Is your heart beating to a different rhythm?

A guide to managing arrhythmias

Most everyone has experienced an odd heartbeat - feeling your heart race, pound, flutter, pause or skip a beat. These episodes of unusual heart rhythm, or arrhythmia, caused by abnormal electrical impulses in the heart, are often minor and harmless. However, sustained or more serious irregular rhythms can pose a danger and lead to cardiac arrest.

Some people don’t notice any symptoms. Others feel:

  • palpitations or a galloping or sluggish heartbeat
  • shortness of breath
  • chest pain or discomfort
  • fatigue or weakness
  • dizziness
  • unexplained falls or fainting.

If you experience any of these symptoms suddenly or frequently, seek urgent care.

The presence or absence of symptoms does not determine the severity of the problem. Sometimes very symptomatic arrhythmias can be a nuisance but benign. However, less symptomatic arrhythmias can appear without warning and can be lethal. “Sudden cardiac arrest is a potentially lethal arrhythmia that kills 400,000 a year in the U.S. and it may have no warning,” says Dr. Robert Sorrentino, Cardiologist and Director of Arrhythmia Services at the Heart and Cardiovascular Services. 

What’s going on with your heart rhythm?

A normal heart rate is between 50 and 100 beats a minute. Physicians classify the many types of arrhythmias according to where they originate and the type of heart rate they cause. A rate faster than 100 beats a minute is called tachycardia and slower than 50 beats a minute is called bradycardia.

Treating your arrhythmia

Not all arrhythmias require treatment, but patients need to manage arrhythmias that cause significant symptoms, increase risk for a more serious condition, or impair the heart’s efficiency and circulation. The Heart and Cardiovascular Services offers many effective options for taking care of arrhythmias including:

  • Lifestyle measures. Exercise, an improved diet, better stress management, not smoking, and limiting caffeine and alcohol are ways to reduce arrhythmia that results from underlying heart disease.
  • Vagal maneuvers. Some types of tachycardia can be treated by stimulating your vagus nerve—the part of the nervous system that helps regulate your heart rate—which acts to slow your heart rate. 
  • Drugs. There are medicines that effectively treat many arrhythmias to slow or suppress tachycardia. Those taking these medicines are monitored regularly by their doctor for any side effects. Frequently, one must take these medicines for the rest of his or her life.
  • Implantable devices. Surgery to implant an artificial pacemaker is a common treatment for bradycardia. Another device, the implantable cardiac defibrillator, can be placed in the chest to correct an abnormally fast heartbeat.  “These defibrillators have the ability to recognize arrhythmias in 10 seconds or less and are potentially lifesaving for those at high risk for heart rhythm abnormalities,” says Dr. Sorrentino. 
  • Cardioversion. This treatment uses drugs or an electrical shock to reset the heart to its regular rhythm. 
  • Electrophysiology studies.  This method is performed by threading catheters through blood vessels and positioning them in the heart to determine the specific mechanism and location of a heart rhythm abnormality. 
  • Catheter ablation. Ablation is frequently done at the same time as the diagnostic electrophysiology study.  The doctor delivers radiofrequency energy, via the catheter, to carefully destroy, or ablate, the abnormal portions of the heart causing the arrhythmia. 
  • Open-heart surgery. Your heart rhythm expert may refer you to a cardiothoracic surgeon, who may use open-heart surgery or minimally invasive techniques to help eliminate arrhythmias.  Patients suffering severe coronary artery disease in addition to ventricular tachycardia may require coronary bypass to improve blood supply to the heart.

The bottom line

It’s important to tell your doctor about any symptoms of arrhythmia you experience. Even if symptoms pass quickly, your heart’s ability to work may be compromised. Over time, a seemingly harmless arrhythmia could lead to a more serious condition.