Heart rhythm problems (heart arrhythmias) occur when the electrical impulses that coordinate your heartbeats don’t work properly, causing your heart to beat too fast, too slow or irregularly.
Heart arrhythmias (uh-RITH-me-uhs) may feel like a fluttering or racing heart and may be harmless. However, some heart arrhythmias may cause bothersome — sometimes even life-threatening — signs and symptoms.
Heart arrhythmia treatment can often control or eliminate fast, slow or irregular heartbeats. In addition, because troublesome heart arrhythmias are often made worse — or are even caused — by a weak or damaged heart, you may be able to reduce your arrhythmia risk by adopting a heart-healthy lifestyle.
What’s a normal heartbeat?
Your heart is made up of four chambers — two upper chambers (atria) and two lower chambers (ventricles). Your heart rhythm is normally controlled by a natural pacemaker (sinus node) located in the right atrium. The sinus node produces electrical impulses that normally start each heartbeat. These impulses cause the atria muscles to contract and pump blood into the ventricles.
The electrical impulses then arrive at a cluster of cells called the atrioventricular (AV) node. The AV node slows down the electrical signal before sending it to the ventricles. This slight delay allows the ventricles to fill with blood. When electrical impulses reach the muscles of the ventricles, they contract, causing them to pump blood either to the lungs or to the rest of the body.
In a healthy heart, this process usually goes smoothly, resulting in a normal resting heart rate of 60 to 100 beats a minute.
Types of arrhythmias
Doctors classify arrhythmias not only by where they originate (atria or ventricles) but also by the speed of heart rate they cause:
- Tachycardia (tak-ih-KAHR-dee-uh). This refers to a fast heartbeat — a resting heart rate greater than 100 beats a minute.
- Bradycardia (brad-e-KAHR-dee-uh). This refers to a slow heartbeat — a resting heart rate less than 60 beats a minute.
Not all tachycardias or bradycardias mean you have heart disease. For example, during exercise it’s normal to develop a fast heartbeat as the heart speeds up to provide your tissues with more oxygen-rich blood. During sleep or times of deep relaxation, it’s not unusual for the heartbeat to be slower.
Arrhythmias may not cause any signs or symptoms. In fact, your doctor might find you have an arrhythmia before you do, during a routine examination. Noticeable signs and symptoms don’t necessarily mean you have a serious problem, however.
Noticeable arrhythmia symptoms may include:
- A fluttering in your chest
- A racing heartbeat (tachycardia)
- A slow heartbeat (bradycardia)
- Chest pain
- Shortness of breath
Other symptoms may include:
- Lightheadedness or dizziness
- Fainting (syncope) or near fainting
Certain conditions can lead to, or cause, an arrhythmia, including:
- A heart attack that’s occurring right now
- Scarring of heart tissue from a prior heart attack
- Changes to your heart’s structure, such as from cardiomyopathy
- Blocked arteries in your heart (coronary artery disease)
- High blood pressure
- Overactive thyroid gland (hyperthyroidism)
- Underactive thyroid gland (hypothyroidism)
- Sleep apnea
Other things that can cause an arrhythmia include:
- Drinking too much alcohol or caffeine
- Drug abuse
- Stress or anxiety
- Certain medications and supplements, including over-the-counter cold and allergy drugs and nutritional supplements
Certain conditions may increase your risk of developing an arrhythmia. These include:
- Coronary artery disease, other heart problems and previous heart surgery. Narrowed heart arteries, a heart attack, abnormal heart valves, prior heart surgery, heart failure, cardiomyopathy and other heart damage are risk factors for almost any kind of arrhythmia.
- High blood pressure. This increases your risk of developing coronary artery disease. It may also cause the walls of your left ventricle to become stiff and thick, which can change how electrical impulses travel through your heart.
- Congenital heart disease. Being born with a heart abnormality may affect your heart’s rhythm.
- Thyroid problems. Having an overactive or underactive thyroid gland can raise your risk of arrhythmias.
- Diabetes. Your risk of developing coronary artery disease and high blood pressure greatly increases with uncontrolled diabetes.
- Obstructive sleep apnea. This disorder, in which your breathing is interrupted during sleep, can increase your risk of bradycardia, atrial fibrillation and other arrhythmias.
- Electrolyte imbalance. Substances in your blood called electrolytes — such as potassium, sodium, calcium and magnesium — help trigger and conduct the electrical impulses in your heart. Electrolyte levels that are too high or too low can affect your heart’s electrical impulses and contribute to arrhythmia development.
Other factors that may put you at higher risk of developing an arrhythmia include:
- Drugs and supplements. Certain over-the-counter cough and cold medicines and certain prescription drugs may contribute to arrhythmia development.
- Drinking too much alcohol. Drinking too much alcohol can affect the electrical impulses in your heart and can increase the chance of developing atrial fibrillation.
- Caffeine, nicotine or illegal drug use. Caffeine, nicotine and other stimulants can cause your heart to beat faster and may contribute to the development of more-serious arrhythmias. Illegal drugs, such as amphetamines and cocaine, may profoundly affect the heart and lead to many types of arrhythmias or to sudden death due to ventricular fibrillation.
If you have an arrhythmia, treatment may or may not be necessary. Usually, it’s required only if the arrhythmia is causing significant symptoms or if it’s putting you at risk of a more serious arrhythmia or arrhythmia complication.
Treating slow heartbeats
If slow heartbeats (bradycardias) don’t have a cause that can be corrected, doctors often treat them with a pacemaker because there aren’t any medications that can reliably speed up the heart.
A pacemaker is a small device that’s usually implanted near your collarbone. One or more electrode-tipped wires run from the pacemaker through your blood vessels to your inner heart. If your heart rate is too slow or if it stops, the pacemaker sends out electrical impulses that stimulate your heart to beat at a steady rate.
Treating fast heartbeats
For fast heartbeats (tachycardias), treatments may include one or more of the following:
- Vagal maneuvers. You may be able to stop an arrhythmia that begins above the lower half of your heart (supraventricular tachycardia) by using particular maneuvers that include holding your breath and straining, dunking your face in ice water, or coughing. These maneuvers affect the nervous system that controls your heartbeat (vagus nerves), often causing your heart rate to slow. However, vagal maneuvers don’t work for all types of arrhythmias.
- Medications. For many types of tachycardia, you may be prescribed medication to control your heart rate or restore a normal heart rhythm. It’s very important to take any anti-arrhythmic medication exactly as directed by your doctor in order to minimize complications. If you have atrial fibrillation, your doctor may prescribe blood-thinning medications to help keep dangerous blood clots from forming.
- Cardioversion. If you have a certain type of arrhythmia, such as atrial fibrillation, your doctor may use cardioversion, which can be conducted as a procedure or by using medications. In the procedure, a shock is delivered to your heart through paddles or patches on your chest. The current affects the electrical impulses in your heart and can restore a normal rhythm.
- Catheter ablation. In this procedure, your doctor threads one or more catheters through your blood vessels to your heart. Electrodes at the catheter tips can use heat, extreme cold or radiofrequency energy to damage (ablate) a small spot of heart tissue and create an electrical block along the pathway that’s causing your arrhythmia.
Treatment for heart arrhythmias also may involve use of an implantable device:
- Pacemaker. A pacemaker is an implantable device that helps control abnormal heart rhythms. A small device is placed under the skin near the collarbone in a minor surgical procedure. An insulated wire extends from the device to the heart, where it’s permanently anchored.
If a pacemaker detects a heart rate that’s abnormal, it emits electrical impulses that stimulate your heart to beat at a normal rate.
- Implantable cardioverter-defibrillator (ICD). Your doctor may recommend this device if you’re at high risk of developing a dangerously fast or irregular heartbeat in the lower half of your heart (ventricular tachycardia or ventricular fibrillation). If you have had sudden cardiac arrest or have certain heart conditions that increase your risk of sudden cardiac arrest, your doctor may also recommend an ICD. An ICD is a battery-powered unit that’s implanted under the skin near the collarbone — similar to a pacemaker. One or more electrode-tipped wires from the ICD run through veins to the heart. The ICD continuously monitors your heart rhythm. If it detects an abnormal heart rhythm, it sends out low- or high-energy shocks to reset the heart to a normal rhythm. An ICD doesn’t prevent an abnormal heart rhythm from occurring, but it treats it if it occurs.
Surgery or other procedures
In some cases, surgery may be the recommended treatment for heart arrhythmias:
- Maze procedure. In the maze procedure, a surgeon makes a series of surgical incisions in the heart tissue in the upper half of your heart (atria) to create a pattern or maze of scar tissue. Because scar tissue doesn’t conduct electricity, it interferes with stray electrical impulses that cause some types of arrhythmia. The procedure is effective, but because it requires surgery, it’s usually reserved for people who don’t respond to other treatments or for those who are having heart surgery for other reasons.
- Coronary bypass surgery. If you have severe coronary artery disease in addition to arrhythmias, your doctor may perform coronary bypass surgery. This procedure may improve the blood flow to your heart.
If you had tried various conventional treatments, and still do not have any improvement. There are possibilities that you might have heavy metal accumulated in your body.
Our doctor begin by identifying the underlying cause of your Arrhythmias, followed by a metal test, before putting together a suitable treatment plan.