemaker
  • Medicines given through a vein or by mouth

Sometimes, better treatment for your angina or heart failure will lower your chance of having an arrhythmia.

Medicines called anti-arrhythmic drugs may be used:

  • To prevent an arrhythmia from happening again
  • To keep your heart rate from becoming too fast or too slow

Some of these medicines can have side effects. Take them as prescribed by your provider. DO NOT stop taking the medicine or change the dose without first talking to your provider.

Other treatments to prevent or treat abnormal heart rhythms include:

  • Cardiac ablation, used to destroy areas in your heart that may be causing your heart rhythm problems
  • An implantable cardioverter defibrillator, placed in people who are at high risk of sudden cardiac death
  • Permanent pacemaker, a device that senses when your heart is beating irregularly, too slowly, or too fast. It sends a signal to your heart that makes your heart beat at the correct pace.

What is the outlook (prognosis) for Arrhythmias?

The outcome depends on several factors:

  • The kind of arrhythmia you have. (Some abnormal heart rhythms may be life threatening if not treated right away, or DO NOT respond well to treatment.)
  • Whether you have coronary artery disease, heart failure, or valvular heart disease.

When should I contact a medical professional for Arrhythmias?

Call your provider if:

  • You develop any of the symptoms of a possible arrhythmia.
  • You have been diagnosed with an arrhythmia and your symptoms worsen or DO NOT improve with treatment.

How do I prevent Arrhythmias?

Taking steps to prevent coronary artery disease may reduce your chance of developing an arrhythmia.

REFERENCES

Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Heart Rhythm. 2017. S1547-5271(17)31249-3. PMID: 29097320 www.ncbi.nlm.nih.gov/pubmed/29097320.

Olgin JE. Approach to the patient with suspected arrhythmia. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 62.

Tomaselli GF, Rubart M, Zipes DP. Mechanisms of cardiac arrhythmias. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 34.

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: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2012;60(14):1297-1313. PMID: 22975230 www.ncbi.nlm.nih.gov/pubmed/22975230.

Latest Research

Latest Advance
Study
  • Condition: COVID-19
  • Journal: Clinical and translational science
  • Treatment Used: Repurposed Drugs
  • Number of Patients: 0
  • Published —
This study evaluated the risk of drug-induced long QT syndrome (heart rhythm condition that can potentially cause fast, chaotic heartbeats) in patients with COVID-19 (a pandemic infection caused by a coronavirus) treated with repurposed drugs.
Latest Advance
Study
  • Condition: COVID-19 Infection and Cardiac Events
  • Journal: New microbes and new infections
  • Treatment Used: Hydroxychloroquine (HCQ) and Azithromycin
  • Number of Patients: 1
  • Published —
This study investigated the instance of cardiac events in patients taking HCQ and azitrhomycin to treat patients with COVID-19 infections.
Latest Advance
Study
  • Condition: COVID-19
  • Journal: CJC open
  • Treatment Used: QT interval monitoring
  • Number of Patients: 33
  • Published —
The study researched the outcomes of QT interval monitoring in patients with COVID-19.
Latest Advance
Study
  • Condition: COVID-19
  • Journal: Journal of electrocardiology
  • Treatment Used: Hydroxychloroquine and Azithromycin
  • Number of Patients: 109
  • Published —
In this study, researchers evaluated the outcomes of a 5-day course of hydroxychloroquine and azithromycin in combination on the heart rhythm of persons with COVID-19.

Clinical Trials

Clinical Trial
Other
  • Status: Recruiting
  • Participants: 30
  • Start Date: July 15, 2020
Ablation of Ventricular Tachycardia Guided by Multi-site Pacing Using Parallel Mapping
Clinical Trial
Procedure
  • Status: Recruiting
  • Study Type: Procedure
  • Participants: 200
  • Start Date: June 23, 2020
Ripple Mapping Guided Ablation for Atrial Tachycardia: A Randomised Controlled Trial
Clinical Trial
Device
  • Status: Recruiting
  • Study Type: Device
  • Participants: 340
  • Start Date: June 23, 2020
Impact of E-assisted Connected Follow up on the Delay of Management of Postoperative Complications in Digestive Surgery