Atrial Arrhythmia

What is atrial arrhythmia?

Atrial arrhythmias are irregular heartbeats that cause poor circulation. They occur when the upper chambers of your heart are out of rhythm with the lower chambers. This can cause your heart to beat either too fast or slow.

These arrhythmias may result from too much caffeine, alcohol or stress. They can also result from a serious health condition or heart problem. Atrial arrhythmias can range from harmless to life-threatening. If you notice any irregularities in your heartbeat, see your healthcare provider for an evaluation.

What are the types of atrial arrhythmias?

The types of atrial arrhythmias include:

• Atrial fibrillation (Afib), which is a very common type of arrhythmia. It causes a fast, disorganized, irregular heartbeat. Untreated, it can lead to stroke and other health problems.
• Accessory pathway tachycardia (bypass tract tachycardia), a fast heartbeat that results from an extra pathway between the atria and the ventricles. If electrical signals travel more quickly through the pathway than they do through the AV node, the heart beats faster than it should. Wolff-Parkinson-White syndrome is an example of this type of arrhythmia.
• Atrial flutter, which happens when electrical signals fire quickly in the atria, causing the atria to beat too fast. It can occur along with heart failure, heart attack and structural problems with the heart.
• Atrial tachycardia (AT), a fast heart rate (tachycardia) that happens when an electrical signal comes from the wrong place in the atria.
• AV nodal re-entrant tachycardia (AVNRT), which happens when there is more than one pathway through the AV node. AVRNT is a type of paroxysmal supraventricular tachycardia (PSVT), a fast heart rate that has a regular rhythm. AVRNT can come and go suddenly.
• Premature atrial contractions (PACs), a type of ectopic heartbeat that causes the heart to beat too soon. PACs are usually harmless and may not require treatment.

How common are atrial arrhythmias?

Heart arrhythmias are common. Millions of people in the United States live with some type of arrhythmia. Afib is the most common kind of arrhythmia. Around 2.7 million people in the U.S. have the condition. PACs (harmless irregularities in the heart rate) affect nearly everyone from time to time.

What causes atrial arrhythmia?

Atrial arrhythmias result from abnormal electrical signals. These signals, or impulses, start in the atria. The abnormal impulses can be inherited (passed down through families) or result from several health problems or heart conditions, including:

• Anemia (low red blood cell count).
• Cardiomyopathy, a disease of the heart muscle.
• Diabetes.
• Heart attack or damage from a previous heart attack.
• Heart disease, coronary artery disease (CAD) and heart failure.
• High blood pressure (hypertension).
• Lung conditions such as chronic obstructive pulmonary disease (COPD).
• Structural heart problems, including valve disease.
• Thyroid problems, including hyperthyroidism.

Atrial arrhythmias can also develop as a result of lifestyle factors:

• Dehydration.
• Drinks and foods that contain caffeine. Foods that are high in fat, sugar or carbohydrates can cause heart palpitations after eating.
• Drug use, including nasal decongestants that contain pseudoephedrine.
• Excessive alcohol.
• Having extra weight and obesity.
• High levels of anxiety and stress.
• Hormonal changes, including those that happen during menopause or pregnancy. Heart palpitations during pregnancy are very common and usually harmless.
• Smoking and using tobacco products.

What are the symptoms of atrial arrhythmia?

Symptoms of atrial arrhythmia include:

• A heartbeat that’s fast and regular. It may feel like your heart is racing.
• An irregular heartbeat. You may feel like it skipped a beat, stopped for a minute, sped up or slowed down.
• Chest pain, discomfort or tightness in the chest.
• Difficulty breathing or shortness of breath.
• Dizziness or confusion.
• Fainting (syncope) or loss of consciousness.
• Fatigue or feeling sluggish.
• Fluttering or pounding in your chest, throat or neck (heart palpitations).
• Swelling (edema) in your limbs, especially your legs, ankles and feet.

How are atrial arrhythmias diagnosed?

After asking about your symptoms and listening to your heart, your provider will recommend a blood test (complete blood count or CBC). A blood test looks for anemia, vitamin deficiencies or a problem with your thyroid.

Your provider will do a test called an electrocardiogram (EKG or ECG). This test monitors your heart rate using sensors that attach to your skin. You get this test in your provider’s office. It takes about 15 minutes.

If the EKG doesn’t detect an irregular heartbeat, your provider may recommend an ambulatory monitor such as a Holter monitor. This device is portable and you wear it for about a week. It records your heart rate and any irregular heartbeats.

How do providers treat atrial arrhythmias?

If you have an arrhythmia, you’ll see a heart specialist called a cardiologist. Your cardiologist will recommend treatment based on your overall health and the type of arrhythmia. Many arrhythmias get better with lifestyle and dietary changes, such as:

• Avoiding alcohol, caffeine and some types of medications, such as cold medications and nasal decongestants that include pseudoephedrine.
• Drinking plenty of water to avoid dehydration.
• Getting help for anxiety and doing relaxation exercises and deep breathing to lower stress levels.
• Losing weight and maintaining a healthy weight if you are obese.
• Quitting smoking and using tobacco products.

Some arrhythmias require treatments in addition to lifestyle changes. If you have more than one type of arrhythmia, you may need several treatments. Atrial arrhythmia treatments include:

• Catheter ablation, a minimally invasive procedure that destroys a bit of the tissue on the inside of the heart that is sending irregular electrical signals and causing arrhythmia.
• Devices, such as an implantable cardioverter-defibrillator (ICD), subcutaneous ICD or pacemaker.
• Electrical cardioversion, a procedure that delivers safe jolts of energy to your heart and disrupts the abnormal rhythm back to a normal rhythm.
• Medications, including arrhythmia medications to make your heart rhythm regular or prevent heartbeat irregularities. Other drugs, such as blood thinners, reduce your risk of stroke from Afib.

How can I reduce my risk of atrial arrhythmia?

You may not be able to prevent atrial arrhythmia, but you can lower your risk by staying healthy and making smart choices. These include:

• Following a diet that’s good for your heart.
• Getting plenty of exercise and staying active.
• Losing weight and maintaining a healthy weight if you have obesity.
• Lowering your blood pressure if you have hypertension.
• Managing cholesterol
• Talking to your provider about a plan to quit smoking and using tobacco.

If you have a heart condition or health problem that puts you at an increased risk, talk to your provider. They will give you specific information about other steps you can take to lower your chance of developing arrhythmia.

What can I expect if I have atrial arrhythmia?

The outlook for people with atrial arrhythmias depends on several factors, including the type of arrhythmia and your overall health. Many people relieve symptoms with lifestyle and dietary changes. Treatments for atrial arrhythmias can help you live a healthier life overall. See your provider regularly so they can monitor your heart health and work with you to feel your best.

When should I see my healthcare provider about atrial arrhythmia?

If you have any concerns about your heartbeat or you have symptoms of arrhythmia, talk to your provider. If you’ve been diagnosed with atrial arrhythmia, see your cardiologist on a regular basis.

Seek medical help right away if you have:

• Chest pain.
• Fainting spells.
• Sudden or unexplained fatigue or exhaustion.
• Swelling in your legs, feet or ankles.
• Trouble breathing.

A note from Cleveland Clinic

Atrial arrhythmias can cause serious health problems, including stroke. But treatments and lifestyle changes can help. See your provider if you experience symptoms of arrhythmia, especially if you have a history of heart disease or you have a health condition, such as high blood pressure. By making heart-healthy dietary choices and staying active, you can reduce your risk of developing arrhythmia and feel better overall.