Abnormal heart rhythms
Key points
- Arrhythmias are caused by a disruption of the normal electrical conduction system of the heart.
- The first symptom may be sudden cardiac arrest (loss of heartbeat), which requires CPR.
- A doctor will listen to your heart with a stethoscope and feel your pulse.
- When an arrhythmia is serious and not well-tolerated, there may not be enough blood flow from the heart to vital organs, such as the brain or kidneys or to the heart itself.
Alternative names
Dysrhythmias; Arrhythmias
Definition
An arrhythmia is any disorder of heart rate or rhythm.
Causes, incidence, and risk factors
Arrhythmias are caused by a disruption of the normal electrical conduction system of the heart. Normally, the four chambers of the heart (two atria and two ventricles) contract in a very specific, coordinated manner.
The signal for the heart to contract in a synchronized manner is an electrical impulse that begins in the sinoatrial node (also called the SA node), which is the body's natural pacemaker.
The signal leaves the sinoatrial node and travels through the two atria, stimulating them to contract. Then the signal passes through another node (the AV node), and finally travels through the ventricles and stimulates them to contract in synchrony.
Problems can occur anywhere along the conduction system, causing various arrhythmias. There can be a problem in the heart muscle itself, causing it to respond differently to the signal, or causing the ventricles to contract independently of the normal conduction system.
Arrhythmias include tachycardias (the heartbeat is too fast), bradycardias (the heartbeat is too slow), and "true" arrhythmias (a disturbed rhythm).
Arrhythmias can be life-threatening if they cause a severe decrease in the pumping function of the heart. When the pumping function is severely decreased for more than a few seconds, blood circulation is essentially stopped, and organ damage (such as brain damage) may occur within a few minutes.
Life-threateaning arrhythmias include the following:
- Ventricular fibrillation
- Ventricular tachycardia that is rapid and sustained or pulseless
- Sustained episodes of other arrhythmias
Other arrhythmias include the following:
- Atrial fibrillation/flutter
- Multifocal atrial tachycardia
- Paroxysmal supraventricular tachycardia
- Wolff-Parkinson-White syndrome
- Sinus tachycardia
- Sinus bradycardia
- Bradycardia associated with heart block
- Sick sinus syndrome
- Ectopic heartbeat.
People at higher risk for arrhythmias and complications from arrhythmias include the following:
Frequently asked questions
What are the risk factors for abnormal heart rhythms?
Arrhythmias are caused by a disruption of the normal electrical conduction system of the heart. Normally, the four chambers of the heart (two atria and two ventricles) contract in a very specific, coordinated manner. The signal for the heart to contract in a synchronized manner is an electrical impulse that begins in the sinoatrial node (also called the SA node), which is the body's natural pacemaker. The signal leaves the sinoatrial node and travels through the two atria, stimulating them to contract. Then the signal passes through another node (the AV node), and finally travels through the ventricles and stimulates them to contract in synchrony.
What are the symptoms of abnormal heart rhythms?
- Sensation of feeling the heart beat (palpitations)
- Fainting
- Light-headedness, dizziness
- Chest pain
- Shortness of breath
- Changes in the rate, rhythm, or pattern of the pulse
- Paleness
- Temporarily absent breathing Note: The person may not have symptoms. The first symptom may be sudden cardiac arrest (loss of heartbeat), which requires CPR.
How are abnormal heart rhythms treated?
When an arrhythmia is serious and not well-tolerated, there may not be enough blood flow from the heart to vital organs, such as the brain or kidneys or to the heart itself. In such cases, treatment is urgent and may include electrical "shock" (defibrillation or cardioversion), the implantation of a temporary pacemaker to interrupt the arrhythmia by fast pacing (overdrive supression), or the administration of intravenous medications. For long-term treatment of arrhythmias, daily medications may be necessary. These include antiarrhythmic medications, medications to speed up or slow down the heart rate, and others.
Written and revised by
David Cohen, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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