An arrhythmia (also called dysrhythmia) is an irregular or abnormal heartbeat.
Your pulse indicates your heart rate, or the number of times your heart beats in one minute. Pulse rates vary from person to person. Your pulse is slower when you are at rest and increases when you exercise, since more oxygen- rich blood is needed by the body during exercise.
You can tell how fast your heart is beating by feeling your pulse. You can feel your pulse on your wrist or neck. Place the tips of your index and middle fingers on the inner wrist of your other arm, just below the base of your thumb. Or, place the tips of your index and middle fingers on your lower neck, on either side of your windpipe. Press lightly with your fingers until you feel the blood pulsing beneath your fingers. You may need to move your fingers around slightly up or down until you feel the pulsing.
You can count the number of beats in 10 seconds and multiply by 6 to determine your heart rate in beats per minute. A normal heart rate, at rest, is 50 to 100 beats per minute.
Your Heart Rate: Pulse in 10 seconds x 6 = _
The heart’s electrical system triggers the heartbeat. Each beat of the heart is represented on the electrocardiogram (EKG or ECG) by a wave arm.
The normal heart rhythm (normal sinus rhythm) shows the electrical activity in the heart is following the normal pathway. The rhythm is regular and the node is normal (about 50 to 100 beats per minute).
Tachycardia: fast heart rhythm (greater than 100 beats per minute)
Bradycardia: slow heart rhythm (less than 60 beats per minute)
The atria (the heart’s upper chambers) and ventricles (the heart’s lower chambers) work together, alternately contracting and relaxing to pump blood through the heart. The electrical system of the heart is the power source that makes this possible. Here’s what happens during a normal heartbeat:
Irregular heart rhythms can also occur in normal, healthy hearts. Arrhythmias can also be caused by certain substances or medications, such as caffeine, nicotine, alcohol, cocaine, inhaled aerosols, diet pills, and cough and cold remedies. Emotional states such as shock, fright or stress can also cause irregular heart rhythms.
Arrhythmias that are recurrent or related to an underlying heart condition are more concerning and should always be evaluated by a doctor.
In most cases, treating the underlying condition will take care of the arrhythmia. If not, many medications and procedures are available to eliminate or control the abnormal heart rhythm.
Supraventricular arrhythmias begin in the atria
Types of supraventricular arrhythmias include:
Premature atrial contractions (PACs)
Early, extra heartbeats that originate in the atria.
Paroxysmal supraventricular tachycardia (PSVT)
A rapid but regular heart rhythm that comes from the atria. This type of arrhythmia begins and ends suddenly.
Accessory pathway tachycardias (bypass tract tachycardias)
A fast heart rhythm caused by an extra, abnormal electrical pathway or connection between the atria and ventricles. The impulses travel through the extra pathways as well as the usual route. This allows the impulses to travel around the heart very quickly, causing the heart to beat unusually fast (example: Wolff- Parkinson-White syndrome).
AV nodal re-entrant tachycardia (AVNRT)
A fast heart rhythm caused by the presence of more than one pathway through the atrioventricular (AV) node.
A rapid heart rhythm that originates in the atria.
A very common irregular heart rhythm. Many impulses begin and spread through the atria, competing for a chance to travel through the AV node. The resulting rhythm is disorganized, rapid and irregular. Because the impulses are traveling through the atria in a disorderly fashion, there is a loss of coordinated atrial contraction.
An atrial arrhythmia caused by one or more rapid circuits in the atrium. Atrial flutter is usually more organized and regular than atrial fibrillation.
A ventricular arrhythmia begins in the heart’s ventricles.
Types of ventricular arrhythmias include:
Premature ventricular contractions (PVCs)
Early, extra heartbeats that originate in the ventricles. Most of the time, PVCs don’t cause any symptoms or require treatment. This type of arrhythmia is common and can be related to stress, too much caffeine or nicotine, or exercise. They can be also be caused by heart disease or electrolyte imbalance. People who have several PVCs and/or symptoms associated with them should be evaluated by a cardiologist (heart doctor).
Ventricular tachycardia (V-tach)
A rapid heartbeat that originates in the ventricles. The rapid rhythm keeps the heart from adequately filling with blood, and less blood is able to pump through the body. V-tach can be serious, especially in people with heart disease, and may be associated with more symptoms than other types of arrhythmia. A cardiologist should evaluate this condition.
Ventricular fibrillation (V-fib)
An erratic, disorganized firing of impulses from the ventricles. The ventricles quiver and cannot generate an effective contraction, which results in a lack of blood being delivered to the body. This is a medical emergency that must be treated with cardiopulmonary resuscitation (CPR) and defibrillation (delivery of an energy shock to the heart muscle to restore a normal rhythm) as soon as possible.
The QT interval is the area on the ECG that represents the time it takes for the heart muscle to contract and then recover, or for the electrical impulse to fire and then recharge. When the QT interval is longer than normal, it increases the risk for “torsade de pointes,” a life-threatening form of ventricular tachycardia.
A bradyarrhythmia is a slow heart rhythm that is usually caused by disease in the heart’s conduction system. Types of bradyarrhythmias include:
Sinus node dysfunction
Slow heart rhythms due to an abnormal SA node.
A delay or complete block of the electrical impulse as it travels from the sinus node to the ventricles. The level of the block or delay may occur in the AV node or HIS-Purkinje system. The heartbeat may be irregular and slow.
An arrhythmia may be “silent” and not cause any symptoms. A doctor can detect an irregular heartbeat during an examination by taking your pulse, listening to your heart or by performing diagnostic tests. If symptoms occur, they may include:
Arrhythmias can be caused by:
If you have symptoms of an arrhythmia, you should make an appointment with a cardiologist. You may want to see an electrophysiologist — a cardiologist who has additional specialized training in the diagnosis and treatment of heart rhythm disorders.After evaluating your symptoms and performing a physical examination, the cardiologist may perform a variety of diagnostic tests to help confirm the presence of an arrhythmia and indicate its causes.Some tests that may be done to confirm the presence of an irregular heart rhythm include:
Treatment depends on the type and severity of your arrhythmia. In some cases, no treatment is necessary. Treatment options include medications, lifestyle changes, invasive therapies, electrical devices or surgery.
Antiarrhythmic drugs are medications used to convert the arrhythmia to a normal sinus rhythm or to prevent an arrhythmia. Other medications may include heart rate-control drugs and anticoagulant or antiplatelet drugs such as warfarin (a “blood thinner”) or aspirin, which reduce your risk of stroke or developing blood clots.It is important that you know the names of your medications, why they are prescribed, how often and at what times to take them, what side effects may occur, and what medications you have previously taken for your arrhythmia.
Airrhythmias may be related to certain lifestyle factors. The following tips can help limit the occurrence of arrhythmias:
Electrical cardioversion and catheter ablation are invasive therapies used to treat or eliminate irregular heart rhythms. Your doctor will determine the best treatment for you and discuss the benefits and risks of these therapies with you.
There are several ways an ICD can restore a normal heart rhythm:
Surgery may be needed to correct arrhythmias that can’t be controlled with medications or nonsurgical treatment methods. Arrhythmia surgery may also be recommended if you need surgery, such as valve surgery or bypass surgery, to correct other forms of heart disease. The Maze and modified Maze procedures are two surgeries used to correct atrial fibrillation.Your doctor will determine the best treatment for you and discuss these options with you, including more information about surgical treatment if it is an appropriate treatment option.
You will need to visit your doctor for regular follow-up visits to:
Your doctor will tell you how often you should visit. Call your doctor in between visits if your symptoms become more frequent or severe.
Doctors vary in quality due to differences in training and experience; hospitals differ in the number of services available. The more complex your medical problem, the greater these differences in quality become and the more they matter.
Clearly, the doctor and hospital that you choose for complex, specialized medical care will have a direct impact on how well you do. To help you make this choice, please review our Miller Family Heart and Vascular Institute Outcomes.
Choosing a doctor to treat your abnormal heart rhythm depends on where you are in your diagnosis and treatment. The following Heart and Vascular Institute Sections and Departments treat patients with Arrhythmias:
The Heart and Vascular Institute has specialized centers to treat certain populations of patients:
For younger patients with abnormal heart rhythms:
See About Us to learn more about the Sydell and Arnold Miller Family Heart & Vascular Institute.
If you need more information, click here to contact us, chat online with a nurse or call the Miller Family Heart and Vascular Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.
Diagnostic tests are used to diagnose your abnormal heartbeat and the most effective treatment method.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 06/12/2018