Dysrhythmia

What is it?

A cardiac dysrhythmia (also called arrhythmia) is an abnormal or irregular heartbeat. An abnormal heart rate means that your heart rate is either too fast (typically over 100 beats per minute) or too slow (typically below 60 beats per minute). On the other hand, an irregular heartbeat means that your heart’s rhythm is disrupted in some way. For instance, the electrical signal that controls your heartbeat might be interrupted due to scar tissue in the heart. Or, the electrical signal might start too soon and give you the feeling of your heart skipping a beat. In that case, you’ll notice a stronger heartbeat right after the brief pause.

When you feel something unusual, like a rapid heart rate or skipped beats that come out of nowhere, you might wonder what’s going on. A dysrhythmia may be harmless, but it’s hard to know without getting a physical exam and talking with your healthcare provider. Some dysrhythmias require medication, invasive therapies, the insertion of devices (like pacemakers) or heart surgery.

What is the most common cause of dysrhythmia?

Usually, some sort of trigger disrupts the heart’s rate or rhythm, leading to a dysrhythmia. The most common triggers include:

• Damage to your heart from a heart condition like coronary artery disease or cardiomyopathy.
• Problems with your heart’s conduction system.
• Electrolyte, hormone or fluid imbalances in your blood.
• Some prescription and over-the-counter medicines.

Certain medical conditions, such as high blood pressure, heart valve disease, COPD and sleep apnea can raise your risk of developing a dysrhythmia.

What are the symptoms of a dysrhythmia?

A dysrhythmia may be “silent” and not cause any symptoms. Your healthcare provider can detect an irregular heartbeat during an exam by taking your pulse, listening to your heart or running diagnostic tests. If symptoms occur, they may include:

• Palpitations: A feeling of skipped heartbeats, fluttering, “flip-flops” or your heart “running away.”
• Pounding in your chest.
• Dizziness or feeling lightheaded.
• Shortness of breath.
• Chest discomfort.
• Weakness or fatigue (feeling very tired).

What is an arrhythmia vs. dysrhythmia?

There’s no difference in meaning between the words “arrhythmia” and “dysrhythmia.” They both refer to an abnormal or irregular heartbeat. You will see these terms used interchangeably in various articles and resources.

You might wonder, then, why we have these two words. Why not just use one word to describe an abnormal or irregular heartbeat? The reason can be traced to a little-known controversy among doctors that began in 1967.

History of the word “arrhythmia”

Until 1967, “arrhythmia” was the only word used to describe an abnormal or irregular heartbeat. In fact, this same word had been used for a long time, ever since ancient Greece. In the second century A.D., a physician named Galen used “arrhythmia” to identify dangerous pulse irregularities.

Let’s fast forward to the late 1800s and early 1900s. This is an important time when physicians were first starting to record and analyze the heart’s electrical impulses. During this groundbreaking period, French, British and German researchers all used “arrhythmia” to describe patterns that weren’t seen as normal.

“Dysrhythmia” and a debate among doctors

In 1967, someone stirred the pot. An author in the British Heart Journal used the term “dysrhythmia” to mean a “bad rhythm” or “defective rhythm.” This author, and others from the same camp, argued that “arrhythmia” was an inaccurate term because it meant “no rhythm at all.” According to their logic, “dysrhythmia” was a more accurate word because it meant “difficulty with” or “a disorder of” rhythm.

The debate grew complicated as the advocates on each side started breaking down the linguistic meanings of each word. They looked at the prefixes (a- and dys-) and analyzed what each one meant to justify their views.

The defenders of “arrhythmia” argued that what matters most is how the word had been used for many centuries. They said if the ancient Greeks thought “arrhythmia” was accurate, then the tradition should continue. But the defenders of “dysrhythmia” insisted that their term was better and more precise.

Off and on, doctors wrote editorials and responses to each other in their professional journals. The most ardent defenders of the classical “arrhythmia” viewed the new “dysrhythmia” as an “upstart” or “vogue word” that has no place in conversations about the heart.

Sometimes humorous in tone, these articles still took the issue seriously and urged their colleagues to use terms consistently to avoid confusion. And by the early 1990s, the consensus seemed to favor “arrhythmia.” Yet by that point, “dysrhythmia” had gained traction and was hard to erase from the professional vocabulary.

In 1990, one anesthesiologist observed that cardiologists and cardiology journals were only using “arrhythmia." He, therefore, questioned why anesthesiologists were still using “dysrhythmia.” He argued that “dysrhythmia” could be used to describe rhythm problems elsewhere in the body, but not to talk about the heart. Six months later, another anesthesiologist agreed and said everyone should use “arrhythmia.” It would seem the debate was settled.

“Dysrhythmia” and “arrhythmia” today

In 2015, a journal that addresses cardiac arrhythmias published yet another defense of “arrhythmia” as the preferred term. The authors argued that no one uses the word to mean “no heart rhythm,” as advocates of “dysrhythmia” had long declared. Far from being settled, then, this debate has continued over the decades.

Throughout all this time, unless you were a doctor who read those journals, you wouldn’t have realized a debate was going on. If you felt there was something wrong with your heartbeat, you’d have gone to your doctor. And your doctor probably would’ve used “arrhythmia.”

But words, once we begin to use them, like to stick around. That’s why today, you’ll find many resources that use “arrhythmia” and “dysrhythmia” interchangeably. And maybe you enjoy studying word origins and want to choose a side in the debate. That’s up to you. But either way, it’s important to understand how irregular or abnormal heartbeat can affect your life.

Please click here to learn more about cardiac dysrhythmias (arrhythmias), including types, causes, symptoms, diagnosis, treatment and prevention.

A note from Cleveland Clinic

It can be scary to notice changes to your heartbeat, especially if they appear suddenly or when you feel fine otherwise. You might also worry if a loved one shares their own symptoms, such as a racing heart or skipped heartbeats. Dysrhythmia can catch you off guard and make you fear the worst. But most dysrhythmias are treatable, and if caught early, usually aren’t life-threatening. Because dysrhythmias can be triggered by many different medical conditions, it’s essential to talk with your healthcare provider and share your medical history. Also, share your family history and discuss your risk factors. Your provider can help you manage symptoms and get treatments so you can regain the rhythm of your daily life.