What is an arrhythmia?

What is arrhythmia? 

Types of arrhythmias 

Atrial fibrillation 

Atrial flutter  

Ectopic heartbeats  

Paroxysmal arrhythmias  

Heart block (atrioventricular heart block and bundle branch block) 

Long QT syndrome, Brugada syndrome and Wolff-Parkinson-White (WPW) syndrome 

Supraventricular tachycardia (SVT) 

Tachybrady syndrome (sick sinus syndrome)  

Ventricular tachycardia 

Ventricular fibrillation  

Are arrhythmias serious? 

Arrhythmia symptoms 

• Anxiety 
• Chest pain 
• Fainting (syncope) 
• Fatigue 
• Fluttering or pounding in your chest 
• Light-headedness or dizziness 
• Racing heartbeat when feeling at the wrist (tachycardia) 
• Slow heartbeat when feeling at the wrist (bradycardia)  
• Shortness of breath 
• Sweating

Causes of arrhythmia  

• A heart attack 
• Congenital heart disease  
• Coronary heart disease  
• Diabetes 
• High blood pressure 
• Heart failure 
• Obstructive sleep apnea (OSA) 
• Structural heart abnormalities – such as from cardiomyopathy, valve disease or scarring from a previous heart attack. 
• Thyroid problems

• Aging 
• Being overweight 
• Drinking too much alcohol or caffeine 
• Drug abuse 
• Electrolyte imbalance 
• Genetics 
• Smoking 
• Some medications and supplements, including over-the-counter cold and allergy medications and weight loss or nutritional supplements 
• Stress or anxiety. 

Arrhythmia triggers 

• Alcohol 
• Caffeine 
• Nicotine (either cigarettes or e-cigarettes) 
• Tiredness 
• Unrelated illness such as a cold or flu 
• Some medications (either over-the-counter or prescription).  
• Stress (physical or emotional). 

Diagnosing arrhythmia 

• Electrocardiogram (ECG) – This test measures your heart’s electrical signals and  the timing and duration of each electrical phase in your heartbeat. 
• Holter monitor – This is a portable ECG. It records your heart's activity for 24 hours or longer. 
• Event recorder – This is also a portable ECG. It records your heart's activity over weeks to months. 
• Echocardiogram – This test creates moving pictures of your heart. It may diagnose structural heart disease or blood clots in your heart. 
• Implantable loop recorder – This may be implanted under your skin in the chest area to continually record your heart's electrical activity and detect abnormal heart rhythms. 
• Stress test (exercise testing) – This test measures arrhythmias triggered by exercise. 
• Tilt table test – This test monitors your heart rate and blood pressure as you lie flat on a table and how your heart responds when you stand up. 
• Electrophysiological testing and mapping – In this test, electrodes can map the spread of electrical impulses through your heart. Doctors can use the electrodes to stimulate the heart to trigger an arrhythmia. 

Arrhythmia treatment

Arrhythmia treatment may only be required if the arrhythmia is life-threatening, or causes significant symptoms or serious health problems. Treatment depends on the cause of the arrhythmia and how it impacts your health. 

These include:  

• Electrical cardioversion – An electrical shock to the chest done under general anaesthesia to restore the heart’s normal electrical rhythm. 
• Catheter ablation – A procedure performed in hospital using a catheter to destroy (ablate) the area inside the heart that is causing the abnormal rhythm. If your doctor recommends an ablation, they will discuss the benefits and risks with you. 
• Medication – Regular medication can be given to normalise the heart’s rhythm (anti-arrhythmic agents) or slow the heart rate (beta-blockers, some calcium channel blockers and digoxin). Blood thinning (anticoagulation) medications may be prescribed if your doctor feels your arrhythmia increases your risk of stroke.   
• Pacemaker – A small implantable device that electrically stimulates the heart to maintain a regular heart rhythm. 
• Implantable cardiac defibrillator (ICD) – To continuously monitor and correct your abnormal heart rhythms as needed. 
• Automate External Defibrillation (AED) – A mild electrical current is used to ‘reset’ your heart rhythm in a cardiac arrest.  

Living with an arrhythmia 

If you’ve been diagnosed with an arrhythmia, you may have a lot of questions. You may wonder how serious your condition is and what it means for the future. 

It's normal to feel many emotions such as fear, anxiety and low mood. Talk to your doctor if these feelings last longer than two weeks. There are steps you can take to help you manage your condition and relieve any worries you may have.  

To help manage your condition, you can: 

• Ask your doctor questions to understand your arrhythmia and its treatment 
• Identify your arrhythmia triggers 
• Avoid or reduce alcohol intake 
• Always take your medication as prescribed 
• Know when to seek urgent help 
• Stay physically active 
• Manage your risk factors for heart attack, as they are also important in management of arrhythmias 
• Attend cardiac rehabilitation – structured exercise and education about heart health.