Arrhythmia

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Dr Sarah Marshall

Medically reviewed by:

Dr Sarah Marshall - Medical Officer

Updated: Aug 18, 2021
Next review: Aug 18, 2022
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Arrhythmia is when you have a problem with the rhythm of your heart - it could beat too fast, too slow or irregularly. It is caused by a problem with the electrical impulses in your heart.

There are many different types of arrhythmia. A lot of people can live with the condition without much worry, but in some people it can be a dangerous condition.

There are a number of different types of heart rhythm problems, some of which include:

  • Atrial fibrillation

This is the most common type and it’s where your heart beats irregularly and often too quickly. It is more common in men over the age of 60 (although it can affect anyone) and can lead to a stroke in some cases.

  • Atrial flutter

This can develop suddenly and may come and go, but it can be a serious condition causing the heart to beat very fast. It’s similar to atrial fibrillation, but more common in people who have existing heart conditions.  

  • Bradycardia

This is where your heart beats slower than normal and can be a problem if it means that you aren’t getting enough oxygen pumped around your body.

  • Sick sinus syndrome

If your sinus node, which sets your heart rate, isn’t working properly, your heart can slow down, and beat irregularly.

  • Heart block

Heart block is a blockage of the normal conductive mechanism in the heart and it can cause you to feel dizzy or faint.

  • Supraventricular tachycardia

This is where your heart beats too quickly, and it can start unexpectedly, and last for a short time, or a long time. It usually starts when you’re a child or teenager but can affect anyone.

  • Ventricular fibrillation

This is life-threatening - it causes a rapid, irregular heartbeat that means your heart can’t pump blood around your body, so your heart output drops and can cause you to lose consciousness and may cause cardiac arrest.

  • Ventricular tachycardia

This causes your heart to beat faster and is more common in people who have an existing heart condition. It can also lead to ventricular fibrillation.

Due to the different arrhythmia types, the symptoms can vary depending on the type that you have. Some of the most common arrhythmia symptoms include:

  • Thumping or fluttering feeling in your chest (palpitations)
  • Breathlessness
  • Dizziness or lightheadedness
  • Irregular pulse or a fast/slow pulse
  • Loss of consciousness
  • Sweating
  • Chest pain
  • Anxiety

As we mentioned though, as there are many different types, it is hard to say which symptoms you will get.

It is normal for your heart rate to change at different times, such as when you are resting or during exercise. However, an abnormal heart rhythm could mean that there is a problem with the electrical signals that cause your heart to beat. You should see a doctor if:

  • you are worried about your palpitations
  • the palpitations happen regularly
  • you feel faint or dizzy when you have the palpitations
  • you have heart problems, or a family history of them.

If an arrhythmia is suspected, It is likely you will be referred to a heart specialist, who will usually run tests, such as an electrocardiogram (ECG), to give them a clear picture of what is causing your symptoms. This can be done in hospital, or you may need to wear a portable heart monitor for a period of time so your heart can be monitored.

Other tests may include:

  • An ECG whilst you are doing exercise
  • Blood tests
  • Electrophysiological study

Other tests are available - the heart specialist will be able to advise on which tests you will need, how they work and why you are having them.

You should go straight to the Emergency Department if you experience:

  • Palpitations and chest pain
  • Palpitations that go on continuously for more than 15 minutes
  • Palpitations which cause you to faint or nearly faint
  • Palpitations and significant shortness of breath

There are a number of cardiac arrhythmia causes. It could be because of a heart attack or angina, high blood pressure, or it could have something to do with your thyroid. It can also be caused by medication, consuming too much caffeine, smoking, or many other things.

As the condition is so varied, it’s best to speak to an expert to try to understand the cause of the arrhythmia.

Your treatment will be suited to the type of arrhythmia you have. In some cases, no treatment may be necessary, but other people will need it.

If there is another medical condition causing the problem, such as angina, then this will be treated at the same time.

Some treatments that may be recommended include:

  • medication to stop or try to prevent the arrhythmia happening
  • cardioversion - an electrical shock is used to try to restore your heart to its normal rhythm, under anaesthetic
  • catheter ablation - this treatment will destroy the damaged heart tissue, through keyhole surgery but is only suitable for certain types of arrhythmias
  • implantable cardioverter defibrillator (ICD) - this is a device that will monitor your heart rate and shock the heart to restore normal rhythm if needed - it’s inserted just under your skin
  • pacemaker - this device is fitted just under your skin and produces electrical signals to keep your heart beating normally.

You can also adjust parts of your lifestyle to help you stay as healthy as possible, including cutting back on alcohol and caffeine, quitting smoking if you are a smoker and eating a balanced diet. Regular exercise may also help.

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