About heart disease and abnormal heart rhythm (arrhythmia)
What is heart disease and abnormal heart rhythm (arrhythmia)?
Introduction to Arrhythmia
An irregular heartbeat is an arrhythmia (also called dysrhythmia). Heart rates can also be irregular. A normal heart rate is 50 to 100 beats per minute. Arrhythmias and abnormal heart rates don't necessarily occur together. Arrhythmias can occur with a normal heart rate, or with heart rates that are slow (called bradyarrhythmias -- less than 50 beats per minute). Arrhythmias can also occur with rapid heart rates (called tachyarrhythmias -- faster than 100 beats per minute). In the United States, more than 850,000 people are hospitalized for an arrhythmia each year.
What are the symptoms for heart disease and abnormal heart rhythm (arrhythmia)?
Heart arrhythmias may not cause any signs or symptoms. A doctor may notice the Irregular heartbeat when examining you for another health reason.
In general, signs and symptoms of arrhythmias may include:
- A fluttering in the chest
- A Racing heartbeat (tachycardia)
- A Slow heartbeat (bradycardia)
- Chest pain
- Shortness of breath
Other symptoms may include:
What are the causes for heart disease and abnormal heart rhythm (arrhythmia)?
You could have an arrhythmia even if your heart is healthy. Or it could happen because of:
- Heart disease
- The wrong balance of electrolytes (such as sodium or potassium) in your blood
- Heart injury or changes such as reduced blood flow or stiff heart tissue
- Healing process after heart surgery
- Infection or fever
- Certain medications
- Problems with the electrical signals in your heart
- Strong emotions, stress, or surprise
- Things in your daily life like alcohol, tobacco, caffeine, or exercise
What are the treatments for heart disease and abnormal heart rhythm (arrhythmia)?
Treatment for heart arrhythmias depends on whether you have a fast heartbeat (tachycardia) or slow heartbeat (bradycardia). Some heart arrhythmias do not need treatment. Your doctor may recommend regular checkups to monitor your condition.
Heart arrhythmia treatment is usually only needed if the irregular heartbeat is causing significant symptoms, or if the condition is putting you at risk of more-serious heart problems. Treatment for heart arrhythmias may include medications, therapies such as vagal maneuvers, cardioversion, catheter procedures or heart surgery.
Medications used to treat heart arrhythmias depend on the type of arrhythmia and potential complications.
For example, drugs to control the heart rate and restore a normal heart rhythm are often prescribed for most people with tachycardia.
If you have atrial fibrillation, blood thinners may be prescribed to prevent blood clots. It's very important to take the medications exactly as directed by your doctor in order to reduce the risk of complications.
Therapies to treat heart arrhythmias include vagal maneuvers and cardioversion to stop the irregular heartbeat.
- Vagal maneuvers. If you have a very fast heartbeat due to supraventricular tachycardia, your doctor may recommend this therapy. Vagal maneuvers affect the nervous system that controls your heartbeat (vagus nerves), often causing your heart rate to slow. For example, you may be able to stop an arrhythmia by holding your breath and straining, dunking your face in ice water, or coughing. Vagal maneuvers don't work for all types of arrhythmias.
Cardioversion. This method to reset the heart rhythm may be done with medications or as a procedure. Your doctor may recommend this treatment if you have a certain type of arrhythmia, such as atrial fibrillation.
During the cardioversion procedure, a shock is delivered to your heart through paddles or patches on your chest. The current affects the electrical impulses in your heart and can restore a normal rhythm.
Surgery or other procedures
Treatment for heart arrhythmias may also involve catheter procedures or surgery to implant a heart (cardiac) device. Certain arrhythmias may require open-heart surgery.
Types of procedures and surgeries used to treat heart arrhythmias include:
- Catheter ablation. In this procedure, the doctor threads one or more catheters through the blood vessels to the heart. Electrodes at the catheter tips use heat or cold energy to create tiny scars in your heart to block abnormal electrical signals and restore a normal heartbeat.
Pacemaker. If slow heartbeats (bradycardias) don't have a cause that can be corrected, doctors often treat them with a pacemaker because there aren't any medications that can reliably speed up the heart.
A pacemaker is a small device that's usually implanted near the collarbone. One or more electrode-tipped wires run from the pacemaker through the blood vessels to the inner heart. If the heart rate is too slow or if it stops, the pacemaker sends out electrical impulses that stimulate the heart to beat at a steady rate.
Implantable cardioverter-defibrillator (ICD). Your doctor may recommend this device if you're at high risk of developing a dangerously fast or irregular heartbeat in the lower heart chambers (ventricular tachycardia or ventricular fibrillation). If you have had sudden cardiac arrest or have certain heart conditions that increase your risk of sudden cardiac arrest, your doctor may also recommend an ICD.
An ICD is a battery-powered unit that's implanted under the skin near the collarbone — similar to a pacemaker. One or more electrode-tipped wires from the ICD run through veins to the heart. The ICD continuously monitors your heart rhythm.
If the ICD detects an abnormal heart rhythm, it sends out low- or high-energy shocks to reset the heart to a normal rhythm. An ICD doesn't prevent an irregular heart rhythm from occurring, but it treats it if it occurs.
Maze procedure. In the maze procedure, a surgeon makes a series of incisions in the heart tissue in the upper half of your heart (atria) to create a pattern (or maze) of scar tissue. Because scar tissue doesn't conduct electricity, it interferes with stray electrical impulses that cause some types of arrhythmia.
The maze procedure is usually reserved for people who don't get better with other treatments or who are having open-heart surgery for other reasons.
- Coronary bypass surgery. If you have severe coronary artery disease in addition to a heart arrhythmia, your doctor may perform coronary bypass surgery. This procedure may improve the blood flow to your heart.
What are the risk factors for heart disease and abnormal heart rhythm (arrhythmia)?
Things that may increase the risk of heart arrhythmias include:
- Coronary artery disease, other heart problems and previous heart surgery. Narrowed heart arteries, a heart attack, abnormal heart valves, prior heart surgery, heart failure, cardiomyopathy and other heart damage are risk factors for almost any kind of arrhythmia.
- High blood pressure. This condition increases the risk of developing coronary artery disease. It may also cause the walls of the left lower heart chamber (left ventricle) to become stiff and thick, which can change how electrical signals travel through the heart.
- Congenital heart disease. Being born with a heart condition may affect the heart's rhythm.
- Thyroid disease. Having an overactive or underactive thyroid gland can raise the risk of irregular heartbeats.
- Obstructive sleep apnea. This condition causes pauses in breathing during sleep. It can lead to a slow heartbeat (bradycardia) and irregular heartbeats, including atrial fibrillation.
- Electrolyte imbalance. Substances in the blood called electrolytes — such as potassium, sodium, calcium and magnesium — help trigger and send electrical impulses in the heart. An imbalance in electrolytes — for example, if they are too low or too high — can interfere with heart signaling and lead to irregular heartbeats.
- Certain drugs and supplements. Some prescription drugs and certain cough and cold medications bought without a prescription can cause arrhythmias.
- Excessive alcohol. Drinking too much alcohol can affect the electrical impulses in your heart and can increase the chance of developing atrial fibrillation.
- Caffeine, nicotine or illegal drug use. Caffeine, nicotine and other stimulants can cause your heart to beat faster and may lead to the development of more-serious arrhythmias. Illegal drugs, such as amphetamines and cocaine, may greatly affect the heart and cause many types of arrhythmias or sudden death due to ventricular fibrillation.