Your heart may skip a beat in love or excitement, but if you feel like your heart regularly skips or flutters, it may be a sign of a cardiac arrhythmia.
An arrhythmia is any disturbance in the rhythm of the heartbeat which may cause your heart to beat too slow, too fast or erratically. The heart is made up of four chambers. Two upper chambers (the atria) and two lower chambers (the ventricles). The sinus node, located in the upper right chamber, cues each heartbeat with an electrical impulse. The flow of electricity through the heart must follow an exact path to tell each chamber when to contract and relax for the heart to pump correctly. At any point in the cycle if the electrical flow through the heart doesn’t follow the right path or doesn’t begin in the right spot, an arrhythmia can occur.
Arrhythmias can be categorized in four ways:
- Supraventricular arrhythmias, which affect the upper chambers of the heart (atrial fibrillation is the most common)
- Ventricular arrhythmias, which affect the lower chambers of the heart
- Tachycardia, a heartbeat that is too fast, more than 100 beats per minute
- Bradycardia, a heartbeat that is too slow, less than 60 beats per minute
“Certain types of arrhythmias are actually fairly common and not necessarily serious,” said Christine Magill, PA-C, from Samaritan Health Services’ Heart Rhythm Center. “Sometimes a healthy heart can have a temporary arrhythmia because of medication, caffeine, nicotine, alcohol or an emotional fright or shock.”
Arrhythmias are a concern when the heart isn’t pumping effectively for an extended period of time, which can mean your body’s vital organs aren’t receiving enough blood. Magill reports that potentially serious arrhythmias are usually caused by an underlying condition such as coronary artery disease, high blood pressure or an overactive thyroid.
You may notice symptoms of an arrhythmia but not always. Symptoms you may notice include:
- Palpitations or a fluttering feeling in your chest
- Racing heartbeat (tachycardia)
- Slow heartbeat (bradycardia)
- Shortness of breath
- Chest pain
If you experience any of these symptoms for more than a few minutes at a time on a regular basis, it may signal a more serious arrhythmia. Depending on your symptoms, your doctor may send you for an electrocardiogram (EKG), stress test or electrophysiology study, or recommend a home monitoring system to diagnose you. Even if you have no obvious symptoms, a doctor may be able to detect a “silent” arrhythmia while listening to your heart or taking your pulse.
For many people, arrhythmias can be treated with medications that help to suppress the arrhythmia or prevent them from occurring in the first place. Certain types of arrhythmias also need to be treated with blood thinners to help reduce risk of stroke. Lifestyle changes like quitting smoking or limiting alcohol and caffeine may also help. And Magill reports that some arrhythmias disappear once the underlying condition is treated. But for those who need more help, therapeutic procedures or electrical devices may be more effective.
Following a therapeutic heart rhythm procedure — a minor surgery — the heart should operate normally. Options include catheter ablation, where controlled amounts of energy are delivered to small places on the heart to block areas where abnormal electrical pathways are occurring. Cardioversion is another option, where the chest wall is given an electrical shock to help restore normal sinus rhythm.
Pacemakers are electrical devices that can be permanently placed in the heart to help a person have a normal heartbeat on an ongoing basis. Pacemakers can also prevent the heart from beating too slowly. Defibrillators are also electrical devices that can be permanently placed in the heart. Defibrillators differ from pacemakers in the sense that they are designed to detect life threatening ventricular arrhythmias and deliver a controlled electrical shock in an attempt to restore sinus rhythm.
According to Magill, the best treatment for an arrhythmia depends on your type of arrhythmia and individual health.
“You may have a friend with atrial fibrillation who used medication to treat their condition but another used cardioversion,” said Magill. “There are a lot of factors that affect how an arrhythmia is treated.”
If you suspect you have an arrhythmia, ask your doctor for a referral to Samaritan’s Heart Rhythm Center.