Heart Disease and Abnormal Heart Rhythm (Arrhythmia)
What Are the Symptoms of Arrhythmias?
An arrhythmia can be silent and not cause any symptoms. A doctor can detect an irregular heartbeat during a physical exam by taking your pulse or through an electrocardiogram (ECG or EKG).
When symptoms of an arrhythmia occur, they may include:
- Palpitations (a feeling of skipped heart beats, fluttering or "flip-flops").
- Pounding in your chest.
- Dizziness or feeling light-headed.
- Shortness of breath.
- Chest discomfort.
- Weakness or fatigue (feeling very tired).
How Are Arrhythmias Diagnosed?
Tests used to diagnose an arrhythmia or determine its cause include:
How Are Arrhythmias Treated?
Treatment depends on the type and seriousness of your arrhythmia. Some people with arrhythmias require no treatment. For others, treatments can include medication, making lifestyle changes, and undergoing surgical procedures.
What Drugs Are Used to Treat Arrhythmias?
A variety of drugs are available to treat arrhythmias. These include:
- Antiarrhythmic drugs. These drugs control heart rate and include beta-blockers.
- Anticoagulant or antiplatelet therapy. These drugs reduce the risk of blood clots and stroke. These include warfarin (a blood thinner) or aspirin. Other blood thinners called Pradaxa (dabigatran), Eliquis, and Xeralta (rivaroxaban) have been approved to prevent stroke in people with atrial fibrillation.
Because everyone is different, it may take trials of several medications and doses to find the one that works best for you.
Can Lifestyle Changes Help Arrhythmias?
- If you notice that your arrhythmia occurs more often with certain activities, you should avoid them.
- If you smoke, stop.
- Limit your intake of alcohol.
- Limit or stop using caffeine. Some people are sensitive to caffeine and may notice more symptoms when using caffeine products (such as tea, coffee, soft drinks, and some over-the-counter medications).
- Stay away from stimulants used in cough and cold medications. Some such medications contain ingredients that promote irregular heart rhythms. Read the label and ask your doctor or pharmacist what medication would be best for you.
What Is Electrical Cardioversion?
If drugs are not able to control a persistent irregular heart rhythm (such as atrial fibrillation), cardioversion may be required. After administration of short-acting anesthesia, an electrical shock is delivered to your chest wall that synchronizes the heart and allows the normal rhythm to restart.
What Is a Pacemaker?
A pacemaker is a device that sends small electrical impulses to the heart muscle to maintain a suitable heart rate. The pacemaker has a pulse generator (which houses the battery and a tiny computer) and leads (wires) that send impulses from the pulse generator to the heart muscle. Newer pacemakers have many sophisticated features that are designed to help manage arrhythmias.
What Is an Implantable Cardioverter Defibrillator (ICD)?
An ICD is a sophisticated device used primarily to treat ventricular tachycardia and ventricular fibrillation, two life-threatening heart rhythms. The ICD constantly monitors the heart rhythm. When it detects a very fast, abnormal heart rhythm, it delivers energy to the heart muscle to cause the heart to beat in a normal rhythm again. There are several ways the ICD can be used to restore normal heart rhythm. They include:
- Anti-tachycardia pacing (ATP). When the heart beats too fast, a series of small electrical impulses may be delivered to the heart muscle to restore a normal heart rate and rhythm.
- Cardioversion. A low energy shock may be delivered at the same time as the heart beats to restore normal heart rhythm.
- Defibrillation. When the heart is beating dangerously fast or irregularly, a higher energy shock may be delivered to the heart muscle to restore a normal rhythm.
- Anti-bradycardia pacing. Many ICDs provide back-up pacing to maintain heart rhythm if it slows too much.