An arrhythmia is an abnormal heart rhythm or heartbeat.

There are two basic types of arrhythmias:

  • Bradycardia — when the heartbeat is too slow
  • Tachycardia — when the heartbeat is too fast

Atrial fibrillation, sometimes called afib, is the most common type of tachycardia.

Atrial fibrillation is an irregular heartbeat that sometimes feels like quivering or fluttering in the chest.

Some arrhythmias are harmless and have no noticeable symptoms.

Others can be serious or life threatening. In some instances, abnormal or irregular heart rhythms can cause the heart to stop beating. This is called cardiac arrest.

Causes of Arrhythmias

Arrhythmias happen when the electrical signals that control heartbeat don't work properly.

This can happen if the nerve cells that send the electrical signals are damaged or if the electrical signals don't travel properly through the heart.

Normal heartbeat can also be disrupted if the heart produces too many electrical signals.

Sometimes the cause of an arrhythmia is unknown.

Arrhythmias are common in older adults. Older adults are more likely to have heart disease, high blood pressure, and other health conditions that can cause arrhythmias.

Some medications can also cause arrhythmias as a side effect.

Prescription and over-the-counter (OTC) drugs that can cause arrhythmias include tricyclic antidepressants (TCAs), antihistamines, and beta-blockers.

Additionally, illegal drugs such as cocaine and methamphetamines, and stimulants including caffeine and nicotine, can cause arrhythmias.

Arrhythmia Symptoms

Many arrhythmias don't cause any symptoms.

If they do, common signs and symptoms of an arrhythmia may include:

  • Palpitations (may feel like fluttering in your chest, like your heart is skipping a beat, or like it is beating too hard or too fast)
  • Feeling pauses between heartbeats or an irregular pattern
  • Fatigue, weakness, lightheadedness
  • A slow heartbeat

Some arrhythmias are medical emergencies. During an arrhythmia, the heart may not be able to pump enough blood to the body and the heart may stop working.

If you experience the following symptoms, call 9-1-1:

  • Significant weakness, dizziness, or light-headedness
  • Fainting or feeling like you are going to faint
  • Shortness of breath
  • Chest pain

Arrhythmia Diagnosis

There are a number of tests and devices that may be used to detect an arrhythmia.

Diagnosing an arrhythmia usually requires recording the heart's electrical activity using an electrocardiogram, or ECG.

A Holter monitor — a portable, 24-hour ECG — may also be ordered by your doctor.

Small patches or stickers called electrodes will be stuck to several spots on your chest and body.

These electrodes will generate a picture of your heart's electrical activity so doctors can see where any irregularities may occur.

An echocardiogram — a type of ultrasound that uses sound waves to produce images of your heart — may also be used to diagnose arrhythmia.

Stress tests, which use physical exertion (such as running on a treadmill) or drugs to simulate such exercise, can trigger an arrhythmia and help a doctor make an accurate diagnosis.

Risk Factors For Arrhythmias

Common risk factors for arrhythmias include:

  • Heart attack
  • Heart failure or cardiomyopathy
  • Abnormal heart valves
  • Congenital (present at birth) heart defects
  • High blood pressure
  • Sleep apnea
  • Smoking
  • Use of some prescription or over-the-counter medicines
  • Use of some street drugs (cocaine or amphetamines)
  • Too much caffeine or nicotine
  • Extreme emotional stress or anger

Arrhythmia Treatments

Arrhythmias can be treated with drugs, medical procedures, or surgery.

Medications can slow down a heartbeat that is too fast. They can also be used to even out or stabilize an abnormal heart rhythm.

Classes of drugs used to treat arrhythmias include beta-blockers, anticoagulants, calcium channel blockers, and anti-arrhythmic drugs.

Some arrhythmias, including heartbeats that are too slow, can be treated with a pacemaker.

A pacemaker is a medical device that's placed under the skin on your chest. The device electronically monitors and (by sending electrical impulses to your heart) moderates your heartbeat.

Arrhythmias caused by coronary artery disease may be treated with an intracoronary stent or a coronary artery bypass graft, or CABG.

In a CABG, a surgeon implants a piece of healthy blood vessel (usually taken from a leg or arm) to create a bypass around a blocked coronary artery.

Home Remedies for Arrhythmia

Regardless of any medical interventions that are recommended for treating arrhythmia, your doctor may also advise common-sense lifestyle changes, including:

Additionally, some arrhythmias can be treated with simple home exercises called vagal maneuvers that can help control heart rate.

Some vagal maneuvers include:

  • Gagging or coughing
  • Holding your breath and bearing down
  • Putting your fingers on your eyelids and pressing down gently

Vagal maneuvers aren't right for everyone, and they only work for certain types of arrhythmias. Talk with your doctor before trying any of these exercises.