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Overview
What Is Cardiac Arrhythmia?
Cardiac arrhythmia, also called cardiac dysrhythmia, is an abnormal heart rhythm. The heart may beat too quickly, too slowly, or irregularly. Some rhythm changes are harmless and temporary, while others need medical evaluation and treatment. Arrhythmia can affect people with or without known heart disease.
Symptoms
Cardiac Arrhythmia Symptoms
Some arrhythmias cause no symptoms and are found during a routine examination or heart test. Others cause noticeable changes in the heartbeat or reduce effective blood flow. Symptoms may occur with fast, slow, or irregular rhythms and can come and go.
- Palpitations or a fluttering, pounding, or racing heartbeat.
- A heartbeat that feels slow, irregular, or as though it skips beats.
- Dizziness, lightheadedness, unusual tiredness, or weakness.
- Shortness of breath or reduced ability to exercise.
- Chest discomfort or fainting.
Causes
Causes of Cardiac Arrhythmia
Arrhythmias result from abnormal formation or conduction of electrical signals through the heart. Heart disease, changes in body chemistry, medicines, and substances that stimulate the heart can all affect this electrical system. Sometimes, no specific cause is identified.
- Heart conditions such as coronary artery disease, prior heart attack, heart failure, or valve disease.
- Changes present from birth or scarring of the heart muscle.
- Thyroid disorders or abnormal potassium, magnesium, or calcium levels.
- Some prescription medicines, recreational drugs, caffeine, alcohol, or nicotine.
- In some people, no specific cause can be identified.
Risk Factors
Risk Factors for Cardiac Arrhythmia
Several medical, inherited, and lifestyle factors can increase the likelihood of a heart arrhythmia. Having a risk factor does not mean that a person will develop an arrhythmia, but it may make monitoring and control of related conditions more important.
| Risk-factor type | Examples |
|---|---|
| Nonmodifiable | Older age, family history, inherited conditions, or congenital heart disease. |
| Potentially modifiable | Smoking, heavy alcohol use, stimulant exposure, high blood pressure, obesity, sleep apnea, and uncontrolled thyroid disease. |
Complications
Complications of Cardiac Arrhythmia
Complications depend on the arrhythmia type, how long it lasts, the health of the heart, and whether the rhythm reduces effective blood flow. Some arrhythmias have little long-term effect, while persistent or high-risk rhythms can cause serious problems.
- Some arrhythmias can allow blood clots to form, increasing the risk of stroke.
- Persistent fast or irregular rhythms may weaken the heart and contribute to heart failure.
- Dizziness or fainting can lead to falls and other injuries.
- Certain dangerous rhythms can cause cardiac arrest and require immediate emergency treatment.
Diagnosis
How Cardiac Arrhythmia Is Diagnosed
Diagnosis begins with a medical history, the timing and pattern of symptoms, a pulse and heart examination, and a review of medicines and health conditions. Because some rhythms come and go, clinicians may use monitoring over days or longer to capture an episode.
- A resting electrocardiogram records the heart’s electrical activity during the test.
- A Holter, event, or other ambulatory monitor records rhythms over longer periods when episodes are intermittent.
- Blood tests can look for thyroid, electrolyte, or other medical contributors.
- An echocardiogram or stress test can assess heart structure and function.
- An electrophysiology study may map electrical pathways when more detailed evaluation is needed.
Treatment & Management
Treatment and Management of Cardiac Arrhythmia
Treatment depends on the rhythm, symptoms, duration, underlying heart health, and risk of complications. A harmless or symptom-free rhythm may only need observation, while a clinically significant arrhythmia may require treatment of its cause, rate or rhythm control, clot prevention, or emergency stabilization.
| Approach | What it may involve |
|---|---|
| Monitoring and lifestyle measures | Follow-up, limiting triggers, and treating conditions such as high blood pressure, thyroid disease, or sleep apnea. |
| Medicines | Drugs to control heart rate or rhythm, and anticoagulants for stroke prevention when indicated. |
| Procedures | Electrical cardioversion or catheter ablation to restore or maintain a safer rhythm. |
| Implanted devices | A pacemaker or implantable cardioverter-defibrillator for selected slow or dangerous rhythms. |
Prevention
Can Cardiac Arrhythmia Be Prevented?
Inherited, congenital, and some disease-related arrhythmias cannot always be prevented. However, controlling cardiovascular risks and treating related conditions may reduce the likelihood or severity of some rhythms and help prevent complications.
- Manage blood pressure, cholesterol, diabetes, thyroid disease, and other contributing conditions.
- Avoid tobacco and illicit stimulants, and limit alcohol if it triggers symptoms.
- Maintain regular physical activity and a heart-healthy eating pattern when medically appropriate.
- Seek evaluation for possible sleep apnea and follow the prescribed treatment.
- Take rhythm or anticoagulant medicines exactly as directed and keep follow-up appointments.
Outlook and Prognosis
Outlook and Prognosis
Some arrhythmias are brief and harmless, while others are chronic but manageable with monitoring and treatment. Certain rhythms can become dangerous without appropriate care, so there is no single outcome for everyone. The outlook depends on the specific arrhythmia and the person’s overall heart health.
When Should You See a Doctor
When Should You See a Doctor?
Get medical advice
Rhythm symptoms
Arrange medical evaluation for new, recurrent, or persistent palpitations, an unusually fast or slow pulse, dizziness, or reduced exercise tolerance. Seek advice promptly if these symptoms occur in someone with known heart disease.
Emergency
Seek emergency care
Call emergency services for chest pain or pressure, severe shortness of breath, fainting, collapse, confusion, or palpitations accompanied by severe weakness. Do not drive yourself to the hospital.
Branches
1 topic
Cardiac Arrhythmia
Cardiology
