Practically everyone experiences some version of an arrhythmia (irregular heartbeat) on occasion, usually in the form of a gentle palpitation or a “skipped” heartbeat. Mild, isolated disturbances of this kind are normally harmless, but a recurrent heartbeat disturbance should be checked by your physician. Your heart is made up of four chambers, and during each heartbeat the upper chambers (the atria) contract, followed by the two lower chambers (the ventricles). This precisely timed action is all governed by the heart’s electrical system. Arrhythmia, or abnormal heart rhythm, occurs when the heart’s electrical system isn’t working properly. During an arrhythmia (also called a dysrhythmia), the heart may beat too fast, too slow or irregularly.
While irregular heart rhythms can occur in normal, healthy hearts, there are numerous conditions that can affect the structure of the heart muscle or its valves. This alters the electrical activity within the heart and can interfere with a regular heartbeat. Arrhythmia factors include:
Coronary artery disease, when
arteries become clogged and nar-
rowed, restricting blood flow to
the heart.
Electrolyte imbalances in your
blood (such as sodium or potas-
sium).
Changes in your heart muscle.
Injury from a heart attack.
Healing process after heart
surgery.
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Some arrhythmias are silent and do not cause any symptoms but can be detected by your doctor during a physical exam by taking your pulse or through an electrocardiogram test (EKG). Signs of more serious arrhythmias are:
Recurrent palpitations (a feeling
of skipped heart beats or
fluttering).
Pounding in your chest.
Dizziness or feeling light-headed.
Fainting.
Shortness of breath.
Chest discomfort.
Weakness or fatigue.
Once an arrhythmia is confirmed, your doctor will decide whether the condition merits medical or surgical treatment. Treatment decisions depend not only on the type and seriousness of arrhythmia, but also on a patient’s age, physical condition and history of heart disease. In some cases, no treatment is necessary. For mild conditions, your doctor will usually recommend ways for you to control the arrhythmia. If necessary, medication is prescribed. For more serious conditions, treatment options include the application of electric shock or cardioversion, which is used to break an arrhythmia and restore normal heart rate and rhythm. Cardioversion might also be used if a patient fails to respond to medication or if your doctor anticipates an emergency because of another existing heart condition. Sometimes, implantable devices are used to control arrhythmic conditions for the long term. They can include:
Implanted cardiac defibrillator
(ICD)—a small electronic device
implanted into the body to moni-
tor the heart’s rhythm. If a dan-
gerously fast heart rhythm is
sensed, the ICD delivers electrical
impulses and/or shocks to restore
a normal heart rhythm.
Pacemaker—a small lightweight
electronic device implanted in
patients whose hearts beat too
slowly or pause between beats.
A pacemaker helps to stimulate
and pace the heart to keep it
beating at the proper speed.
Cardiac resynchronization therapy
(CRT)—delivers small electrical
pulses that help correctly time or
“resynchronize” the heart’s con-
tractions, helping a weakened
heart pump more efficiently.
More invasive treatments are occasionally necessary to treat an arrhythmia. Catheter ablation is a fairly low-risk procedure where high-frequency electrical energy is delivered through a catheter to a small area of tissue inside the heart that causes the abnormal heart rhythm. This energy “disconnects” the electrical pathway responsible for the abnormal rhythm. The Maze procedure is another surgical treatment that corrects atrial fibrillation, a common type of arrhythmia. During the procedure, your surgeon creates scar tissue, which doesn’t conduct electrical activity and, therefore, blocks the abnormal electrical signals causing arrhythmia. If your doctor determines your arrhythmia does not require treatment, there still are some lifestyle changes you can make to minimize the problem. Should you notice that your irregular heart rhythm occurs more often with certain activities, try to avoid them. If you are a smoker, it’s time to quit. Limit your intake of alcohol and caffeine, because some people are sensitive to caffeine and may notice more symptoms. Stay away from stimulants used in cough and cold medications, as some contain ingredients that promote irregular heart rhythms. Read the label and ask your doctor or pharmacist what medication would be best for you. It is important to learn about your heart to help prevent heart disease. And if you have cardiovascular disease, you can live a healthier, more active life by learning about your disease and treatments and by becoming an active participant in your care.
