Arrhythmia is an irregular heartbeat - the heart may beat too fast or too slowly. The condition is caused by changes in the heart’s electrical system or a short circuit in the heart. This causes the heart to pump blood inefficiently resulting in poor blood circulation in the body. This can lead to an increased risk of heart failure and stroke.

Types of Arrhythmia

There are two major types of arrhythmia, as follows:

  • Tachycardia (the heartbeat is too fast)
  • Bradycardia (the heartbeat is too slow)

Causes of Arrhythmia

The causes of arrhythmias vary in each patient.  Whether the heartbeat becomes faster or slower depends on the individual’s lifestyle, health history, and environment. Common causes of arrhythmia include:

  • Congenital defects or heart defects, such as congenital heart disease, valvular heart disease, hypertrophy (swelling of the heart), and ischemic heart disease (coronary artery disease).
  • Physical abnormalities that affect the ability of the heart to function well, such as high blood pressure, high blood cholesterol, diabetes, thyrotoxicosis, and electrolyte imbalance.
  • Certain medications, substances, and caffeine in tea, coffee, or carbonated drinks.
  • Stress and anxiety

Symptoms of Arrhythmia

Most patients with arrhythmias do not know that they have this problem. Arrhythmias are mostly discovered during a medical checkup or the treatment of other diseases. Sometimes, patients might have a family history of sudden cardiac arrest. However, some patients experience the following symptoms:

  • Dizziness
  • Blackouts
  • Lightheadedness
  • Palpitations
  • Shortness of breath
  • Chest pain
  • Fainting and collapsing

Diagnosis of Arrhythmia

  • Patient information is collected, including caffeine consumption (such as in tea, coffee or carbonated drinks) and underlying diseases (such as coronary thrombosis, high blood pressure, diabetes, and thyroid diseases)
  • Electrocardiogram (ECG or EKG) is performed when symptoms are observed at the hospital or could be performed at home as:
    • Holter monitoring test (a test of the heart’s rate and rhythm) is performed for 24 or 48 hours if the patient experiences symptoms often but not constantly.
    • Event recorder is only used when you have symptoms. The device can be a wrist band with an activation button or a pager-sized device that you press onto your chest if had dizziness and palpitation.
    • A looping monitor may be a wrist band, finger attachment, chest plate, or surgically placed under your skin. This device records several minutes at a time, then starts over. The patient will push a button during or after an event to save the recording if they rarely faint or collapse.
  • Exercise Stress Test (EST)
  • Echocardiogram
  • Cardiac electrophysiology study

Arrhythmia Treatment Options

The doctor will select a treatment based on the causes, symptoms, location, and severity of the disease. While some types of arrhythmias may not require treatment, certain types will necessitate medical intervention. These types are as follows:

  • Heart Rate Control Medications: Although the medications do not cure the problem, they can reduce episodes of arrhythmia and the severity of the symptoms. Some rhythm disorders respond well to medication.
  • Pacemaker: In order to maintain the heart rate at a regular beat, a small device called a pacemaker is placed under the skin near the collarbone with a wire extending from the device to the heart. The pacemaker helps regulate and optimise heart-rate-related functions.
  • Cardioversion: Cardioversion is used to slow down a rapid heartbeat. This is done externally, in a monitored setting. A small electrical shock is delivered to the chest wall that synchronises the heart rate in order to bring the heart back to a normal rhythm.
  • Ablation Therapy: This procedure is used to eliminate the source of the irregular heartbeat and can permanently cure certain heart arrhythmias. Ablation therapy is usually combined with electrophysiology studies. A catheter is threaded through the area of the heart that is believed to be the source of the arrhythmia. High-frequency electrical energy is then delivered to eliminate the small area of tissue inside the heart that causes the abnormal heart rhythm.
  • Implantable cardioverter defibrillator: This is a similar procedure to implanting a pacemaker. This device is recommended if the patient is at risk of developing a dangerously irregular heartbeat in the lower half of the heart (ventricular fibrillation). If the device detects a rhythm that is too slow, it will stimulate the heartbeat. In contrast, when the heart beats too fast, a series of small electrical impulses will be delivered to the heart muscle to slow it down and restore a normal heart rate.

Prevention of Arrhythmia

There is no guaranteed method for preventing arrhythmia, but you can reduce the risk in the following ways:

  • Don’t smoke, reduce stress, and drink coffee and alcohol in moderation, or not at all.
  • Eat a healthy diet and exercise regularly.
  • See your doctor for regular medical check-ups.