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Irregular heartbeat (arrhythmia)

Arrhythmia is a term used to describe any irregularity in a normal heart rate. There are various types of arrhythmia which differ in severity.

  1. Common symptoms include palpitations and dizziness
  2. Usually triggered by a heart condition
  3. Treatment depends on the cause

It is important to consult a doctor if you notice any possible signs of arrhythmia and have not been diagnosed with a heart condition. Our consultation service is available for you to speak to a doctor about your symptoms and whether you require further medical attention or treatment.

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Description

What is arrhythmia?

If you experience chest pain or any symptoms which might indicate a heart attack, you should seek emergency medical attention by calling 999.

Arrhythmia is an abnormal rhythm of the heartbeat caused by a fault in the way in which electrical signals are sent. Arrhythmias can be found in numerous forms and conditions, and they can also affect different areas of the heart, triggering variations in heart rate. 

The sinus node sends electrical signals to different chambers of the heart, and blood is pushed through it. This electrical pattern is called the sinus rhythm. It will usually range from around 60-100 beats per minute (bpm) when resting. 

In arrhythmia, electrical impulses may stem from a different part of the heart, and not the sinus node. It is also possible that the electrical signals are being sent from the sinus node but not reaching the lower chambers. In some cases, an arrhythmia can be caused by an abnormality in chemical levels in the blood.

If an arrhythmia is left untreated, it can lead to life-threatening complications in some cases. Heart failure may occur when repeat arrhythmias stop the heart from pumping blood in the lower chambers. 

Who gets arrhythmia?

It is thought that arrhythmias are fairly common. The NHS states that arrhythmias affect 2 million people in the UK annually, and getting older is a risk factor for developing the condition. It’s understood to be more prevalent in men than women, and more common in people of African descent.

It’s far more likely that heart failure will develop if there’s already an underlying heart condition. Stroke is a possible complication of atrial fibrillation, as blood may clot in the atria and this can then travel to the brain. Ventricular fibrillation can lead to a cardiac arrest, where the heart suddenly stops beating.

If you are already taking medication for a heart condition such as arrhythmia and want to speak to a doctor about your prescription, you can do so through our online video consultation service. You may also want to discuss symptoms, or any changes in your heart rate that you may have noticed. Book an appointment at a convenient time for you. 

Page last reviewed:  15/06/2020
Diagnosis and treatment

What are the causes of arrhythmia?

There are numerous causes of arrhythmia, the most common being coronary heart disease. It reduces the flow of blood to some sections of the heart, which can trigger arrhythmia. Heart valve diseases can cause the heart muscle to enlarge, and high blood pressure can also put a strain on the heart, which may lead to arrythmia. 

Less commonly, arrhythmia can be caused by an abnormality in an electrical pathway which has developed from birth.

What are some of the different types of arrhythmia?

The heart is made up of several different parts, which pass on impulses and signals to trigger muscle movements, and pump blood around the body. When one part doesn’t work properly, it can affect someone's heartbeat.

The most common type of arrhythmia is atrial fibrillation, which occurs when the heart beats both irregularly and faster, and the ventricles contract at between 160-180 beats per minute (bpm). 

Supraventricular tachycardia (SVT) occurs when a different part of the heart takes over from the sinus node (the heart’s natural pacemaker), making impulses faster and more regular. 

A heart block (bradycardia) happens when the electrical impulses between the atria and the ventricles are partially or completely blocked. 

Ventricular tachycardia is fairly uncommon, and arises from electrical signals not working properly, causing a regular and faster heart rate.

It’s a rare type of arrhythmia, where impulses are sent from the ventricles (lower chambers of the heart) at a faster rate than normal, which means that they don’t have enough time to fill up with blood.

Will I need tests?

In order to diagnose a form of arrhythmia, it’s very likely that a doctor will want to run some tests. It’s possible to be diagnosed from just a physical examination where your pulse is taken; however, this could prove to be insufficient, as intermittent heart palpitations can occur for a number of reasons unrelated to arrythmia. 

An electrocardiogram (ECG) is the most common test that a doctor will use. It involves small electrodes being stuck to your body, and the impulses are detected by a machine which generates a reading on a computer. In the event of intermittent arrhythmia, a doctor may ask you to have an ambulatory ECG, which involves wearing an ECG for an extended period while doing normal activities.

Other tests that can be conducted include a cardiac event recorder (a device which records occasional symptoms), an electrophysiological study (a test to look for issues with electrical signals in the heart) and an echocardiogram (a scan to view the structures of the heart).

How is arrhythmia managed?

Each individual type of arrhythmia has specific treatment options, and in many cases treatment for the condition will involve treating the underlying cause, such as high blood pressure. 

Medications such as calcium channel blockers, beta-blockers and anticoagulants can control the electrical impulses of the heart. They’re commonly used to prevent intermittent arrhythmias and regulate heart rate in atrial fibrillation. 

Cardioversion is the most common treatment for the different types of tachycardia. The technique involves the issuing of an electrical shock whilst you are under anaesthetic. Catheter ablation treatment is suitable when a small section of the heart emits abnormal electrical signals. Catheters are inserted into blood vessels and threaded to the heart, and this corrects the heart’s rhythms. Artificial pacemakers are useful for entire heart blocks; wires from the pacemaker are passed underneath the chest through the veins, to help stimulate the heart.

Page last reviewed:  15/06/2020
Questions and Answers

How is an arrhythmia treated?

Arrhythmia can be treated in a number of ways. Usually the underlying condition needs to be diagnosed through various tests, such as an electrocardiogram (ECG) or using a cardiac event recorder.

If high blood pressure is the cause, this will often be treated with a combination of medicine and lifestyle adjustments. Atrial fibrillation is sometimes treated with antiarrhythmic medicines, such as flecainide or amiodarone. In some cases of arrhythmia, a synthetic pacemaker device may be fitted to help regulate heartbeat. 

How long will it take for me to recover?

The prognosis of an arrythmia largely depends on what type it is. For example, ventricular tachycardia will generally require more monitoring and treatment than atrial fibrillation. The person’s overall health and the ability of the heart to pump blood are other factors to consider.

Can I consult a doctor about arrhythmia online?

Our video consultation service enables you to speak to a doctor directly about your symptoms. They can offer advice and let you know if you need to have a physical examination.

However, if you’re experiencing chest pain or loss of feeling in your left arm, or any other possible symptoms of a heart attack, you should call 999 immediately.

Page last reviewed:  15/06/2020

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