Heart Rhythm Disturbances: Types, Symptoms, Causes, and Treatments

16.10.197224.08.2021 by alexxlab

What are the different types of arrhythmias. How can you recognize the symptoms of heart rhythm disturbances. What causes irregular heartbeats. How are arrhythmias diagnosed and treated.

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Understanding Arrhythmias: The Basics of Heart Rhythm Disturbances

An arrhythmia, also known as dysrhythmia, is an irregular or abnormal heartbeat. It occurs when the heart’s electrical system, which controls the heart’s pumping action, malfunctions. This can cause the heart to beat too fast, too slow, or erratically.

Your pulse is a direct indicator of your heart rate, measuring the number of times your heart beats in one minute. A normal resting heart rate for adults typically ranges from 50 to 100 beats per minute. However, this can vary depending on factors such as age, fitness level, and overall health.

How to Check Your Pulse

Checking your pulse is a simple process that can provide valuable information about your heart’s rhythm:

Place the tips of your index and middle fingers on your wrist, just below the base of your thumb, or on either side of your windpipe on your neck.
Press gently until you feel the blood pulsing beneath your fingers.
Count the number of beats in 10 seconds.
Multiply this number by 6 to get your heart rate in beats per minute.

Is a fluctuating pulse always a cause for concern. Not necessarily. Some variation in heart rate is normal, especially in response to physical activity, stress, or emotions. However, persistent irregularities should be evaluated by a healthcare professional.

The Heart’s Electrical System: Powering Your Heartbeat

The heart’s electrical system is the driving force behind each heartbeat. It coordinates the contraction and relaxation of the heart’s chambers to efficiently pump blood throughout the body. Here’s a simplified breakdown of a normal heartbeat:

The sinoatrial (SA) node, located in the right atrium, initiates an electrical impulse.
This impulse spreads through the atria, causing them to contract.
The impulse reaches the atrioventricular (AV) node, which acts as a relay station.
From the AV node, the impulse travels through the bundle of His and Purkinje fibers to the ventricles.
This causes the ventricles to contract, pumping blood to the lungs and body.

When this system functions properly, it results in a normal sinus rhythm, visible on an electrocardiogram (ECG or EKG) as a regular pattern of wave arms.

Types of Arrhythmias: When the Heart’s Rhythm Goes Off-Beat

Arrhythmias can be classified based on their origin in the heart and their effect on heart rate. The main categories include:

Tachycardia: A fast heart rhythm exceeding 100 beats per minute
Bradycardia: A slow heart rhythm below 60 beats per minute
Supraventricular arrhythmias: Originating in the atria
Ventricular arrhythmias: Originating in the ventricles
Bradyarrhythmias: Slow rhythms caused by conduction system diseases

Supraventricular Arrhythmias

Supraventricular arrhythmias encompass a range of rhythm disturbances that originate above the ventricles. These include:

Premature Atrial Contractions (PACs): Early, extra heartbeats originating in the atria
Paroxysmal Supraventricular Tachycardia (PSVT): A rapid but regular heart rhythm that starts and stops suddenly
Accessory Pathway Tachycardias: Fast rhythms caused by extra electrical pathways between the atria and ventricles
AV Nodal Re-entrant Tachycardia (AVNRT): A fast rhythm due to multiple pathways through the AV node
Atrial Tachycardia: A rapid rhythm originating in the atria
Atrial Fibrillation: A very common irregular rhythm characterized by disorganized atrial contractions
Atrial Flutter: A regular, rapid atrial rhythm

Can supraventricular arrhythmias be dangerous. While many supraventricular arrhythmias are not immediately life-threatening, they can lead to complications if left untreated, such as increased risk of stroke in atrial fibrillation.

Recognizing the Signs: Symptoms of Heart Rhythm Disturbances

Arrhythmias can manifest in various ways, and some people may not experience any symptoms at all. However, common signs of heart rhythm disturbances include:

Palpitations (a feeling of skipped heartbeats or fluttering in the chest)
Rapid heartbeat or racing heart sensation
Slow heartbeat
Chest discomfort or pain
Shortness of breath
Lightheadedness or dizziness
Fainting (syncope) or near-fainting episodes
Fatigue or weakness
Anxiety

Do all arrhythmias cause noticeable symptoms. No, some arrhythmias can be “silent” and may only be detected during routine medical examinations or when investigating other health concerns.

Unraveling the Causes: Factors Behind Irregular Heartbeats

Arrhythmias can occur in both healthy hearts and those with underlying conditions. Some common causes and risk factors include:

Heart disease (coronary artery disease, heart valve problems, heart failure)
High blood pressure
Electrolyte imbalances
Thyroid disorders
Diabetes
Smoking
Excessive alcohol consumption
Stress and anxiety
Certain medications
Caffeine or stimulant use
Illegal drug use (particularly cocaine and amphetamines)
Sleep apnea
Genetic factors

Can lifestyle choices influence the development of arrhythmias. Absolutely. Maintaining a healthy lifestyle, including regular exercise, a balanced diet, stress management, and avoiding excessive alcohol and caffeine, can help reduce the risk of developing certain types of arrhythmias.

Diagnosing the Disorder: Methods to Detect Heart Rhythm Abnormalities

Diagnosing arrhythmias often involves a combination of medical history, physical examination, and various diagnostic tests. Common diagnostic methods include:

Electrocardiogram (ECG or EKG): Records the heart’s electrical activity
Holter Monitor: A portable ECG device worn for 24-48 hours
Event Recorder: A wearable device that records heart activity over several weeks
Echocardiogram: Uses sound waves to create images of the heart’s structure and function
Stress Test: Monitors heart activity during exercise
Tilt Table Test: Evaluates how the heart rate and blood pressure respond to changes in body position
Electrophysiology Study: An invasive test that directly measures the heart’s electrical activity

How accurate are these diagnostic methods. While each test has its strengths and limitations, using a combination of these methods can provide a comprehensive picture of the heart’s electrical activity and help pinpoint the specific type of arrhythmia.

Treatment Approaches: Managing and Controlling Arrhythmias

The treatment of arrhythmias depends on the type, severity, and underlying causes. Options may include:

Lifestyle modifications (e.g., reducing caffeine intake, managing stress)
Medications (antiarrhythmic drugs, blood thinners)
Cardioversion (electrical or pharmacological)
Catheter ablation
Implantable devices (pacemakers, implantable cardioverter-defibrillators)
Surgery (in rare cases)

Is treatment always necessary for arrhythmias. Not all arrhythmias require treatment, especially if they are infrequent and don’t cause significant symptoms. However, potentially dangerous arrhythmias or those that impact quality of life should be addressed under medical supervision.

Living with Arrhythmias: Strategies for a Heart-Healthy Life

For many people, living with an arrhythmia involves a combination of medical management and lifestyle adjustments. Here are some strategies to promote heart health:

Follow your treatment plan as prescribed by your healthcare provider
Maintain regular check-ups and monitor your condition
Adopt a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins
Engage in regular physical activity as approved by your doctor
Manage stress through relaxation techniques, meditation, or counseling
Avoid triggers that may precipitate arrhythmias (e.g., excessive caffeine, alcohol)
Learn to recognize your symptoms and when to seek medical attention
Consider joining a support group for individuals with heart rhythm disorders

Can people with arrhythmias lead normal, active lives. In many cases, yes. With proper management and care, many individuals with arrhythmias can maintain a good quality of life and participate in regular activities.

Understanding heart rhythm disturbances is crucial for recognizing potential issues and seeking timely medical attention. While arrhythmias can be concerning, advances in medical technology and treatment options have greatly improved the outlook for many patients. By working closely with healthcare providers and adopting heart-healthy habits, individuals with arrhythmias can often lead fulfilling, active lives.

As research in cardiology continues to evolve, new insights into the mechanisms of arrhythmias and innovative treatment approaches are constantly emerging. This ongoing progress offers hope for even better management strategies and outcomes for those affected by heart rhythm disorders in the future.

Types, Symptoms, Causes, Diagnosis & Treatments

Overview

What is an arrhythmia?

An arrhythmia (also called dysrhythmia) is an irregular or abnormal heartbeat.

What is my pulse?

Your pulse indicates your heart rate, or the number of times your heart beats in one minute. Pulse rates vary from person to person. Your pulse is slower when you are at rest and increases when you exercise, since more oxygen- rich blood is needed by the body during exercise.

How do I take my pulse?

You can tell how fast your heart is beating by feeling your pulse. You can feel your pulse on your wrist or neck. Place the tips of your index and middle fingers on the inner wrist of your other arm, just below the base of your thumb. Or, place the tips of your index and middle fingers on your lower neck, on either side of your windpipe. Press lightly with your fingers until you feel the blood pulsing beneath your fingers. You may need to move your fingers around slightly up or down until you feel the pulsing.

You can count the number of beats in 10 seconds and multiply by 6 to determine your heart rate in beats per minute. A normal heart rate, at rest, is 50 to 100 beats per minute.

Your Heart Rate: Pulse in 10 seconds x 6 = _

Learn more about your pulse and target heart rate.

Heart Rhythms on ECG

The heart’s electrical system triggers the heartbeat. Each beat of the heart is represented on the electrocardiogram (EKG or ECG) by a wave arm.

The normal heart rhythm (normal sinus rhythm) shows the electrical activity in the heart is following the normal pathway. The rhythm is regular and the node is normal (about 50 to 100 beats per minute).

Tachycardia: fast heart rhythm (greater than 100 beats per minute)

Bradycardia: slow heart rhythm (less than 60 beats per minute)

The Heart’s Electrical System

The atria (the heart’s upper chambers) and ventricles (the heart’s lower chambers) work together, alternately contracting and relaxing to pump blood through the heart. The electrical system of the heart is the power source that makes this possible. Here’s what happens during a normal heartbeat:

Irregular heart rhythms can also occur in normal, healthy hearts. Arrhythmias can also be caused by certain substances or medications, such as caffeine, nicotine, alcohol, cocaine, inhaled aerosols, diet pills, and cough and cold remedies. Emotional states such as shock, fright or stress can also cause irregular heart rhythms.

Arrhythmias that are recurrent or related to an underlying heart condition are more concerning and should always be evaluated by a doctor.

In most cases, treating the underlying condition will take care of the arrhythmia. If not, many medications and procedures are available to eliminate or control the abnormal heart rhythm.

What are the types of arrhythmias?

Tachycardia: A fast heart rhythm with a rate of more than 100 beats per minute.
Bradycardia: A slow heart rhythm with a rate below 60 beats per minute.
Supraventricular arrhythmias: Arrhythmias that begin in the atria (the heart’s upper chambers). “Supra” means above; “ventricular” refers to the lower chambers of the heart, or ventricles.
Ventricular arrhythmias: Arrhythmias that begin in the ventricles (the heart’s lower chambers).
Bradyarrhythmias: Slow heart rhythms that may be caused by disease in the heart’s conduction system, such as the sinoatrial (SA) node, atrioventricular (AV) node or His-Purkinje network.

Types of Supraventricular Arrhythmias

Supraventricular arrhythmias begin in the atria

Types of supraventricular arrhythmias include:

Premature atrial contractions (PACs)

Early, extra heartbeats that originate in the atria.

Paroxysmal supraventricular tachycardia (PSVT)

A rapid but regular heart rhythm that comes from the atria. This type of arrhythmia begins and ends suddenly.

Accessory pathway tachycardias (bypass tract tachycardias)

A fast heart rhythm caused by an extra, abnormal electrical pathway or connection between the atria and ventricles. The impulses travel through the extra pathways as well as the usual route. This allows the impulses to travel around the heart very quickly, causing the heart to beat unusually fast (example: Wolff- Parkinson-White syndrome).

AV nodal re-entrant tachycardia (AVNRT)

A fast heart rhythm caused by the presence of more than one pathway through the atrioventricular (AV) node.

Atrial tachycardia

A rapid heart rhythm that originates in the atria.

Atrial fibrillation

A very common irregular heart rhythm. Many impulses begin and spread through the atria, competing for a chance to travel through the AV node. The resulting rhythm is disorganized, rapid and irregular. Because the impulses are traveling through the atria in a disorderly fashion, there is a loss of coordinated atrial contraction.

Atrial flutter

An atrial arrhythmia caused by one or more rapid circuits in the atrium. Atrial flutter is usually more organized and regular than atrial fibrillation.

Types of Ventricular Arrhythmias

A ventricular arrhythmia begins in the heart’s ventricles.

Types of ventricular arrhythmias include:

Premature ventricular contractions (PVCs)

Early, extra heartbeats that originate in the ventricles. Most of the time, PVCs don’t cause any symptoms or require treatment. This type of arrhythmia is common and can be related to stress, too much caffeine or nicotine, or exercise. They can be also be caused by heart disease or electrolyte imbalance. People who have several PVCs and/or symptoms associated with them should be evaluated by a cardiologist (heart doctor).

Ventricular tachycardia (V-tach)

A rapid heartbeat that originates in the ventricles. The rapid rhythm keeps the heart from adequately filling with blood, and less blood is able to pump through the body. V-tach can be serious, especially in people with heart disease, and may be associated with more symptoms than other types of arrhythmia. A cardiologist should evaluate this condition.

Ventricular fibrillation (V-fib)

An erratic, disorganized firing of impulses from the ventricles. The ventricles quiver and cannot generate an effective contraction, which results in a lack of blood being delivered to the body. This is a medical emergency that must be treated with cardiopulmonary resuscitation (CPR) and defibrillation (delivery of an energy shock to the heart muscle to restore a normal rhythm) as soon as possible.

Long QT

The QT interval is the area on the ECG that represents the time it takes for the heart muscle to contract and then recover, or for the electrical impulse to fire and then recharge. When the QT interval is longer than normal, it increases the risk for “torsade de pointes,” a life-threatening form of ventricular tachycardia.

Types of Bradyarrhythmias

A bradyarrhythmia is a slow heart rhythm that is usually caused by disease in the heart’s conduction system. Types of bradyarrhythmias include:

Sinus node dysfunction

Slow heart rhythms due to an abnormal SA node.

Heart block

A delay or complete block of the electrical impulse as it travels from the sinus node to the ventricles. The level of the block or delay may occur in the AV node or His-Purkinje system. The heartbeat may be irregular and slow.

Management and Treatment

How is an arrhythmia treated?

Treatment depends on the type and severity of your arrhythmia. In some cases, no treatment is necessary. Treatment options include medications, lifestyle changes, invasive therapies, electrical devices or surgery.

Medications

Antiarrhythmic drugs are medications used to convert the arrhythmia to a normal sinus rhythm or to prevent an arrhythmia. Other medications may include heart rate-control drugs and anticoagulant or antiplatelet drugs such as warfarin (a “blood thinner”) or aspirin, which reduce your risk of stroke or developing blood clots.It is important that you know the names of your medications, why they are prescribed, how often and at what times to take them, what side effects may occur, and what medications you have previously taken for your arrhythmia.

Lifestyle changes

Arrhythmias may be related to certain lifestyle factors. The following tips can help limit the occurrence of arrhythmias:

If you smoke, stop.
Limit your intake of alcohol.
Limit or stop using caffeine. Some people are sensitive to caffeine and may notice more symptoms when using caffeinated products, such as tea, coffee, colas and some over-the- counter medications.
Avoid using stimulants. Beware of stimulants used in cough and cold medications and herbal or nutritional supplements. Some of these substances contain ingredients that cause irregular heart rhythms. Read the label and ask your doctor or pharmacist which medication is best for you.
Your family may also want to be involved in your care by learning to recognize your symptoms and how to start CPR if needed.
If you notice that your irregular heart rhythm occurs more often with certain activities, you should avoid them.

Invasive therapies

Electrical cardioversion and catheter ablation are invasive therapies used to treat or eliminate irregular heart rhythms. Your doctor will determine the best treatment for you and discuss the benefits and risks of these therapies with you.

Electrical cardioversion Patients with persistent arrhythmias, such as atrial fibrillation, may not be able to achieve a normal heart rhythm with drug therapy alone. Electrical cardioversion delivers an electrical shock to your chest wall, which synchronizes the heart and allows the normal rhythm to restart. This procedure is done after you receive short-acting anesthesia.
Catheter ablation: During ablation, energy is delivered through a catheter to tiny areas of the heart muscle. This energy can either “disconnect” the pathway of the abnormal rhythm, block the abnormal pulses and promote normal conduction of impulses, or disconnect the electrical pathway between the atria and the ventricles.
- Pulmonary vein isolation: In patients with frequent, paroxysmal or persistent atrial fibrillation, isolation of the pulmonary veins is a procedure that uses special catheters to render bands of vein tissue, thought to cause atrial fibrillation, dysfunctional. The goal is to isolate, rather than ablate, the foci responsible for triggering atrial fibrillation through a circumferential conduction block.
Electrical devices

Permanent pacemaker: A device that sends small electrical impulses to the heart muscle to maintain a normal heart rate. The pacemaker has a pulse generator (which houses a battery and a tiny computer) and leads (wires) that send impulses from the pulse generator to your heart muscle, as well as sense the heart’s electrical activity. Pacemakers are mostly used to prevent the heart from beating too slowly. Newer pacemakers have many sophisticated features that are designed to help manage arrhythmias, optimize heart rate-related functions and improve synchronization.
Implantable cardioverter-defibrillator (ICD): A sophisticated electronic device used primarily to treat ventricular tachycardia and ventricular fibrillation — two life-threatening abnormal heart rhythms. The ICD constantly monitors the heart rhythm. When it detects a very fast, abnormal heart rhythm, it delivers energy to the heart muscle to cause the heart to beat in a normal rhythm again.

There are several ways an ICD can restore a normal heart rhythm:

Antitachycardia pacing (ATP): When the heart beats too fast, a series of small electrical impulses are delivered to the heart muscle to restore a normal heart rate and rhythm.
Cardioversion: A low-energy shock is delivered at the same time as the heartbeat to restore a normal heart rhythm.
Defibrillation: When the heart is beating dangerously fast or irregularly, a higher energy shock is delivered to the heart muscle to restore a normal rhythm.
Antibrachycardia pacing: Many ICDs provide back-up pacing to prevent heart rhythms that are too slow.

Heart surgery

Surgery may be needed to correct arrhythmias that can’t be controlled with medications or nonsurgical treatment methods. Arrhythmia surgery may also be recommended if you need surgery, such as valve surgery or bypass surgery, to correct other forms of heart disease. The Maze and modified Maze procedures are two surgeries used to correct atrial fibrillation.Your doctor will determine the best treatment for you and discuss these options with you, including more information about surgical treatment if it is an appropriate treatment option.

Resources

Doctors vary in quality due to differences in training and experience; hospitals differ in the number of services available. The more complex your medical problem, the greater these differences in quality become and the more they matter.

Clearly, the doctor and hospital that you choose for complex, specialized medical care will have a direct impact on how well you do. To help you make this choice, please review our Miller Family Heart, Vascular & Thoracic Institute Outcomes.

Cleveland Clinic Heart, Vascular & Thoracic Institute Cardiologists and Surgeons

Choosing a doctor to treat your abnormal heart rhythm depends on where you are in your diagnosis and treatment. The following Heart, Vascular & Thoracic Institute Sections and Departments treat patients with Arrhythmias:

Section of Electrophysiology and Pacing: cardiology evaluation for medical management or electrophysiology procedures or devices – Call Cardiology Appointments at toll-free 800. 223.2273, extension 4-6697 or request an appointment online.
Department of Thoracic and Cardiovascular Surgery: surgery evaluation for surgical treatment for atrial fibrillation, epicardial lead placement, and in some cases if necessary, lead and device implantation and removal. For more information, please contact us.
You may also use our MyConsult second opinion consultation using the Internet.

The Heart, Vascular & Thoracic Institute has specialized centers to treat certain populations of patients:

Learn more about experts who specialize in the diagnosis and treatment of arrhythmias.

For younger patients with abnormal heart rhythms:

See About Us to learn more about the Sydell and Arnold Miller Family Heart, Vascular & Thoracic Institute.

Contact

If you need more information, click here to contact us, chat online with a nurse or call the Miller Family Heart, Vascular & Thoracic Institute Resource & Information Nurse at 216. 445.9288 or toll-free at 866.289.6911. We would be happy to help you.

Becoming a Patient

Treatment Options

Treatment Guides

Diagnostic Tests

Diagnostic tests are used to diagnose your abnormal heartbeat and the most effective treatment method.

Related Health Information

Anatomy

Webchats

Our webchats and video chats give patients and visitors another opportunity to ask questions and interact with our physicians.

Videos and Podcasts

Interactive Tools

Resource Links

Surgical Outcomes

Why choose Cleveland Clinic for your care?

Our outcomes speak for themselves. Please review our facts and figures and if you have any questions don’t hesitate to ask.

Types, Symptoms, Causes, Diagnosis & Treatments

Overview

What is an arrhythmia?

An arrhythmia (also called dysrhythmia) is an irregular or abnormal heartbeat.

What is my pulse?

How do I take my pulse?

You can count the number of beats in 10 seconds and multiply by 6 to determine your heart rate in beats per minute. A normal heart rate, at rest, is 50 to 100 beats per minute.

Your Heart Rate: Pulse in 10 seconds x 6 = _

Learn more about your pulse and target heart rate.

Heart Rhythms on ECG

The heart’s electrical system triggers the heartbeat. Each beat of the heart is represented on the electrocardiogram (EKG or ECG) by a wave arm.

Tachycardia: fast heart rhythm (greater than 100 beats per minute)

Bradycardia: slow heart rhythm (less than 60 beats per minute)

The Heart’s Electrical System

Arrhythmias that are recurrent or related to an underlying heart condition are more concerning and should always be evaluated by a doctor.

In most cases, treating the underlying condition will take care of the arrhythmia. If not, many medications and procedures are available to eliminate or control the abnormal heart rhythm.

What are the types of arrhythmias?

Tachycardia: A fast heart rhythm with a rate of more than 100 beats per minute.
Bradycardia: A slow heart rhythm with a rate below 60 beats per minute.
Supraventricular arrhythmias: Arrhythmias that begin in the atria (the heart’s upper chambers). “Supra” means above; “ventricular” refers to the lower chambers of the heart, or ventricles.
Ventricular arrhythmias: Arrhythmias that begin in the ventricles (the heart’s lower chambers).
Bradyarrhythmias: Slow heart rhythms that may be caused by disease in the heart’s conduction system, such as the sinoatrial (SA) node, atrioventricular (AV) node or His-Purkinje network.

Types of Supraventricular Arrhythmias

Supraventricular arrhythmias begin in the atria

Types of supraventricular arrhythmias include:

Premature atrial contractions (PACs)

Early, extra heartbeats that originate in the atria.

Paroxysmal supraventricular tachycardia (PSVT)

A rapid but regular heart rhythm that comes from the atria. This type of arrhythmia begins and ends suddenly.

Accessory pathway tachycardias (bypass tract tachycardias)

AV nodal re-entrant tachycardia (AVNRT)

A fast heart rhythm caused by the presence of more than one pathway through the atrioventricular (AV) node.

Atrial tachycardia

A rapid heart rhythm that originates in the atria.

Atrial fibrillation

Atrial flutter

An atrial arrhythmia caused by one or more rapid circuits in the atrium. Atrial flutter is usually more organized and regular than atrial fibrillation.

Types of Ventricular Arrhythmias

A ventricular arrhythmia begins in the heart’s ventricles.

Types of ventricular arrhythmias include:

Premature ventricular contractions (PVCs)

Ventricular tachycardia (V-tach)

Ventricular fibrillation (V-fib)

Long QT

Types of Bradyarrhythmias

A bradyarrhythmia is a slow heart rhythm that is usually caused by disease in the heart’s conduction system. Types of bradyarrhythmias include:

Sinus node dysfunction

Slow heart rhythms due to an abnormal SA node.

Heart block

Management and Treatment

How is an arrhythmia treated?

Medications

Antiarrhythmic drugs are medications used to convert the arrhythmia to a normal sinus rhythm or to prevent an arrhythmia. Other medications may include heart rate-control drugs and anticoagulant or antiplatelet drugs such as warfarin (a “blood thinner”) or aspirin, which reduce your risk of stroke or developing blood clots. It is important that you know the names of your medications, why they are prescribed, how often and at what times to take them, what side effects may occur, and what medications you have previously taken for your arrhythmia.

Lifestyle changes

Arrhythmias may be related to certain lifestyle factors. The following tips can help limit the occurrence of arrhythmias:

If you smoke, stop.
Limit your intake of alcohol.
Limit or stop using caffeine. Some people are sensitive to caffeine and may notice more symptoms when using caffeinated products, such as tea, coffee, colas and some over-the- counter medications.
Avoid using stimulants. Beware of stimulants used in cough and cold medications and herbal or nutritional supplements. Some of these substances contain ingredients that cause irregular heart rhythms. Read the label and ask your doctor or pharmacist which medication is best for you.
Your family may also want to be involved in your care by learning to recognize your symptoms and how to start CPR if needed.
If you notice that your irregular heart rhythm occurs more often with certain activities, you should avoid them.

Invasive therapies

Electrical cardioversion Patients with persistent arrhythmias, such as atrial fibrillation, may not be able to achieve a normal heart rhythm with drug therapy alone. Electrical cardioversion delivers an electrical shock to your chest wall, which synchronizes the heart and allows the normal rhythm to restart. This procedure is done after you receive short-acting anesthesia.
Catheter ablation: During ablation, energy is delivered through a catheter to tiny areas of the heart muscle. This energy can either “disconnect” the pathway of the abnormal rhythm, block the abnormal pulses and promote normal conduction of impulses, or disconnect the electrical pathway between the atria and the ventricles.
- Pulmonary vein isolation: In patients with frequent, paroxysmal or persistent atrial fibrillation, isolation of the pulmonary veins is a procedure that uses special catheters to render bands of vein tissue, thought to cause atrial fibrillation, dysfunctional. The goal is to isolate, rather than ablate, the foci responsible for triggering atrial fibrillation through a circumferential conduction block.
Electrical devices

Permanent pacemaker: A device that sends small electrical impulses to the heart muscle to maintain a normal heart rate. The pacemaker has a pulse generator (which houses a battery and a tiny computer) and leads (wires) that send impulses from the pulse generator to your heart muscle, as well as sense the heart’s electrical activity. Pacemakers are mostly used to prevent the heart from beating too slowly. Newer pacemakers have many sophisticated features that are designed to help manage arrhythmias, optimize heart rate-related functions and improve synchronization.
Implantable cardioverter-defibrillator (ICD): A sophisticated electronic device used primarily to treat ventricular tachycardia and ventricular fibrillation — two life-threatening abnormal heart rhythms. The ICD constantly monitors the heart rhythm. When it detects a very fast, abnormal heart rhythm, it delivers energy to the heart muscle to cause the heart to beat in a normal rhythm again.

There are several ways an ICD can restore a normal heart rhythm:

Antitachycardia pacing (ATP): When the heart beats too fast, a series of small electrical impulses are delivered to the heart muscle to restore a normal heart rate and rhythm.
Cardioversion: A low-energy shock is delivered at the same time as the heartbeat to restore a normal heart rhythm.
Defibrillation: When the heart is beating dangerously fast or irregularly, a higher energy shock is delivered to the heart muscle to restore a normal rhythm.
Antibrachycardia pacing: Many ICDs provide back-up pacing to prevent heart rhythms that are too slow.

Heart surgery

Resources

Cleveland Clinic Heart, Vascular & Thoracic Institute Cardiologists and Surgeons

Section of Electrophysiology and Pacing: cardiology evaluation for medical management or electrophysiology procedures or devices – Call Cardiology Appointments at toll-free 800.223.2273, extension 4-6697 or request an appointment online.
Department of Thoracic and Cardiovascular Surgery: surgery evaluation for surgical treatment for atrial fibrillation, epicardial lead placement, and in some cases if necessary, lead and device implantation and removal. For more information, please contact us.
You may also use our MyConsult second opinion consultation using the Internet.

The Heart, Vascular & Thoracic Institute has specialized centers to treat certain populations of patients:

Learn more about experts who specialize in the diagnosis and treatment of arrhythmias.

For younger patients with abnormal heart rhythms:

See About Us to learn more about the Sydell and Arnold Miller Family Heart, Vascular & Thoracic Institute.

Contact

If you need more information, click here to contact us, chat online with a nurse or call the Miller Family Heart, Vascular & Thoracic Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.

Becoming a Patient

Treatment Options

Treatment Guides

Diagnostic Tests

Diagnostic tests are used to diagnose your abnormal heartbeat and the most effective treatment method.

Related Health Information

Anatomy

Webchats

Our webchats and video chats give patients and visitors another opportunity to ask questions and interact with our physicians.

Videos and Podcasts

Interactive Tools

Resource Links

Surgical Outcomes

Why choose Cleveland Clinic for your care?

Our outcomes speak for themselves. Please review our facts and figures and if you have any questions don’t hesitate to ask.

Arrhythmia – NHS

Arrhythmias or heart rhythm problems are experienced by more than 2 million people a year in the UK. Most people with an abnormal heart rhythm can lead a normal life if it is properly diagnosed.

The main types of arrhythmia are:

atrial fibrillation (AF) – this is the most common type, where the heart beats irregularly and faster than normal
supraventricular tachycardia – episodes of abnormally fast heart rate at rest
bradycardia – the heart beats more slowly than normal
heart block – the heart beats more slowly than normal and can cause people to collapse
ventricular fibrillation – a rare, rapid and disorganised rhythm of heartbeats that rapidly leads to loss of consciousness and sudden death if not treated immediately

Arrhythmias can affect all age groups, but atrial fibrillation is more common in older people. Drinking alcohol in excess or being overweight increases your likelihood of developing atrial fibrillation.

You may also be at risk of developing an arrhythmia if your heart tissue is damaged because of an illness – for example, if you have had a heart attack or have heart failure.

Atrial fibrillation is a common cause of stroke. Having atrial fibrillation means your risk of stroke is 5 times higher than for someone whose heart rhythm is normal.

Certain types of arrhythmia occur in people with severe heart conditions, and can cause sudden cardiac death. This kills 100,000 people in the UK every year. Some of these deaths could be avoided if the arrhythmias were diagnosed earlier.

Common triggers for an arrhythmia are viral illnesses, alcohol, tobacco, changes in posture, exercise, drinks containing caffeine, certain over-the-counter and prescribed medicines, and illegal recreational drugs.

Information:

Coronavirus (COVID-19) advice

Get advice about coronavirus (COVID-19) and arrhythmia from the British Heart Foundation

How do you lower your risk of an arrhythmia?

It is not always possible to prevent an arrhythmia developing, although a healthy lifestyle can lower your risk of developing a heart condition.

Treatment aims to prevent future episodes. You can also make lifestyle changes so you avoid some of the triggers for your heart rhythm problem.

Your heart’s electrical system

The heart’s rhythm is controlled by electrical signals. An arrhythmia is an abnormality of the heart’s rhythm. It may beat too slowly, too quickly, or irregularly.

These abnormalities range from a minor inconvenience or discomfort to a potentially fatal problem.

Could you have an arrhythmia?

Symptoms of arrhythmias include palpitations, feeling dizzy, fainting and being short of breath, although having these symptoms does not always mean you have a heart rhythm problem.

Arrhythmia Alliance’s heart rhythm checklist can help you gather information to discuss with your GP if you have any of these symptoms.

Diagnosing arrhythmias

If your symptoms persist or there’s a history of unexplained sudden death in your family, it’s important for your GP to refer you to a heart specialist (a cardiologist or electrophysiologist who specialises in heart rhythm disorders).

The most effective way to diagnose an arrhythmia is with an electrical recording of your heart rhythm called an electrocardiogram (ECG). If the ECG doesn’t find a problem, you may need further monitoring of your heart.

This may involve wearing a small portable ECG recording device for 24 hours or longer. This is called a Holter monitor or ambulatory ECG monitoring.

If your symptoms seem to be triggered by exercise, an exercise ECG may be needed to record your heart rhythm while you are using a treadmill or exercise bike.

You should request a copy of your ECG. Take it with you to see the cardiologist or heart rhythm specialist and always keep a copy for future use.

Other tests used in diagnosing arrhythmias include:

cardiac event recorder – a device to record occasional symptoms over a period of time whenever you have them
electrophysiological (EP) study – a test to locate problems with the electrical signals in your heart by passing soft wires up a vein in your leg and into your heart while you are sedated
echocardiogram (echo) – an ultrasound scan of your heart

Treatment for arrhythmias

How your arrhythmia will be treated will depend on whether it is a fast or slow arrhythmia or heart block. Any underlying causes of your arrhythmia, such as heart failure, will need to be treated as well.

The treatments used for arrhythmias include:

medication – to stop or prevent an arrhythmia or control the rate of an arrhythmia
cardioversion – a treatment that uses electricity to shock the heart back into a normal rhythm while you are anaesthetised or sedated
catheter ablation – a keyhole treatment under local or general anaesthetic that carefully destroys the diseased tissue in your heart that causes the arrhythmia
pacemaker – a small device containing its own battery that is implanted in your chest under local anaesthetic; it produces electrical signals to do the work of the natural pacemaker in your heart to help it beat at a normal rate
ICD – a device similar to a pacemaker that monitors your heart rhythm and shocks your heart back into a normal rhythm whenever this is needed

Staying safe with an arrhythmia

If you have an arrhythmia that affects your driving, you must tell the Driver and Vehicle Licensing Agency (DVLA).

If your job involves working at height or with machinery that could be dangerous, you will need to stop work at least until your arrhythmia is diagnosed or you get treatment for your underlying condition. Get advice from your GP or cardiologist.

Support services

Find heart disease information and support services

Find atrial fibrillation services

Find pacemaker implantation services

Other heart rhythm pages

See the list below for information about specific heart rhythm problems.

Atrial fibrillation

Brugada syndrome

Heart block

Heart palpitations

Long QT syndrome

Supraventricular tachycardia

Wolff-Parkinson-White syndrome

Page last reviewed: 18 June 2018
Next review due: 18 June 2021

Arrhythmias (Heart Rhythm Disorders): Causes, Symptoms, and Types

Your heart is hard at work as it pumps blood and nutrients throughout your body. You can sometimes hear it or even feel it as it beats at a steady pace. It’s got an even, reliable rhythm that’s controlled by your body’s own electrical system.

When that system has issues, though, you get a change in your heart’s rhythm that’s called arrhythmia.

If you have an arrhythmia, it doesn’t necessarily mean you’ve got heart disease. There are many things that can cause your heart to flutter.

What Causes Your Heart to Break Its Rhythm?

It’s possible to have a random arrhythmia even if your heart is healthy. If you do, talk to your doctor.

Arrhythmias are caused by:

Symptoms of a Heart Rhythm Disorder

A typical heart will beat at 60 to 100 times per minute. It can beat faster if you need it to during exercise or in a stressful situation. It can slow down while you sleep. Your heart is used to slowing down and speeding up. That’s normal.

When its rhythm is interrupted, you might not notice. Some people, however, can feel it when it happens.

Common symptoms include:

Palpitations, or “skipped beats”
Thumping or fluttering in the chest
Sensation of the heart racing

Other things that might happen:

You may have these sensations and have no arrhythmias. The symptoms may be from anxiety, stress, or other causes besides a problem with your heartbeat.

What’s Controlling Your Heartbeat?

There’s a node in the upper right section of your heart that monitors your body’s need for blood. It’s called the sinoatrial (SA) or sinus node, and it acts like a natural pacemaker. It’s the main control and source of each heartbeat. It can speed up your heart rate when you need it, like when you exercise or get sick, or even when you feel happy.

Your SA node sends out electrical impulses across the heart. These cause the chambers to contract at specific times, causing a heartbeat.

Types of Arrhythmias

Heart arrhythmias fall into two categories. One starts from inside the heart’s lower chambers. Doctors call this kind “ventricular” because the lower chambers of the heart are the ventricles. The other kind starts outside or above the ventricles. You may hear these called “supraventricular” arrhythmias.

The most common types of arrhythmia include:

Premature atrial contractions. Doctors may call these “PACs” or “APCs.” When your heart contracts earlier than expected, it adds an extra heartbeat.

Supraventricular tachycardiaor paroxysmal SVT. This is when your heart beats rapidly because of abnormal electrical impulses above the lower heart chamber.

Sick sinus syndrome. This has nothing to do with the sinuses in your head. It’s about your heart’s SA node. Your electrical system fires abnormally, slowing down your heart rate.

Atrial fibrillation. This happens when your heart sends electrical impulses at a fast rate, causing a fast and irregular heartbeat.

Atrial flutter. Your heart misfires its electrical impulses, bringing on an irregular or fast heartbeat.

Premature ventricular complex, or PVCs. Your heart fires an abnormal electrical impulse, causing an early heartbeat. Usually, the heart returns to its normal rhythm right away.

Ventricular tachycardia. Your heart sends fast impulses and causes a very rapid heart rate. This is usually serious. Get medical help right away.

Ventricular fibrillation. Electrical impulses start in a fast and disordered sequence, which causes your heart to lose its ability to beat and pump blood. This typically causes cardiac arrest.

Supraventricular arrhythmias. These are more common, are generally temporary, and often aren’t serious. They can create a sensation of a fast heart beat and dizziness.

When to Get Medical Care

You may have noticed your heart racing, a fluttering in your chest, or a sensation that your heart skipped a beat. If this happens once or infrequently with no other symptoms, it’s usually not serious. Talk to your doctor about your questions and concerns. If you get treatment and it doesn’t help, make sure to let them know.

If you have any of these symptoms, call 911 right away:

Unexplained shortness of breath
Light-headedness or feeling faint
You feel that your heart is beating too slowly or too quickly
Chest pain with any of these symptoms

Heart Rhythm Tests

When your doctor checks you for heart rhythm disorders, they’ll ask about your symptoms, give you a physical exam, and give you a few tests.

An electrocardiogram (EKG) will track and record your heart’s rhythm to find out the type of disorder you have. It could take 24 hours or longer to find any problem. If the arrhythmia doesn’t happen often, your doctor will give you a Holter monitor or an “event recorder,” which you can turn on when you feel the symptoms.

Your doctor might recommend an echocardiogram, which is an ultrasound of the heart. It gives a better picture of the structure and function of your heart, looking at the size of the chambers of your heart and its valves.

In more serious cases, you might be tested with electrodes placed inside the heart. This is called an electrophysiologic study, and it is performed by an electrophysiologist.

Treatment for Heart Rhythm Disorders

If you need treatment, the kind you get will depend on your case. You might need medication, surgery, such as cardiac ablation, or a device implanted. During a cardiac ablation, the heart tissue that is causing the irregular rhythm is surgically destoryed. In another type of surgery, the doctor places an implanted cardioverter defibrillator (ICD) in your chest or belly. It will track your heart and reset your heart rhythm if it has a problem. Often, the ICD also works as a pacemaker to prevent you from developing a slow heart rate and to help your heart beat properly.

You’ll see your regular doctor, and probably a heart specialist, to make sure your treatment works well and to find out if the arrhythmia has returned.

Arrhythmias | Johns Hopkins Medicine

What You Need to Know About Arrhythmias

Normally, special heart cells generate an electrical signal that
travels through the heart. The electricity causes the heart muscle
to contract, and that’s what makes a heartbeat.
An arrhythmia means the heart is not beating in the proper rhythm.
This can cause anything from minor symptoms all the way to cardiac
arrest and death.
Since different rhythm disturbances need different treatments,
diagnosing the precise type of arrhythmia is important.
Advanced treatments include medication, destruction of cells that
produce unusual signals and devices inserted into the body to
generate proper heart rhythms.

When should I call an ambulance?

If someone experiences severe chest pain, shortness of breath, prolonged palpitations or racing heart
If someone loses consciousness. You may need to perform cardiopulmonary resuscitation (CPR) if the heartbeat or breathing has stopped, and use an automated external defibrillator (AED)

What is an arrhythmia?

An arrhythmia is an abnormality in the timing or pattern of the heartbeat. When you have an arrhythmia, your heart may beat too quickly or too slowly, or you may experience an irregular rhythm in which your heart feels as if it is “skipping a beat.”

Some types of arrhythmia may not be serious. Other types may be of great concern because they can cause fainting, heart failure or even sudden death. If you think you have an arrhythmia, consult your doctor.

How does a normal heart rhythm work?

The heart is a four-chambered muscle that pumps blood, which carries oxygen and nutrients, throughout the body. The two upper chambers of the heart, the right and left atria (plural of atrium), receive and collect the blood. The lower chambers, the right and left ventricles, pump the blood to other parts of the body.

The right atrium receives oxygen-depleted blood from the body and pushes it to the right ventricle. The right ventricle pumps blood through the pulmonary artery to the lungs, where it picks up oxygen.

In the same beat, the left atrium receives oxygen-rich blood from the lungs and pushes it to the left ventricle. The left ventricle pumps it through a large artery, called the aorta, to the rest of the body.

Heart Rhythms Depend on Electricity

The heart uses muscle contractions to pump blood through the body. A small burst of electricity causes the muscle to contract.

In normal heart function, an electrical impulse starts in the upper right chamber of the heart in the sinus node (sinoatrial node), often thought of as the heart’s natural pacemaker. The sinus node is a group of specialized cells capable of generating a momentary electrical current. The current spreads through the atria (upper chambers), causing them to contract and squeeze blood into the ventricles (lower chambers).

The electrical signal then travels to the atrioventricular (AV) node, located between the atria and the ventricles. The AV node delays the signal for a fraction of a second. This delay allows the ventricles time to fill completely with blood.

Once the ventricles are filled, the electrical impulse travels rapidly through the bundle of His, a network of specialized fibers. The bundle of His splits into the right and left bundle branches, which conduct the electrical impulse into the right and left ventricles. With that burst of electricity, the ventricles contract and pump blood out to the body.

Normally, the heart’s electrical system triggers the resting heart to beat in this precise sequence 60 to 100 times each minute. This is referred to as normal sinus rhythm. With exercise, the heart rate will increase to above 100 times per minute. A person’s peak heart rate can be calculated by subtracting their age from 220. For example, the peak heart rate for a 40 year old is 220 − 40 = 180.

What are the symptoms of arrhythmia?

Cardiac arrhythmias may cause a wide variety of symptoms, such as:

Palpitations: a racing, skipping or fluttering sensation in your chest
Dizziness or light-headedness
Fainting
Low blood pressure
Chest pain
Shortness of breath
Fatigue
Heart failure: heart can’t pump enough oxygenated blood through the body
Cardiac arrest: heart stops beating
Difficulty feeding (in infants)

Sometimes arrhythmias are silent, meaning they cause no obvious symptoms. A doctor can detect an irregular heartbeat during a physical exam by taking your pulse, listening to your heart or by performing diagnostic tests.

What are the different types of arrhythmias?

Palpitations: heartbeat that is out of rhythm. Occurs when the electrical signal does not originate from the sinus node
Supraventricular tachycardia — rapid heartbeat involving the atria (upper chambers of the heart). There are several types of supraventricular tachycardia:
- Atrial fibrillation: ineffective contractions of the atria caused by rapid, irregular signals from multiple sites in the upper half of the heart
- Atrial tachycardia: rapid beating of the atria, much faster than the ventricles, due to a “short circuit” in the upper half of the heart
- Atrial flutter: extremely rapid beating of the atria (between 240 and 340 times per minute) due to a “short circuit” in the upper half of the heart
- Paroxysmal supraventricular tachycardia (PSVT): rapid heartbeat caused by a “short circuit” resulting from an extra electrical pathway in the heart
Ventricular tachycardia: rapid, inefficient contractions of the ventricles
Bradycardia: slow heartbeat due to a failing sinus node or a blockage in the electrical circuit

What causes arrhythmia?

Arrhythmias have many different causes. Here are some examples:

Congenital abnormality of the heart’s electrical system: For example, some patients are born with an abnormal muscle fiber connecting the upper and lower chambers of the heart. The presence of this extra fiber can lead to paroxysmal supraventricular tachycardia (PSVT) later in life.
Inherited heart disease that causes abnormalities over time, setting the stage for an arrhythmia. One example is arrhythmogenic right ventricular dysplasia (ARVD): Patients with this inherited condition are born with normal hearts. But over time the heart muscle is replaced by fat and scar tissue, which can cause arrhythmias.
Acquired conditions: A heart attack, for example, can cause part of the heart muscle to turn to scar. Scar tissue may be the site of a “short circuit” and set the stage for ventricular tachycardia.
Changes over time: The heart may change as years pass, eventually developing an arrhythmia. The best example is atrial fibrillation, which is rare before age 50 but increases dramatically afterward. By the age of 80, one person in 10 has atrial fibrillation.

How are arrhythmias diagnosed?

Some diagnostic tests take place on site in a doctor’s office or hospital. Other tests provide monitoring at home as you follow your daily routine. Click each method to learn more.

On-Site Diagnostic Tests

Electrocardiogram (ECG or EKG): wires taped to various parts of your body to create a graph of your heart’s electrical rhythm
Exercise stress test: ECG recorded while strenuously exercising
Echocardiogramor transesophageal echocardiogram: ultrasound of the heart
Magnetic resonance imaging (MRI): imaging of the heart that does not involve radiation and can diagnose certain rare heart conditions
Computed tomography (CT): high-resolution X-rays; can be performed extremely quickly (ultrafast CT scans), which results in very low radiation exposure
Tilt table test: measurement of heart rate and blood pressure in response to upright tilt, which simulates prolonged standing; used to diagnose syncope (fainting)
Electrophysiology study (EP): test that examines the heart’s electrical activity from the inside; used to diagnose many heart rhythm disorders and performed prior to catheter ablation

In-Home Diagnostic Monitors

Holter monitor: a portable ECG you wear continuously from one to seven days to record your heart rhythms over time
Event monitor: a portable ECG you wear for one or two months, which records only when triggered by an abnormal heart rhythm or when you manually activate it
Implantable monitor: a tiny event monitor with a battery life of several years, inserted under your skin to record very occasional events

How are arrhythmias treated?

Treatment decisions are based on a thorough analysis of your condition, medical history, lifestyle and other factors. Click each treatment to learn more.

Procedures
- Catheter ablation: procedure to cauterize the specific heart cells that cause abnormal heart rhythms
- Cardioversion: procedure delivering a precisely controlled shock to your heart to “reset” an atrial fibrillation or atrial flutter; performed under anesthesia
Medications
Implanted devices
- Pacemakers: inserted under the skin below the collarbone, pacemakers deliver regular electrical pulses through thin, highly durable wires attached to the heart. Pacemakers are used to treat bradycardia, heart block and some types of heart failure
- Implantable cardioverter defibrillators (ICDs): a small implanted device that delivers an electrical pulse to the heart to reset a dangerously irregular heartbeat. Often used to treat ventricular tachycardia or heart failure
- Cardiac resynchronization therapy (CRT): a pacemaker or ICD used to treat certain types of heart failure that are caused by dyssynchronous contractions (when the chambers of heart beat out of time with each other)
Lifestyle changes
- Controlling hypertension
- Losing weight
- Limiting alcohol
- Treating sleep apnea

Arrhythmias – Cardiomyopathy UK

An introduction to heart rhythm disturbances.

Download a PDF version

The heart normally beats in ‘sinus rhythm’, controlled by electrical signals from within the heart.

When electrical signals are disrupted this can cause ‘arrhythmias’ – when the heart beats too fast,
too slow or erratically.

Some arrhythmias are harmless. Others require treatment with medication, surgery or devices.

Jump to:
Atrial fibrillation
Atrial flutter
Bundle branch block
Heart block
Ventricular fibrillation
Ventricular tachycardia

The structure of the heart

The heart is made up of four chambers, two on the right and two on the left. The upper chambers are the atria, which collect blood coming into the heart. The lower chambers are the ventricles, which
receive blood from the atria above. The ventricles are separated by a muscular wall called the septum.

The cardiac cycle

Blood flows around the body in ‘double circulation’: traveling through the heart twice on each complete cycle (from the heart to the lungs to pick up oxygen then from the heart to the rest of the body to deliver oxygen). The following is how this happens.

Deoxygenated blood (carrying no oxygen) enters the right atrium and the chamber fills with blood.

The atrium contracts, forcing the blood into the right ventricle.

The ventricle relaxes and fills with blood.

The ventricle contracts forcing the blood out of the heart through the pulmonary artery.

Blood flows to the lungs where it picks up oxygen.

From the lungs, blood flows into the left atrium.

The atrium contracts, forcing blood into the ventricle.

The ventricle relaxes and fills with blood.

The ventricle contracts forcing the blood out through the aorta to the body to deliver oxygen.

How the heart beats

The heart beat is controlled from within the heart itself, from an area of specialised muscle cells called the sinoatrial node or ‘SAN’.

The SAN spontaneously generates and conducts regular electrical impulses which make the chambers
of the heart relax and fill, or contract and empty, in sequence to force blood through the heart and to the lungs and the body. As the SAN controls the rhythm and speed of the heartbeat, it is sometimes referred to as the ‘pacemaker’. The following is how this happens.

Electrical activity is spontaneously generated by the SAN.

The electrical activity spreads through the muscle wall of both atria, making them contract.

The electrical activity is stopped from spreading to the ventricles by a layer of connective tissue.

Instead, the activity reaches a second group of specialised muscle cells called the atrioventricular
node (or AVN), between the two atria and the top of the ventricles.

The AVN passes the electrical activity down a group of muscle fibres called the Bundle of His,
which sits in the septum – the muscular wall between the two ventricles.

From the Bundle of His, the activity spreads into the left and right bundle branches and to the
smaller muscle fibres (Purkinje fibres). This causes the ventricle walls to contract from the bottom point of the heart (the apex) upwards, pushing the blood out of the heart.

What is a normal rhythm?

The normal rhythm of the heart is called ‘sinus rhythm’. This is when the electrical signals that control the heart beat are relayed through the heart, causing the heart’s chambers to fill and empty effectively and in sequence.

The speed at which the heart beats (pumps blood out) will vary, and depends on what the person is doing. For example, the heart beats more quickly when someone is exercising, and their body needs more oxygen to get to the muscles, than when someone is resting. A normal ‘resting’ heartbeat is usually between 60 and 100 beats per minute in an adult.

What are arrhythmias?

‘Arrhythmia’ is a general term for any abnormal heart rhythm, where the heart is not beating in sinus rhythm. Arrhythmias happen when the electrical signals that control the heartbeat are disrupted in some way.

Arrhythmias are changes in heartbeat that happen independently of the person’s state (not caused by the person’s activity or emotion). For example, the heart would normally beat faster during exercise, or in response to emotions such as fear or stress, but if the heart beats too fast out of context (where there is no other known cause), it may be an arrhythmia.

Some arrhythmias start in the atria (top chambers of the heart) and may be called ‘supraventricular’ as they start above (supra) the ventricles. Some start in the ventricles (the bottom chambers).

Arrhythmias can cause the heart to beat too fast (called ‘tachycardia’, usually more than 100 beats per minute in an adult) or too slow (called ‘bradycardia’, usually less than 60 beats per minute in an adult). Some cause ‘fibrillation’ where the electrical signals cause the heart to beat erratically (called ‘fibrillation’) and be uncoordinated.

Note: arrhythmias are sometimes referred to as ‘dysrhythmia’, and either term can be used.

What is the affect of arrhythmias?

Arrhythmias can reduce how effective the heart is at beating, and pumping blood around the body. This is because the heart’s chambers are uncoordinated or unable to pump properly.

Some arrhythmias are ‘normal’ and do not need treatment. For example, ‘sinus arrhythmia’ is normal and happens when you breath in. Some arrhythmias are short-lived, and may cause no lasting problem for the person. They may not even be aware of them happening. However, some people may be aware of a change in how their heart is beating. It might feel like it is pounding or fluttering, which can be uncomfortable. This is referred to as a ‘palpitation’. Arrhythmias can also cause feelings of dizziness, light-headedness or loss of consciousness, due to the reduced output of blood from the heart.

However, some arrhythmias are more persistent, or can have serious consequences. As they reduce how effective the heart is at pumping blood around the body, they can be life-threatening.

How are arrhythmias treated?

Arrhythmias are often treated with medication (‘anti-arrhythmic drugs’). However, some life-threatening arrhythmias are managed with an ICD (implantable cardioverter defibrillator). These devices constantly monitor the heart’s rhythm, and detect and monitor any arrhythmias in the ventricles. Depending on the type of arrhythmia, the ICD will treat this.

Types of arrhythmia

Below are different types of arrhythmia that may happen in people with cardiomyopathy. They are diagnosed with an ECG (electrocardiograph). This test records the electrical activity of the heart, and looks at the heart rate and rhythm, and how the electrical signals are conducted through the heart.

Atrial fibrillation (AF)

Atrial fibrillation (AF) is a common arrhythmia, and can affect anyone of any age. In cardiomyopathy it can be caused by the changes in the heart’s structure caused by the condition, for example where the muscle is enlarged in dilated cardiomyopathy. It affects the top chamber of the heart (the atrium).

In AF the normal electrical messages that cause the heart muscle to contract are interrupted by abnormal electrical impulses from the atria walls. This means that unlike the normal rhythm of contraction, the atria contracts fast, randomly and is uncoordinated (called ‘fibrillation’). The blood flow around the atria becomes ‘turbulent’. Some of the electrical impulses are passed on to the ventricles below, causing a characteristic fast and erratic heart beat.

AF can be paroxysmal (happening for a short time) or persistent (happening all the time). It can reduce the effectiveness of the heart’s pumping, and so cause palpitations, breathlessness and dizziness. Although AF is not life-threatening, the turbulent flow of blood in the atria can increase the risk of blood clots forming. This can increase the risk of stroke if a blood clot blocked blood flow in the brain.

AF is treated with anticoagulants (such as warfarin or apixaban) to reduce the chance of blood clots forming. Anti-arrhythmia drugs are often used to control the heart rate and rhythm. In some cases electrical cardioversion is used. This is where, under general anaesthetic, an electrical charge is given to the heart to shock it back into a normal rhythm. Some people may have surgery that stops the electrical impulses from the atria travelling to the ventricles, such as an ‘AV node ablation’. After this surgery, the electrical signalling in the ventricles needs to be taken over by an implanted pacemaker.

Read our Facebook group discussion (opens new window) about experiences of AF.

Atrial flutter

Atrial flutter is common, and can develop into atrial fibrillation. It is when the atrium beats (contracts and relaxes) in a regular rhythm but faster than normal. This means that it beats more frequently, and out of synchrony, with the ventricle below (which beats regularly but more slowly).

Atrial flutter is caused by a problem with the normal electrical signalling of the heart that ensures that the chambers of the heart beat in a synchronous rhythm. It is caused by small electrical circuits that form within the atria, so the electrical messages go around these circuits rather than being transmitted from the SAN to the AVN.

Atrial flutter can reduce the effectiveness of the heart’s pumping, and cause palpitations, dizziness
and breathlessness. Although it is not life-threatening, it can increase the risk of blood clots forming. This can increase the risk of a stroke if they block blood flow in the brain.

Atrial flutter is treated with anticoagulants (such as warfarin or apixaban) to reduce the chance of blood clots forming, and anti-arrhythmia drugs are often used to control the heart rhythm. Surgery, called ‘catheter ablation’, is often used to treat atrial flutter and involves a catheter (thin tube) being tunnelled through a vein or artery in the groin into the heart. Radio waves are then transmitted to destroy areas of the heart muscle and stop the transmission of the electrical signals that cause the arrhythmia.

Bundle branch block (BBB)

Bundle branch block (BBB) is when the transmission of electrical messages down the bundle branches in the ventricle walls are slowed down or blocked. These electrical messages usually cause the ventricles to contract, and so when they are slowed or blocked, the ventricles contract more slowly than usual.

BBB can affect the left and the right side of the heart. When the blockage is in the left bundle (called LBBB), the electrical messages travel down the right bundle (to contract the right ventricle), and then have to spread from the right ventricle to the left ventricle, in order for the left ventricle to contract. This means that the ventricles, which normally contract together, become uncoordinated.

The slow and uncoordinated contraction of the ventricles reduced the amount of blood that leaves the heart and circulates to the body.

BBB may not need treatment, depending on how often it happens and how it affects the individual. However, it is important to try and identify the cause. BBB in the left ventricle can happen in both dilated and hypertrophic cardiomyopathy, and can affect how effectively the heart pumps. In some cases a biventricular pacemaker may be needed. This type of pacemaker is used in cardiac resynchronisation therapy (CRT), as it helps both sides of the heart to beat together. This aims to improve how effectively the heart pumps, increase the output of blood, and reduce any symptoms.

Heart block

Heart block happens when the normal spread of electrical activity from the SAN to the AVN, which controls the contracting of the atria and ventricles in sequence, is slowed or stopped. The messages from the SAN may be partially blocked and so delayed in reaching the AVN, or they may be completely blocked. This results in the heart beating too slowly (bradycardia) or interruptions in the heart beat.

Heart block is sometimes called atrioventricular node (or AV node) heart block, if the electrical signals between the SAN and AVN (between the atrium and ventricle) are affected. In tachybrady syndrome, the SAN itself is affected, which affects the electrical signals it sends to the AVN.

Heart block can be caused by many conditions, such as coronary heart disease or a heart attack, high blood pressure, and also cardiomyopathy. It is usually diagnosed by an ECG, which looks at the electrical activity through the heart. It can also happen naturally as part of the aging process.

Heart block can be classified as either first-, second- or third- degree, depending on the symptoms.

First degree heart block – the transmission of the impulse to the ventricles is slightly delayed. The
person will probably have no obvious symptoms, and may not be aware that they have it. It may be
found during tests for other conditions. If they have no symptoms, they may not need treatment.

Second degree heart block – some of the impulses from the atria are not conducted to the ventricles. The person may have symptoms that need to be treated, such as feeling light-headed or dizzy, and fainting (loss of consciousness). They might also have chest pain and feel short of breath. Treatment includes having a pacemaker implanted, which takes over the electrical signalling in the heart to coordinate the contraction of the heart’s chambers.

Third degree heart block – none of the impulses from the atria are conducted to the ventricles.
The symptoms are the same as second degree heart block, but worse, and the person is more
likely to faint, and have palpitations. This type of heart block may require urgent treatment.

Ventricular fibrillation (VF)

Ventriular fibrillation (VF) is a serious arrhythmia. The contraction of the ventricles is uncoordinated and ineffective, so blood is not pumped out of the heart. This condition is life-threatening and requires urgent treatment with a defibrillator.

VF happens when the electrical activity of the heart becomes disorganised and erratic, when abnormal
impulses, coming from many parts of ventricle walls, interrupt the electrical signalling. This causes the ventricles to contract in a fast, uncoordinated way, and ‘quiver’ (or ‘fibrillate’) rather than contract normally. This means that the heart can’t pump out blood effectively, so the heart output is greatly reduced. This means that blood supply to the vital organs such as the brain is affected. Early symptoms can include dizziness and shortness of breath, and the person will lose consciousness and collapse.

VF can be a cause of cardiac arrest. This is when the output of the heart stops suddenly and the person collapses, which can be fatal. However, a shock to the heart (from an AED orICD) interrupts these abnormal ‘chaotic’ signals. This literally ‘de-fibrillates’ (stops the fibrillation), and restores sinus rhythm.

There can be many causes of VF, including a heart attack, or developing from ventricular tachycardia.
It can also be caused by cardiomyopathy. The risk of VF caused by cardiomyopathy can be treated in several ways. Medication such as anti-arrhythmic drugs control the heart’s rhythm and help to prevent arrhythmias happening.

ICDs can be used to monitor the heart’s rhythm and, if a dangerous arrhythmia such as VF is detected, give a shock to the heart to interrupt the arrhythmia and restore the normal heart rhythm.

Ventricular tachycardia (VT)

Ventricular tachycardia (VT) is an arrhythmia that starts due to abnormal electrical activity happening within the ventricle walls, which affects the normal electrical signalling in the heart. It causes the ventricles to beat too quickly (over 100 beats per minute), out of synchrony with the atria. This means that the ventricle doesn’t have time to fill properly so blood cannot be pumped around the body effectively.

VT can be caused by different heart conditions, including a heart attack, and often happens in people
with heart failure. However, cardiomyopathy is a common cause of VT.

VT can be brief and not cause any problems. However, it can be more prolonged it can cause dizziness and light-headedness, and sometimes collapse. The person may have palpitations and chest pain. In extreme cases, it can lead to VF (see above) and can cause the heart’s function to be reduced so much that emergency resuscitation is needed.

VT may be treated with anti-arrhythmic drugs to control the heart’s rhythm and so help to prevent
arrhythmias happening. In some cases, surgery known as radio frequency ablation is used to destroy the area of heart muscle that is generating the abnormal electrical activity.

Some people will have an ICD, to monitor the heart’s rhythm and detects arrhythmias. If it detects a too-fast rhythm which doesn’t return to sinus rhythm, the it ‘paces’ the heart (takes over the electrical signals controlling the heart rate) by giving fast electrical impulses to interrupt the arrhythmia. This is called ‘anti-tachycardia pacing’. If pacing the heart doesn’t restore sinus rhythm the ICD will send an electrical shock to the heart to try stop the arrhythmia and convert the heart back into sinus rhythm.

Arrhythmias in Children | Cedars-Sinai

Not what you’re looking for?

What are arrhythmias in children?

An arrhythmia is an abnormal rhythm of the heart. In an arrhythmia, abnormal electrical
signals through the heart muscle may cause the heart to beat too fast (tachycardia),
too slow (bradycardia), or irregularly. When the heart doesn’t beat normally, it isn’t
able to pump blood to the body as well. That means the brain, lungs, and other organs
may not get enough blood. And the organs can’t work as well and may become damaged.

Arrhythmias in children include:

Long-Q-T syndrome (LQTS). This is a
condition passed from parents to children (inherited). It usually affects children
and young adults. Many children have no symptoms, but fainting is common in those
who
do. It may also cause cardiac arrest
Premature atrial contraction (PAC) and
premature ventricular contraction (PVC).
PACs or PVCs are abnormal beats that
start in the upper chambers of the heart
(atria) or the lower chambers of the heart (ventricles). They are common in
children and teens. Often, they are considered completely normal and harmless.
Sinus tachycardia. A fast heart rate that occurs with fever, excitement, and exercise. It is normal.
Supraventricular tachycardia (SVT),
paroxysmal atrial tachycardia (PAT), or paroxysmal supraventricular tachycardia
(PSVT).
This is the most common tachycardia in children. An abnormal electric
circuit or focal site in the atria can cause rapid heart rates. Treatment may be
needed if it happens often or lasts long.
Wolff-Parkinson-White (WPW) syndrome.
This is an abnormal electrical signal that gets to the ventricle over an extra
electrical pathway. It’s present since birth. A fast heart rate is a common symptom.
Or a child may not have symptoms. Sudden cardiac death may rarely occur.
Ventricular tachycardia (VT). This is
a potentially life-threatening arrhythmia. It may be from serious heart disease. It
is caused by a very fast electrical signal from the ventricles. A child may feel
weak, tired, dizzy, or may faint (syncope). He or she may also feel his or her heart
beat (palpitations).
Sick sinus syndrome. The heart’s
natural pacemaker (sinus node) doesn’t work as it should. This causes slow heart
rates. . It may occur in children who have had open heart surgery. A child may not
have symptoms. A child with symptoms may be tired or dizzy, or may faint.
Complete heart block. The electrical signal from the upper to lower chambers is blocked. The heart usually
beats considerably more slowly. This problem may happen after heart surgery or be
caused by heart disease. It may cause a child to faint.

What causes arrhythmias in a child?

The cause of an arrhythmia may be unknown. Some known causes in children include:

Heart problem that is present at birth (congenital)
Heart problem that is inherited
Infection
Abnormal levels of certain chemicals in the blood
Normal reaction to exercise, fever, or emotions
Changes in the structure of the heart
Electrical conduction abnormality

What are the symptoms of an arrhythmia in a child?

A child with an arrhythmia may not have any symptoms. For those who do, these are
the most common symptoms:

Feeling weak
Feeling tired
Feeling like the heart is fluttering (heart palpitations)
Low blood pressure
Feeling dizzy
Fainting (syncope)
Not feeding or eating well

The symptoms of an arrhythmia may look like other health conditions or heart problems.
Make sure your child sees his or her healthcare provider for a diagnosis.

How is an arrhythmia diagnosed in a child?

Your child’s healthcare provider will ask about your child’s health history and family
history. He or she look for signs and symptoms of an arrhythmia. The provider will
give your child an exam focusing on the heart. Your child may need to see a pediatric
cardiologist. This is a doctor with special training to treat children with heart
problems. Your child may need tests, including:

Electrocardiogram (ECG). This simple
test measures the electrical activity of the heart. An ECG may show an arrhythmia.
The test may be a:
- Resting ECG. Your child will
  lie down while electrodes are connected to the ECG machine by wires. The ECG
  records the heart’s electrical activity for a minute or so.
- Stress test (exercise ECG).
  Your child is attached to the ECG machine as described above. He or she
  will walk on a treadmill or pedal a stationary bike while the ECG is recorded.
  This test is done to check the heart during exercise.
Holter monitoring. Your child will
have his or her heart rhythm checked over 24 to 48 hours. A small portable monitor
is
worn while your child goes about his or her usual activities.
Electrophysiologic study (EPS). For
this test, the doctor puts a small, thin tube (catheter) into a large blood vessel
in
an leg or arm. The doctor moves the catheter to your child’s heart. This test can
find out the type electrical signal causing the problem, and where the signal
is.
Tilt table test. This test may be
done if your child faints often. The test checks your child’s heart rate and blood
pressure as he or she changes position.
Echocardiography (echo). This test
uses sound waves to make detailed pictures of your child’s heart structure and
function.
Implanted loop recorder. This heart monitoring device may be
used when the doctor thinks your child is at high risk for arrhythmia and other
testing has not given a straight-forward result. This test may only be used in
children who are high risk. The device is put under the skin. Itis used for long-term
monitoring

How is an arrhythmia treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also
depend on how severe the condition is. Some children don’t need treatment. If your
child needs treatment, he or she will likely be cared for by a pediatric cardiologist.
Treatment may include:

Medicines. Medicines can ease
symptoms.
Radiofrequency ablation. This
procedure uses a special catheter to destroy the tissue causing the abnormal
electrical signals.
Surgery. Surgery can stop an abnormal
heart rhythm.
Pacemaker. An artificial pacemaker
may be needed with some arrhythmias. The pacemaker is a small device that is put
inside the abdomen or chest. It gives a small amount of electricity to the heart to
keep it beating regularly. Your child may need this if he or she has a slow heart
rate.
Implantable cardioverter defibrillator
(ICD).
This a device is put in the chest or abdomen. It automatically sends a
shock to stop an abnormal and dangerous rhythm. Some ICDs also work as
pacemakers.
Electrical
cardioversion.
An electric shock is given. This briefly stops the abnormal
electrical action in the heart. It “resets” the heart’s normal pacemaker. The heart
can then restart in a normal rhythm.

What are the possible complications of an arrhythmia in a
child?

Complications can happen, depending on the type of arrhythmia and how serious it is.
Complications may include:

Damage to the brain, kidneys, lungs, liver, or other organs
Heart failure
Blood clots. A blood clot in the brain may cause a stroke.
Sudden cardiac death

How can I help my child live with an arrhythmia?

Some arrhythmias don’t cause any
problems. Some are more serious. A child with a serious arrhythmia will need frequent
checkups.

Talk with your child’s healthcare provider about managing your child’s arrhythmia.
Your child may need regular tests. Or your child may not be able to take part in some
sports or activities.

When should I call my child’s healthcare provider?

Call your child’s healthcare provider if your child has symptoms of an arrhythmia.
These include:

Feeling weak or tired
Having heart palpitations
Feeling dizzy
Fainting (syncope)
Not feeding or eating well

Key points about arrhythmias in children

An arrhythmia is an abnormal heart rhythm. It may be a heart rate that is too fast,
too slow, or irregular.
An arrhythmia may not cause any symptoms. Or an arrhythmia may cause moderate to very
serious symptoms.
An arrhythmia may not need treatment.
If treatment is given, your child may need medicine, radiofrequency ablation, a
device, or surgery.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

Know the reason for the visit and what you want to happen.
Before your visit, write down questions you want answered.
At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you for your child.
Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are.
Ask if your child’s condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if your child does not take the medicine or have the test or procedure.
If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
Know how you can contact your child’s provider after office hours. This is important
if your child becomes ill and you have questions or need advice.

Not what you’re looking for?

90,000 Cardiac arrhythmias (arrhythmia)

Cardiac arrhythmias can occur in practically healthy people, are manifestations of almost any heart disease. The reasons for their development include excitement, stress, alcohol consumption, strong tea, coffee, reflex effects in the pathology of internal organs with ischemic heart disease, myocarditis, cardiomyopathies, heart failure. Heart rhythm disturbances can be the cause of death.

If you feel any irregularities in the heart rhythm, immediately consult a doctor!

Etiology and pathogenesis

Any violation of electrical function or damage to the myocardium can lead to the development of arrhythmias. The mechanisms of development of arrhythmias are impulse formation disorders.

Symptoms

Patients with cardiac arrhythmias usually complain of palpitations, cardiac arrest, cardiac arrest. Arrhythmia can also manifest as fainting, hypotension and even the development of cardiac asthma, pulmonary edema, arrhythmic shock.

Diagnostics

It is possible to suspect arrhythmia according to the anamnesis, but to identify it by physical examination (examination, pulse measurement, auscultation).To clarify the diagnosis, ECG and daily (Holter) ECG monitoring are performed. Arrhythmia can also be detected by provoking it through exercise ECG tests. Echocardiography is used to establish the causes of rhythm disturbances.

Along with the above-mentioned methods, the “Cardiological Center for Diagnostics and NLS-Treatment” applies in its practice the latest technology of NLS-graphy. This diagnostic method is universal, since it includes the possibilities of both ECG and EchoCG, ultrasound and other methods.Thanks to NLS-graphy, an accurate diagnosis can be made in the shortest possible time, which, in turn, contributes to the operative treatment and speedy recovery of the patient.

Treatment in the “Cardiological center for diagnostics and NLS-treatment”

After the diagnosis is made, it is necessary to take measures to get rid of the arrhythmia. Specialists of the “Cardiological Center for Diagnostics and NLS-Treatment” will select an individual therapeutic program aimed at treating the underlying disease causing arrhythmia.Then a list of drugs that can cause arrhythmia and which are contraindicated for taking will be compiled. After the treatment of the underlying disease, the cardiologists of the Center will direct their efforts to treating the arrhythmia itself with antiarrhythmic drugs. The final stage is the prevention of repeated attacks of arrhythmia.

We know that in the treatment of any cardiovascular disease, it is necessary to apply complex methods in order to exclude cases of relapse. But at the same time, we do not forget about the individual approach, because each person is individual, which means that the ailment with which he asked for help must be considered separately.

Arrhythmia or irregular heartbeat – Treatment of cardiovascular diseases

An irregular heart rhythm is an abnormality in the frequency, rhythm and sequence of contractions of the heart muscle.

The contraction of the muscles of the heart occurs at a certain pace and rhythm. The heartbeat of a healthy person is distinguished by a fairly clear rhythmic “pattern”, and since this is an autonomous process that practically does not depend on human activity, unlike, for example, the muscles of the arms and legs, a healthy person often simply does not pay attention to the fact that how his heart beats – the rhythm of heart contractions retains its uniformity even when the pace is increased.The frequency of sinus rhythm in most healthy adults at rest is 60-75 beats per minute.

But if disturbances appear in the picture of these contractions, the heart immediately makes itself felt.

Arrhythmias can occur with structural changes in the conducting system in heart disease and under the influence of autonomic, endocrine and other disorders, with intoxication and some drug effects.

Arrhythmia is diagnosed by ECG.

There are several types of arrhythmia (Sinus tachycardia, sinus bradycardia, paraxysmal tachycardia, extrasystole, atrial fibrillation).The symptomatology of each type is different. But any rhythm disturbance, an increase in frequency to 100-140 and more beats per minute, a decrease to 50-60 beats, tremors, premature heart contraction, as well as a feeling of a rapid heartbeat are signs of one or another type of arrhythmia and requires an urgent visit to a cardiologist.

The causes of arrhythmia can be different, it can be caused by stress, tension, as well as concomitant diseases, for example, bradycardia is more common in neuroses, pathology of the digestive system, decreased thyroid function.That is why the cardiologist prescribes treatment only after identifying the main cause that caused the heart rhythm disturbance.

Doctors and cardiologists of the Sadko Clinic Network have all the diagnostic and therapeutic capabilities for the localization, diagnosis and treatment of all types of arrhythmias. Each patient, upon detection of a concomitant disease, has the opportunity to undergo consultation with the necessary specialist.

90,000 Treatment in Germany and Switzerland

If the heart goes out of this rhythm, they talk about heart rhythm disturbances or arrhythmias.Depending on the severity and type of rhythm disturbances, they are divided into several groups. If the heart beats too slowly (below 60 beats per minute), it is called bradycardia. A too fast heartbeat is called tachycardia (100 beats per minute at rest). In addition, there are additional strokes (arrhythmias) or blockage of the conduction of excitation in the heart.

What is arrhythmia?

The human heart beats rhythmically with a frequency of 60 to 100 beats per minute. The heartbeat occurs when the cells of the heart muscle are stimulated by an electrical impulse and this stimulation is transmitted to each cell of the heart.Arousal begins in a small area of the right atrium called the sinus node. It generates its own rhythm and transmits it along specific pathways to the rest of the heart. This frequency can be influenced by various parameters (for example, the state of the sympathetic nervous system, parasympathetic, agitation / tension / physical activity and, conversely, relaxation / digestion).

Not all types of cardiac arrhythmias are pathological. For example, episodic extrasystoles can also occur in healthy people.

What are the causes of abnormal heart rhythms?

Cardiac arrhythmias can have various causes. Most of them are also symptoms.

The reasons include direct disturbances in the heart. They can be congenital, like some types of heart defects, electrical impulse conduction disorders, or ion channel defects. Also, acquired damage to the heart muscle from inflammation of the heart (myocarditis), heart attack, or heart valve disease can lead to irregular heart rhythms.

In addition, irregularities outside the heart can lead to arrhythmias. Since the conduction of an electrical impulse in the heart is carried out by the exchange of ions (for example, potassium and magnesium) between the cell and its environment, electrolyte disturbances, thyroid problems and medications can lead to cardiac arrhythmias.

In addition, stress, lack of oxygen, or alcohol can lead to heart failure. For example, alcohol in some people can cause atrial fibrillation, which is also known as holiday heart syndrome, as it often occurs with excessive alcohol consumption on vacation or on weekends.

Nevertheless, there are cases of cardiac arrhythmias in which, even after a long search, the cause cannot be found.

What are the symptoms of this disease?

Depending on the type of arrhythmia, various symptoms appear. For example, additional contractions of the heart, as a rule, lead to interruption of the next beat, which is sometimes a clear extrasystole. Palpitations are irregular or intense cardiac activity. If the heart beats too quickly, whether regularly or irregularly, there is a kind of anxious heartbeat.Sometimes a person can feel it in the neck.

In addition, pain in the heart (angina pectoris) may occur, and you should consult a physician or

cardiologist

due to the risk of a heart attack.

Since an abnormal heart rhythm can in some cases lead to a massive decrease in heart function, there is a risk of too low cerebral blood flow. In this case, dizziness, convulsions, speech or vision disorders begin. In this case, the stimulation of the heart muscle is irregular, so that rational muscle contraction and the release of blood are no longer possible.In this case, arrhythmias can also lead to fainting (syncope), circulatory failure, and in the worst case, death.

In addition, the underlying medical condition, such as

heart failure

may worsen significantly due to abnormal heart rhythms. This leads to shortness of breath even at rest and the accumulation of fluid in the lungs (pulmonary edema), a change in circulatory pressure that the heart can no longer maintain.

What are the diagnostic methods?

Symptoms usually lead the patient to

general practitioner

or

therapist,

who, after taking a history (medical history) and physical examination (including heart rate and blood pressure measurements, listening to the heart and lungs), performs an ECG (electrocardiography).

When conducting an ECG, up to 12 electrodes are placed on the patient’s body. Then you can investigate the current in the heart, determine if there are violations, and even find the first data on the cause of the arrhythmia.

Since a single ECG measurement usually does not show the full picture of the disease (conventional ECG), a stress ECG (cycling) may be needed. Here you can see arrhythmias that do not appear at rest. In addition, long-term ECG monitoring can be done. Electrodes and a small measuring device are usually attached to the patient’s body for 24 hours.After 24 hours, the ECG results are evaluated

cardiologist

…

Since electrolyte imbalances or thyroid disorders can also lead to cardiac arrhythmias, blood tests are done to check for specific parameters.

Another research method is echocardiography. This is a type of ultrasound in which both the structure and movement of the walls and valves of the heart and the blood flow in the main muscle of the human body can be measured. Echocardiography can be performed at rest and while moving (with stress).In addition, there is an ultrasound examination of the heart through the esophagus (transesophageal echocardiography), which helps to examine the heart from different angles.

Then there are invasive electrophysiological studies. This is a special type of cardiac catheterization. This method makes it possible, with the help of a small tube, which is inserted through a vein or artery into the heart, to examine electrical currents and the place of origin of arrhythmias and, if necessary, to carry out therapy with current pulses (depending on the cause).

How is arrhythmia treated?

Some types of cardiac arrhythmias pose no threat and do not require treatment. However, there are other species that can be extremely dangerous and even fatal. In this connection, all people should at least once check the presence of arrhythmia in

cardiologist

or

therapist

…

In any case, it is always necessary to treat the underlying disease. These are usually diseases of the thyroid gland, poisoning or electrolyte imbalance.Some causes do not respond to conservative treatment and require more invasive therapy.

(cardiac surgery),

for example, valve replacement or coronary artery bypass grafting in

coronary heart disease

…

Sometimes the patient (especially in old age) can do without surgery by undergoing medical treatment. For this, there are a number of so-called antiarrhythmics. These are drugs that (depending on the mode of action) regulate heart contractions in different ways.

If these measures do not help, the next step is to install

pacemaker

… If there is a risk of sudden death from cardiovascular disease (often with

coronary heart disease

) a defibrillator can be implanted.

What are the prognoses and the likelihood of disease progression in cardiac arrhythmias?

Many types of cardiac arrhythmias can be fatal and should be taken seriously.Here, treatment is a must. If targeted therapy follows after identifying the cause, the patient has a good chance of returning to normal life.

Of course, any therapy involves its own risks, both medical and surgical. However, the healer

cardiologist

or

therapist

should discuss all options with the patient and consider their advantages and disadvantages before starting any therapy. If the patient has any questions, he needs to consult a doctor.The better the patient is aware of his problem, the better he can cope with it.

Treatment makes it possible to live a normal life again, without fainting and loss of consciousness due to heart rhythm disturbances – with such symptoms, driving is prohibited.

If a person suffers from cardiac arrhythmias or discovers the corresponding symptoms, he needs to contact a specialist.

Sources:

Gerold, Gerd: Internal Medicine.Cologne, self-published 2012.

Arashee, K .; Bankler, H.-W. ; Bieber, C .; and etc:. Internal medicine. Stuttgart, Ed. Georg Thieme KG 2009.

Heart rhythm disorders – diagnosis and treatment at affordable prices in Chelyabinsk

Heart rate normally ranges from 60 to 80 beats per minute. Unfortunately, in some cases, under the influence of a number of external and internal factors, the heart rhythm changes, and its disturbances occur. The result is chest pain.Patients complain of weakness, shortness of breath, pronounced sensations of heart contractions. The symptoms are not just unpleasant, they are frightening, which provokes severe emotional discomfort.

What to do in case of an attack?

Call an ambulance and see a cardiologist in the near future!

You can take advantage of the support of an experienced professional at the CityMed Clinic of Allergology and Immunology!

Why is the heart rate beating?

The reasons for cardiac arrhythmias can be:
Pathologies of the cardiovascular system (coronary heart disease, defects, cardiomyopathy, arterial hypertension).
Diseases of the thyroid gland.
Alcohol poisoning.
Various tumors.
Dehydration.
Severe hypothermia and other stressful situations.

Factors that provoke heart rhythm disturbances include obesity, bad habits and age over 45-50 years.

Why is it important to see a doctor as soon as possible?

Heart rhythm disturbances are dangerous not only by disturbances in blood circulation, but also by the development of complications such as collapse (a sharp drop in blood pressure), stroke, pulmonary embolism, etc.Lightning-fast seizures in some cases lead to serious consequences.

Treatment of cardiac arrhythmias should be carried out by specialists and is not limited to taking nitroglycerin. Patients are prescribed whole complexes of drugs. They are all safe and effective when taken correctly. The doctor constantly monitors the treatment of cardiac arrhythmias and the patient’s condition. This allows you to achieve a stable positive result of therapy.

Looking for professional support? Call and make an appointment with a cardiologist by phone +7 (351) 265-55-15

Cost of services

Therapist, doctor’s consultation

1000 p.

Heart rhythm disturbances

The heart is a muscular sac that carries oxygen-rich blood to all organs, contracting more than 100,000 times a day. Each contraction is a multi-stage process in which the heart must contract, the valves must open and close exactly at a specific moment, and blood must be pumped at a precisely defined pressure into the aorta – and so on more than 4,000 times an hour.

All this complex orchestra is conducted by the electrical conduction system of the heart (in medical language it is called the Sinus Node, located in the right atrium.It is she who controls the process and synchronizes the contractions of the “pump” -the heart. It sends electrical commands through special fibers. These commands force the atria and ventricles of the heart to contract, pumping blood through the body. It is with disturbances in the electrical conduction system of the heart that diseases under the general name “heart rhythm disturbances” or “arrhythmias” are associated.

Possible causes of cardiac arrhythmias:

The spectrum of violations of this series is very wide – starting from extrasystole (premature contraction of the heart muscle), which has no clinical significance, and almost every person at one time or another in his life felt it, through cases of tachycardia (heart rate acceleration) of varying strength and degree of danger , and up to a violation of the rhythm of the heart, which can become fatal, for example, ventricular fibrillation (very fast scattered, arrhythmic and uncoordinated contractions of individual groups of muscle fibers of the ventricles of the heart) can lead to the death of the patient if a defibrillator is not used during resuscitation.

Patients with a history of heart disease (heart attack, atherosclerosis, dysfunction of the heart valves, etc.) are at risk of developing arrhythmias. For example, in some people who have had a heart attack, scars appear on the heart muscle, which disrupt the correct flow of the electrical signal, and therefore can cause irregularities in the heart rhythm. In addition, there are genetic diseases that negatively affect the heart muscle (such as cardiomyopathy) and increase the risk of arrhythmias.At the same time, sometimes cardiac arrhythmias manifest “on their own”, for no apparent reason, in people without a history of heart disease, when most of the problem is electrical conduction disturbances (for example, Long QT Syndrome), or in people in general with a seemingly healthy heart.

Arrhythmia diagnosis:

Diseases associated with arrhythmia are dealt with by a cardiologist specializing in electrophysiology (a section of physiology that studies electrical phenomena in the body).

As in any diagnosis, the first stage is taking an anamnesis, describing the history of the disease (“When did you start to feel cardiac arrhythmias for the first time?”), A detailed description of the symptoms (“What exactly do you feel at this moment?”), Physical examination, listening heart with a stethoscope.
Electrocardiogram. A routine ECG test is an integral part of the initial diagnosis.

After her, the doctor can send the patient for checks related to pulse and rhythm disturbances.In fact, these are ECG subspecies, since rhythm disturbances appear and disappear, and the regularity of their occurrence is not always clear, and the meaning of these checks is to “catch” the violation and obtain information about its properties.

The classic test in this area is the Holter ECG, a small and mobile device that is attached to the patient’s body for 24 hours and records information. He has two electrodes that are attached to the chest and transmit data on cardiac activity throughout the day.After that, the patient returns the device to the laboratory and the doctor decrypts the results.

The disadvantage of this check is that arrhythmia does not always appear on this day, therefore it is also customary to do an ECG under load

Ergometry (ECG under stress) is a test that is performed in a cardiology clinic. The patient moves on a treadmill (receives a cardiac load), and at this moment his heart ECG is taken.The point of the test is to put the patient’s heart into a state of stress and check whether this will cause harmless extrasystole or significant pathological changes in the heart rhythm.

If these two checks did not reveal any violations, then the patient can be referred for additional in-depth diagnostics.

The Loop Recorder check is similar to the Holter ECG, but it lasts for a month. The patient must press the button when he feels an arrhythmia, then the device saves in the ECG record for several minutes before and after pressing.
Cardio beeper or cardiophone – a device that maintains telephone communication with the clinic and transmits information and ECG recording immediately at the time of arrhythmia manifestation.
Electrophysiological study (EPI) is an invasive study in which electrodes are inserted into the body through the groin to obtain information about heart rhythm disturbances.

It is important to note that the vast majority of patients who have suffered from cardiac arrhythmias once do not need special treatment, and they may only need diagnostics followed by periodic monitoring.

At the same time, a certain number of patients have repeated episodes of arrhythmia, which negatively affects the general condition, and in extreme cases may even pose a threat to life. In such cases, treatment is required, which can only be prescribed by a specialist doctor.

90,000 Cardiac arrhythmias – arrhythmias

At the Yauza Clinical Hospital, a preventive and in-depth cardiological examination is carried out to identify cardiac arrhythmias and their causes (ECG, ECHO-KG, veloergometry, holter, laboratory tests, specialist consultations).We carry out successful treatment of arrhythmias with conservative and minimally invasive surgical methods (cardioresynchronizing techniques, radiofrequency ablation of the focus, professor A.V. Ardashev operates).

One of the main indicators of the effective work of the heart is the correct rhythm. Violations, changes in the heart rate are called arrhythmias. They can be caused by both heart disease (myocarditis, myocardial infarction, etc.) and extracardiac pathology (changes in hormonal levels, disruption of the autonomic nervous system, electrolyte imbalance, etc.)).

Make an appointment with a cardiologist

Types of cardiac arrhythmias

Tachycardia , that is, an increase in the frequency of more than 90 beats / min. In the case when an increase in frequency occurs paroxysmal, they speak of paroxysmal tachycardia.
Bradycardia . This is the name for a decrease in the heart rate of less than 60 beats / min.
Extrasystole . This term denotes the appearance of premature and often irregular heartbeats (extrasystoles).
Atrial fibrillation or atrial flutter (fibrillation) . Depending on the frequency of ventricular contraction, they talk about the normo- or tachy-form of atrial fibrillation.
Wolff-Parkinson-White syndrome (WPW) . Change in rhythm that occurs in the presence of an additional beam of impulse conduction.
Heart block . That is, a violation of the conduction of the excitation impulse through the conducting system of the heart.

Symptoms of arrhythmia

Changes in the frequency and quality of the heartbeat. Some patients describe these sensations as “flip”, “somersault”, short-term “freezing”, even “gurgling”. Perhaps a sensation of intensification of heart beats, recoil to the shoulder, neck, pulsation in the ears.
Dizziness up to dimness of consciousness and fainting.
General weakness, sometimes sweating.
Arrhythmias are often associated with chest pain.
Against the background of arrhythmia, an increase or decrease in blood pressure is possible with the appearance of corresponding symptoms.

Complications of arrhythmias

The most dangerous complication of arrhythmias is cardiac arrest.
Violation of blood circulation can lead to the formation of blood clots that enter different vessels with the current, causing vascular catastrophes and focal necrosis where there is a “blockage” of the artery (brain, heart muscle, lungs, kidney, intestines, etc.).etc.).
Chronic heart rhythm disturbance leads to the development of heart failure.

Survey

If you suspect an arrhythmia, you must undergo a cardiac examination. However, a more or less deep, annual examination for the detection of heart disease is indicated for all patients over 40 years of age.

In the Clinical Hospital on Yauza, the following methods are used to study cardiac activity:

Electrocardiography and echocardiography (ultrasound of the heart).
Daily Holter ECG monitoring (within 24 hours in various conditions).
Exercise tests – an assessment of the reaction of cardiac activity to physical activity (bicycle ergometry). Modern equipment (Swiss apparatus from SCHILLER) allows us to carry out research with maximum precision.
According to indications – CT coronary angiography, study of the calcium index of coronary arteries, MRI of the heart, 24-hour blood pressure monitoring, etc.

Since various reasons can lead to rhythm disturbances, patients with arrhythmias in our hospital are consulted by specialists of different profiles. As a rule, a comprehensive examination includes:

Study of the lipid spectrum of blood.
Electrolyte exchange data.
Analysis of the blood coagulation system.
Study of the function (hormonal analysis) and structure (echoscopy) of the thyroid gland, according to indications – the exclusion of other endocrine pathology.

Make an appointment

Treatment of arrhythmias

Conservative therapy

Selection of optimal pharmacotherapy, control of its effectiveness, correction if necessary. It is carried out by experienced doctors of the hospital’s cardiology department.

Surgical treatment

In our hospital, the following interventions are used for the surgical treatment of arrhythmias:

Radiofrequency ablation (RFA) lesions of pathological heart rhythm using the system of non-fluoroscopic cardiac muscle mapping CARTO-3 (BiosenseWebster).
Cardioresynchronization therapy with implantation of dual-chamber pacemakers or cardioverter-defibrillators.

The operations are carried out by the leading Russian specialist in the field of surgical arrhythmology, Professor A.V. Ardashev. During the preliminary consultation, a competent decision is made on the choice of a method of treatment adequate to the patient’s condition.

Examination, conservative and surgical treatment in a multidisciplinary hospital with its own hospital allows you to quickly and accurately identify cardiac arrhythmias, causes of arrhythmias, prescribe and conduct effective treatment, and then monitor the patient’s health in the cardiology department of the hospital on an outpatient basis.

You can see prices for services in the price list or check by phone, indicated on the website.

The article was checked by a cardiologist of the highest category, Ph.D. Ternovykh I.A. is for general informational purposes only and does not replace specialist advice.
For recommendations on diagnosis and treatment, a doctor’s consultation is required.

90,000 8 causes of cardiac arrhythmias in dogs

Cardiac arrhythmias in dogs are often encountered in the practice of a veterinarian. Normal heart function in dogs depends on coordinated myocardial impulse. Thanks to the efficient operation of the conduction system, the correct sequence of contractions is maintained in clinically healthy dogs.
Cardiac arrhythmias in dogs or arrhythmias, most often secondary to some underlying disease.
How to suspect the presence of heart rhythm abnormalities in your dog?
Small animal arrhythmias may be latent.
Dysrhythmias are often incidental findings on routine cardiac examination by a general practitioner, anesthesiologist, or cardiologist.
Clinical signs that may indicate dysrhythmia in a small pet are nonspecific and therefore pet owners are often unaware that their pet has heart rhythm and conduction disturbances. Fainting, weakness and decreased exercise tolerance, periodic shortness of breath should serve as a motivation for an urgent visit to a veterinary doctor and conduct all necessary diagnostic tests.

Etiology of arrhythmias in dogs

Arrhythmias in dogs often occur with pathology of the heart itself , but no less rarely with various other diseases:

diseases of the gastrointestinal tract
lung diseases
kidney disease
diseases accompanied by vomiting and diarrhea
for anemia
with blood loss
for oncological processes in the abdominal cavity
for oncological processes in the chest

Rhythm disturbances in dogs can appear in response to stress and pain.
Hunger, as well as prolonged lack of water, hypothermia and heat stroke and other critical conditions – can lead to disruption of the electrical activity of the myocardium in dogs.
Various injuries, acute surgical pathologies (for example, torsion of the stomach or spleen, diaphragmatic hernia, trauma and wounds of the chest) are often complicated by arrhythmias.
This list of causes of heart rhythm abnormalities in dogs is almost endless.
It is important to remember that pathology of conduction and arrhythmias significantly complicate the course of the underlying disease, since they can lead to a decrease in cardiac output, as a result of which the process of blood circulation in the body is disrupted, tissues and organs receive less oxygen, and metabolic products accumulate in cells, causing intoxication of the body dogs.
In addition, arrhythmias can cause sudden death in dogs, German Shepherd and Rhodesian Ridgeback dogs.

What will the veterinary doctor of the Veterinary Center “In the world with animals” do?

The doctor will clinically examine your pet and take an electrocardiogram. It is often possible to suspect the presence of disturbances in the rhythm of the heart already at this stage.
Arrhythmias in dogs are often heard on routine cardiac auscultation and require further diagnosis.
ECG in dogs is the main way to determine the type of dysrhythmia, its prognosis and allows you to select therapy and effectively control it.
Echocardiography of dogs is an expert method that allows detecting pathological changes in the myocardium and cardiac dysfunction, indicating the presence of congestive heart failure in a dog.

Having found violations on the electrocardiogram, the veterinary doctor needs to find out the cause of the dysrhythmia. This will require taking blood tests from your dog (general clinical and biochemical).These tests will help to identify the presence of systemic diseases in the dog, the presence of metabolic disorders, which can also cause the development of heart pathology.
To identify the stage of cardiovascular disease and associated pathologies, a plain thoracic radiography in at least two projections may be required.
For a more detailed diagnosis of cardiological pathology in a dog, it will be necessary to conduct a complete cardiological examination by a narrow-profile specialist – a veterinary cardiologist.In addition to the results of blood tests and ECGs, a cardiologist can do echocardiography.
Breed predisposition to heart rhythm disturbances in dogs
In Doberman and Boxer dogs, heart disease occurs, in which dysrhythmias are the main symptom of the disease and threaten the life of the dog. These breeds have an asymptomatic course of dilated cardiomyopathy. It is advisable for all dogs of these breeds to undergo an annual screening prophylactic cardiac examination.

Holter monitoring in small pets

Arrhythmia in dogs is not always constant. If there is enough data on the presence of arrhythmia in a sick dog, but it is not detected by standard electrocardiographic examination, so-called Holter monitoring is performed. For this purpose, a small device is attached to the body of a sick dog with the help of a special vest, which records an electrocardiogram during the day, while the pet does not have to be in a veterinary clinic.Then the data from the device is transferred to a computer, where the cardiologist can analyze them.

Treatment of arrhythmias in dogs

It is necessary to identify the main primary problem that led to the development of the rhythm disturbance, and try to eliminate it. If the therapy of the underlying pathology does not eliminate heart rhythm disturbances, then special antiarrhythmic drugs are prescribed. The effectiveness of therapy in dogs is verified by repeated electrocardiographic examination.
Usually, the conduction system in dogs responds well to drug treatment, and when the main etiological factor is eliminated, the water-electrolyte balance is restored and under the influence of antiarrhythmic drugs, in most cases it is possible to stop an attack of dysrhythmia and prevent the development of new attacks.But in some cases, cardiologists have to deal with persistent, severe arrhythmias that threaten the dog’s life. In this case, the veterinary doctor will try to choose the most effective antiarrhythmic drug for life-long use, or will recommend that you install a pacemaker for your dog.