Heart arrhythmias occur when your heart beats abnormally and irregularly.

At rest, for an adult, your heart will beat between sixty to a hundred times in a minute at a regular rhythm. If your heartbeat is less than sixty or more than a hundred, you might be suffering from a heart arrhythmia. There can be a change in the rhythm as well.

There is an electrical system in your heart that makes it beat at regular intervals. The SA node, a bundle of nerves present in the walls of the right atrium, generates these electrical impulses. Thus, the SA node is the natural pacemaker of the heart. From there, the impulses travel to other chambers of the heart, making them contract and relax, causing a heartbeat.

In arrhythmias, you have problems with the ways the impulses travel across the heart. Your heart may thus beat too fast, slow, or irregularly.

Your heart may beat at a different rate and rhythm at times. Smoking, too much alcohol or coffee, stress, anxiety, etc. are some of the reasons. You will not need any treatment, and your heart rate will be normal after some time. 

But some arrhythmias occur due to problems with the heart and cause various disturbing symptoms. Some other body disorders can also cause arrhythmias. In such situations, you will need treatment to correct it.

More often, treating the condition that is the cause will help to control the situation. Otherwise, you will need medical and surgical procedures of the heart.

Risk factors of arrhythmia

Some of the risk factors that increase your risk are

• Coronary artery disease
• Previous heart attack
• Heart valve disease
• High Blood Pressure and cholesterol levels, diabetes
• Smoking, alcohol or drug abuse  
• Being overweight
• An inactive lifestyle without any exercise
• Physical or mental stress
• Family history of arrhythmias or other heart diseases
• Advancing age
• Sleep apnea
• Use of certain medicines and herbal supplements

What causes arrhythmia?

A heartbeat is a period where your heart contracts and relaxes. During contraction, your heart pumps out blood while during relaxation, it fills up with blood. Your heart contracts and relaxes due to electrical impulses.

The SA node, an area of the heart in the right atrium, is the natural pacemaker of your heart. From there, the impulses move on to the other chambers through a pathway of nerves. 

You can have an arrhythmia due to two reasons. The first one is when areas in your heart other than the SA node start generating electrical signals. It upsets the normal rhythm of your heartbeats. 

A fault in the proper transmission of electrical signals to the heart chambers can also cause arrhythmias. The signals can travel very fast around the heart to increase the heart rate.

Types of arrhythmia

In an arrhythmia, your heart will either beat too slow or too fast. If your heart rate is less than sixty, you have bradycardia. A resting heart rate of more than a hundred means you have tachycardia.

The common types of arrhythmias are:

Atrial fibrillation(A-fib): This is the irregular beating of the atrial chambers. The beating is out of coordination with the lower chambers of the heart, the ventricles. It nearly always involves tachycardia. It is a common type, with older adults more prone to it.

Atrial flutter:  In this type, atria, which are the upper chambers in your heart, beat too quickly. So, your heart will start to beat faster than usual.

Supraventricular tachycardia (SVT):  It is a group of conditions where your heartbeat will be faster than usual. Both A-fib and atrial flutter are Supraventricular tachycardias. 

Ventricular tachycardia refers to a condition where the ventricles, the lower chambers of the heart, beat faster.

Ventricular fibrillation: It is a serious life-threatening condition where the ventricles quiver instead of pumping blood. 

Long QT syndrome: It is a serious heart rhythm disorder that causes rapid heartbeats. 

Symptoms of arrhythmia

Whenever you have an arrhythmia, you will have some of the following symptoms.

• Your heart beats fast than other
• Palpitations
• Breathlessness
• Feeling dizzy
• Other signs include
• Anxiety
• Feeling panicky
• Being nervous
• Sweating 
• Feeling lightheaded

Your symptoms will depend on the type of arrhythmia you have. These may be temporary or last for a longer time. You will need treatment if these signs last for a long time

Diagnosis of arrhythmias

The common tests include:

• Electrocardiogram (ECG): It helps the doctor to identify problems with your heart rhythm
• Holter monitor: This is a portable ECG machine used to monitor the heartbeat over one or two days continuously
• Event monitor:  It can monitor the heartbeats for longer periods like weeks or months 
• Stress testing: to test if you have abnormal heartbeats when the heart has to work harder than normal
• Arrhythmia Treatment  

The doctors will decide your treatment by looking into a few things. These include the,

• The reason why it happens
• Risk of serious complications
• The severity of your symptoms 

Medications

Medicines are the most common mode of treatment. You will have medicines to 

• Keep your heart rate down (beta-blockers and calcium channel blockers)
• Keep your heart rate regular (antiarrhythmic drugs)
• Prevent the formation of clots (blood thinner drugs)

In most cases, these will be enough to keep the condition under control. But if these do not help, you may need other treatments.

Lifestyle modifications

In many cases, you can control arrhythmia by making some changes to your lifestyle such as 

• Stop smoking
• Limit consumption of alcohol, caffeine
• Regular physical activity 
• Avoid stress
• Maintain a healthy weight

Electrical cardioversion

In this procedure, the doctor will use a special machine to give small electric shocks to your heart. It helps to correct the abnormal heart rhythms and rate. 

You will be under sedation during the procedure. While the procedure will take only a few minutes, you will need around two hours to prepare for it. 

Catheter ablation

In this procedure, your doctor will use heat to burn the areas of the heart muscles that create abnormal impulses. It is the best treatment for supraventricular tachycardias.

Your doctor will do the procedure with the help of a catheter with an electrode tip. The catheter will reach the heart through a blood vessel in your arms or groin. The electrode tip creates heat through radio frequency vibrations. The cardiologist will burn the area that creates abnormal impulses by placing the electrode over it. 

It is a safe procedure with very few risks and complications. The duration of the procedure will be around an hour. You will be in the hospital for only a day or two.

Pacemaker implantation

You will have a pacemaker if your heart beats too slowly. The pacemaker has two parts, a pulse generator and leads that connect it to the heart muscles. The surgeon will place the generator in a small pocket under the skin of your collarbone. The leads pass through one of the blood vessels going to the heart.

Whenever your heart slows down, the generator will send signals to make it beat faster.

Implantable cardioverter defibrillators (ICD)

If you have severe ventricular arrhythmias, you will have an ICD. It reduces your risk of a sudden cardiac arrest. This device corrects the rhythm of the heart whenever it starts beating abnormally through electrical impulses.

Maze surgery

It is very useful for atrial fibrillation. In this, the surgeon will create scars in the heart muscles by using electrodes. The scar tissue prevents the abnormal transmission of electrical impulses through the heart muscles