Arrhythmia

medical provider using stethoscope to listen to patient's arrhythmia

Finding care for an arrhythmia starts with knowing which type you have.

Heart arrhythmias are problems with your heart’s electrical signals. These conditions cause abnormal heart rates or rhythms in which your heart beats too quickly (tachycardia), too slowly (bradycardia) or in an irregular pattern. If you have a heart arrhythmia, you may feel like your heart is racing, pounding, fluttering or “skipping a beat.”

The heart muscle has two upper chambers called atria and two lower chambers called ventricles. All four chambers play a vital role in efficiently pumping blood through the heart and lungs and back into the body. Typically, your heart sends electrical signals that tell each chamber to pump in a predictable, coordinated manner. Heart arrhythmias interfere with the usual rate or rhythm.

Some heart arrhythmias are harmless, while others cause more serious issues. If you’ve recently been diagnosed with an arrhythmia, understanding the type you have will help you better understand your treatment options.

Types of arrhythmia

There are many different heart arrhythmias. Some common types include:

Tachycardia (fast heartbeat)

Atrial fibrillation (AFib): Abnormal electrical signals cause the atria to beat too quickly and in a different rhythm than the ventricles. This is the most common type of arrhythmia.
Atrial flutter: Your atria beat too quickly, but unlike AFib, they beat in a more regular rhythm with the ventricles.
Long QT syndrome: Electrical signals in the heart are disrupted, causing signals to take too long to pass from one ventricle to the other. This leads to fast, uncontrolled heartbeats.
Multifocal atrial tachycardia: This is a fast heart rate that happens when too many electrical signals travel from the atria to the ventricles.
Supraventricular tachycardia (SVT): SVTs are a collection of arrhythmias caused by irregular electrical activity in the atria, leading to sudden rises in heart rate.
Ventricular tachycardia: Abnormal electrical signals in the ventricles cause a sudden, fast heart rate.
Wolff-Parkinson-White syndrome: This congenital heart disease happens when there is an extra electrical pathway in the heart, causing episodes of fast heart rate.

Bradycardia (slow heartbeat)

Atrioventricular (AV) heart block: An AV heart block happens when the signal from the atria is delayed or does not reach the ventricles, causing an irregular or slow heartbeat.
Sick sinus syndrome: This type happens when the sinus node at the top of the heart, the heart’s natural pacemaker, doesn’t work as it should. The condition causes a heart rhythm that is sometimes too fast or slow.

Premature heartbeats

Premature atrial contractions (PAC): PACs are extra heartbeats that start in the atria.
Premature ventricular contractions (PVC): PVCs are extra heartbeats that start in the ventricles.

PACs and PCVs are common and may occur in up to 10% of your natural heartbeats daily. They usually require treatment only when other factors, such as heart disease, are present.

Arrhythmia causes

Many health conditions can cause an arrhythmia, such as:

Congenital heart disease or heart conditions present from birth
Congestive heart failure
Coronary heart disease
Diabetes
High blood pressure
Obstructive sleep apnea
Postural orthostatic tachycardia syndrome, a nervous system condition
Structural problems in the heart, often due to damage from another heart issue, such as a heart attack
Thyroid conditions, such as Graves’ disease
Other health concerns, such as fever, infection, a blood clot or other sources of physical or mental stress

Arrhythmia risk factors

Diagnosing arrhythmias

Typically, the first step in diagnosing an arrhythmia is an appointment with your primary care provider (PCP). Your PCP will ask about your medical history and symptoms and perform a physical exam. They may order testing or refer you to a cardiologist if they suspect an arrhythmia.

To diagnose an arrhythmia or determine its underlying cause, one or more of these tests may be ordered:

Electrocardiogram (EKG or ECG)

Electrocardiogram (EKG or ECG)

This test tracks the electrical signals in the heart to monitor its health and functionality.
Blood Tests

Blood Tests

Blood tests can detect increased or decreased levels of substances, such as potassium, electrolytes and other minerals in your body, that may cause an arrhythmia.
Monitoring Devices

Monitoring Devices

Holter monitors and cardiac event recorders are examples of devices your doctor may have you wear to record your heart’s electrical activity and rhythms.
Physical tests

Physical tests

A doctor may perform tests that measure how the heart’s electrical functions change with different activities, for example, how well it works during exercise versus at rest (stress test) or when you change positions from laying down to standing up (tilt-table test).
Imaging and physiologic tests

Imaging and physiologic tests

Tests may include different imaging exams, such as an echocardiogram, which uses ultrasound waves to show your heart while it pumps, or electrophysiology tests, which use electrode catheters to record and map your heart’s electrical signals.
Genetic testing

Genetic testing

Certain gene mutations or inherited genetic traits can increase your risk of developing an arrhythmia.

Electrocardiogram (EKG or ECG)

This test tracks the electrical signals in the heart to monitor its health and functionality.

Blood Tests

Blood tests can detect increased or decreased levels of substances, such as potassium, electrolytes and other minerals in your body, that may cause an arrhythmia.

Monitoring Devices

Holter monitors and cardiac event recorders are examples of devices your doctor may have you wear to record your heart’s electrical activity and rhythms.

Physical tests

A doctor may perform tests that measure how the heart’s electrical functions change with different activities, for example, how well it works during exercise versus at rest (stress test) or when you change positions from laying down to standing up (tilt-table test).

Imaging and physiologic tests

Tests may include different imaging exams, such as an echocardiogram, which uses ultrasound waves to show your heart while it pumps, or electrophysiology tests, which use electrode catheters to record and map your heart’s electrical signals.

Genetic testing

Certain gene mutations or inherited genetic traits can increase your risk of developing an arrhythmia.

Arrhythmia treatment

You have many options for heart arrhythmia treatments. AFib and other forms of the condition may be treated with one or a combination of the following methods:

Lifestyle changes
Lifestyle changes

You can manage a heart arrhythmia with healthy lifestyle choices, such as:
- Eating a heart-healthy diet
- Limiting alcohol to one drink a day for men or two drinks per day for women
- Maintaining a healthy weight
- Managing other chronic conditions, such as diabetes and high blood pressure
- Quitting smoking and avoiding secondhand smoke
- Improving sleep quality or duration
- Avoiding stressful situations
Medication

Medication

Certain medications, including beta blockers, calcium channel blockers and blood thinners, may help you manage symptoms, prevent complications or manage the underlying cause of your arrhythmia.
Therapies
Therapies
- Vagal maneuvers: Vagal maneuvers are physical actions, such as breathing exercises, that you can use to relax, slow your heart rate and lower your blood pressure.
- Cardioversion: Cardioversion is a procedure that uses low-frequency energy pulses to restore your heart rhythm.
- Ablations: Two types of ablations may be used for arrhythmia.
  - A catheter ablation uses a narrow catheter to modify or remove faulty electrical pathways causing your arrhythmia.
  - A cryoablation applies cold temperatures to faulty electrical pathways, and a radiofrequency ablation takes the opposite approach and applies heat to faulty electrical pathways.
The type of ablation procedure used would depend on which type of arrhythmia you have, as well as underlying health issues and other factors.
Devices
Devices
- Pacemaker: This small, implanted device sends electrical signals to the heart to create or maintain a regular rhythm.
- Implantable cardioverter defibrillator (ICD): This small device monitors the heart for abnormal heart rhythms. When an arrhythmia is detected, the ICD sends an electrical signal to correct the rhythm.
Surgery
Surgery
- Maze procedure: This procedure uses various techniques to create scar tissue that blocks the faulty electrical signals causing an arrhythmia

Lifestyle changes

You can manage a heart arrhythmia with healthy lifestyle choices, such as:

Eating a heart-healthy diet
Limiting alcohol to one drink a day for men or two drinks per day for women
Maintaining a healthy weight
Managing other chronic conditions, such as diabetes and high blood pressure
Quitting smoking and avoiding secondhand smoke
Improving sleep quality or duration
Avoiding stressful situations

Medication

Certain medications, including beta blockers, calcium channel blockers and blood thinners, may help you manage symptoms, prevent complications or manage the underlying cause of your arrhythmia.

Therapies

Vagal maneuvers: Vagal maneuvers are physical actions, such as breathing exercises, that you can use to relax, slow your heart rate and lower your blood pressure.
Cardioversion: Cardioversion is a procedure that uses low-frequency energy pulses to restore your heart rhythm.
Ablations: Two types of ablations may be used for arrhythmia.
- A catheter ablation uses a narrow catheter to modify or remove faulty electrical pathways causing your arrhythmia.
- A cryoablation applies cold temperatures to faulty electrical pathways, and a radiofrequency ablation takes the opposite approach and applies heat to faulty electrical pathways.

The type of ablation procedure used would depend on which type of arrhythmia you have, as well as underlying health issues and other factors.

Devices

Pacemaker: This small, implanted device sends electrical signals to the heart to create or maintain a regular rhythm.
Implantable cardioverter defibrillator (ICD): This small device monitors the heart for abnormal heart rhythms. When an arrhythmia is detected, the ICD sends an electrical signal to correct the rhythm.

Surgery

Maze procedure: This procedure uses various techniques to create scar tissue that blocks the faulty electrical signals causing an arrhythmia

Finding care for an arrhythmia starts with knowing which type you have.