Arrhythmia or Irregular Heartbeat: Symptoms and Causes

Statistics suggest that one in 18 people globally either have an arrhythmia or are at risk of developing the same as they age. The overall prevalence of arrhythmia or atrial fibrillation is gradually rising, claiming more and more lives each day.
Arrhythmia is the irregularity in your heartbeat, indicating that your heart isn’t beating in the standard or regular rhythm as it should.
Despite being a matter of concern, arrhythmias aren’t always fatal. Sometimes, they can be due to external factors like rigorous exercise, high altitude, etc. However, that doesn’t rule out the fact that arrhythmias, in some cases, need immediate medical attention.
Prolonged irregularities in the heartbeat can lead to an unwarranted heart attack in some people. So, staying alert and getting immediate help is crucial.
This article will explore more about Arrhythmia, its symptoms, causes, and treatment options.

What is Arrhythmia?

As we mentioned before, arrhythmia is an irregular heartbeat. Instead of beating at a steady rhythm, your heart might skip a few beats or add one of a few into it. This is called “fluttering” and leads to conditions like tachycardia or bradycardia.
If the skipped or added heartbeats aren’t that frequent or happen once, the symptoms aren’t noticeable.
However, if you feel uncomfortable or restless, paired with labored breathing, it can signify underlying complications that need medical interventions.
Also, arrhythmias aren’t always due to an underlying heart disorder. Sometimes, it can happen due to lifestyle habits like a rigorous exercise routine. The sinus, the heart’s natural pacemaker, is responsible for sending the signals to the right atria, which are further propagated.
Arrhythmia happens when this normal progression of the signal from the sinus is somehow inhibited in the process.

What are the Symptoms of Arrhythmia?

Surprisingly, the symptoms of arrhythmia often go unnoticed. If the heart skips or adds one or two beats, you won’t feel anything drastically different with your body.
The signs of arrhythmia generally start becoming more and more noticeable as the disease progresses. The symptoms are also quite prominent in patients with existing heart disorders, heart failure, or congenital heart defects.
Also, an arrhythmia can either be harmless or need immediate medical interventions.
Some of the symptoms of arrhythmia include:

• Palpitations due to a skipped heartbeat,
• Constant fluttering sensation in the chest,
• Fatigue and tiredness,
• Losing consciousness and passing out,
• Shortness of breath,
• Angina or chest pains,
• Uncontrolled heartrate (racing heart),
• Dizziness,
• Anxiety,
• Blurred vision,
• Excessive sweating.

You might feel a few symptoms, all the symptoms or no symptoms at all when it comes to the arrythmia.

What are the Primary Causes Behind Arrhythmia?

You were wrong if you thought that only people with pre-existing chronic disorders or poor lifestyles could have an arrhythmia. You could be a healthy individual and still have an arrhythmia, which isn’t that pronounced.
Besides that, some of the pivotal arrhythmia causes include:

• Congenital heart defects,
• Heart disease,
• Electrolyte imbalance in the blood, especially sodium and potassium,
• Stiffness in heart tissue,
• Restricted blood flow in and out of the heart,
• Post-surgical complications after heart surgery,
• Infection,
• High-grade fever,
• Side-effects of medications,
• Issues with electrical signalling in the heart,
• Poor lifestyle habits like smoking, tobacco, etc.,
• Stress,
• Sudden scare that elicits high emotions like a surprise,
• Hormonal changes,
• Scarring in the heart tissues,
• Blockage in the aorta,
• High blood pressure,
• Genetic predisposition,
• Thyroid disorders.

Although these irregular heartbeat causes seem terrifying, remember that not every arrhythmia results in a fatality. Sometimes, even a healthy person might skip a heartbeat or feel flutters. However, the condition does take a turn for the worse if the patient is already diagnosed with chronic diseases or birth defects.

What are the Types of Arrhythmia or Irregular Beats?

While most people are aware of a “racing heart” or “slagging heart” function, there is much more to it than basic knowledge. Medically, six different types of arrhythmia can show up in the test results.
They include the following.

Tachycardia

This is a type of arrhythmia or heart disorder in which the heart beats too fast (>100 beats per minute). It could be due to internal factors in the body, or it could be due to external factors like exercise, rigorous physical activities, etc.

Bradycardia

This is a type of arrhythmia in which the heart is beating too slow (generally less than 60 beats per minute). Patients with bradycardia often experience arrhythmia symptoms like angina, confusion, exhaustion, lightheadedness, etc.

Atrial fibrillation

In this condition, the sinus node relays irregular signals to the atrium. This leads to irregularities in the amount of blood pumped out of the upper valves. The irregular twitches in the atrium cause fibrillation, which further leads to arrhythmia, making the heart extremely tachycardiac.

Atrial flutter

Atrial flutter is a highly severe type that needs immediate medical intervention before it leads to a stroke. In this, the atrium beats at 250-400 beats per second due to an electrical imbalance in the heart. As the atrium beats at such a fast pace, it prevents the heart from beating efficiently and pumping out enough blood needed by the vital organs in the body. This leads to a lack of oxygenation of the brain and the myocardium, leading to a stroke.

Ventricular fibrillation

Like atrial fibrillation, in ventricular fibrillation, the ventricles fail to pump the blood out of the heart efficiently. Unlike atrial fibrillation, which isn’t always fatal, arrhythmia induced by ventricular fibrillation is often fatal and can lead to heart failure and stroke. Patients with ventricular fibrillation often experience nausea, dizziness, tachycardia, shortness of breath, etc.

Long QT syndrome (LQTS)

is a type of tachycardiac arrhythmia; the heart beats uncontrollably for a prolonged period, leading to dizziness, syncope, unconsciousness, or even death in severe cases. It is a genetic condition passed on to the children from their parents. It is rarely diagnosed at birth, and most patients experience it much later in their lives.

What kind of Complications Happen due to Arrhythmia?

As we have mentioned from the beginning, arrhythmias aren’t always fatal or risky. However, they can lead to multiple complications depending on the severity of the condition.
Some of the common complications associated with arrhythmia include:
Aneurysms – happens due to weakened arterial walls in the heart, leading to an uneven bulge in the structure and function of the artery.
Cardiomyopathy – causes the heart muscles to thicken, dilate or become stiff in some instances. Cardiomyopathy is life-threatening and often leads to excess fluid build-up in the lungs, knees, and brain.
Inflammations in the heart – in cases where the arrhythmia leads to stiffening of the heart muscles, the heart’s muscle can become inflamed as a protective mechanism. This can lead to weakness, shortness of breath, and tachycardia in patients.
Heart failure – a direct consequence of atrial or ventricular fibrillation; heart failure happens when the heart fails to pump the blood in and out of the organ optimally.
Narrowed arteries and valves – persistent arrhythmia affects the heart’s ability to pump enough blood in and out of it. This can even lead to issues with the valve function and lead to gradual narrowing of the supplying arteries.
Chronic obstructive pulmonary disease (COPD) – a very prevalent complication in a smoker, COPD often leads to ventricular fibrillation, which is highly heartbeats patient’s health.

What Risk Factors Contribute to Arrhythmia?

If you experience heart arrhythmia, there are several internal and external risk factors associated with the same. Some include:
Age – people above the age of 40 are at heightened risks of developing arrhythmias.
Genetic anomalies – having someone in the family with arrhythmia can enhance the chances of having the same.
Poor lifestyle choices – consumption of alcohol, tobacco, nicotine, and drugs can lead to risks of arrhythmia and heart failure.
Pre-existing medical conditions – chronic disorders like hypertension, diabetes, sleep apnea, obesity, and certain autoimmune diseases enhance the dangers of arrhythmia in the patients.
Environmental factors – pollution and stress markers can also contribute to arrhythmia.
The easiest way to prevent this is by taming the risk factors and steering clear off of them as much as possible.

What are the Diagnosis Modes for Arrhythmias?

Unless you are exhibiting arrhythmias symptoms, you’d not know when to seek medical help. However, when you talk to a doctor, imaging tests can effectively help monitor the issue.
Some of the standard diagnostic methods include:

Electrocardiogram (EKG)

This records the electrical activity of the heart to look for irregularities. The test is done by placing electrode patches on the chest, arms and legs of the patient, following which the machine is switched on to record the electrical activities in the heart.

Holter monitor

Irregularities in the heartbeat can happen at any time of the day. So, getting a holistic understanding of the all-day heart activity is crucial for a proper diagnosis. A Holter monitor works similar to an EKG machine but is portable equipment. The doctors might ask you to wear the Holter monitor for 1-2 days or even up to two weeks, depending on the severity of your heart functions.

Echocardiogram

The echocardiogram is similar to an ultrasound test but for the heart. It checks the functions and condition of the heart muscle and valve and records the heart's ejection fraction.

Stress test

This test analyzes the extent of stress your heart can sustain. Generally, the patient has to walk on a treadmill or a stationary bike while they are hooked to a heart monitor to check the heart rate and the changes to the blood pressure. The test starts with casual walking or biking, and the technician will gradually increase the intensity to assess the maximum capacity of the heart.
If none of the above tests give a comprehensive understanding of the issues, your doctor might suggest some advanced cardiac function monitoring tests like:

• Cardiac catheterization,
• Electrophysiology study,
• Implantable loop recorder, and
• Head-up tilt table test.

Depending on the overall test results, your doctor will be able to ascertain a diagnosis and then suggest the ideal treatment route.

How are Arrhythmias Treated?

Once you get a definitive diagnosis, your doctor will then move on to the treatment choices. The same depends on the severity of the condition and the long-term quality of life of the patient.
Following are a few treatment routes:

Type of Treatment	What do they do?	Options or Procedure
Medications	Treats uneven heartbeats	Beta-blockers Calcium channel blockers Potassium channel blockers Sodium channel blockers Adenosine Atropine Digoxine
Electrical cardioversion	Treats atrial fibrillation	Involves giving an electrical shock to trigger the heart’s natural rhythm
Pacemaker	Corrects heart rhythm	Implantable device that has a pulse generator that sends a direct impulse to correct uneven or irregular heart rhythms.
Implantable cardioverter-defibrillator (ICD)	Treats ventricular tachycardia or ventricular fibrillation	Tracks the heart rhythm and delivers an instant electrical shock to restore the natural rhythm in the heart.
Catheter ablation	Fixes electrical problems in the heart	Uses a catheter to deliver high-frequency electrical impulses into the heart to restore the natural electrical rhythm in the affected part.
Surgery	Corrects atrial fibrillation	Involves a surgical intervention to create cuts in the upper chambers of the heart for optimal transmission of the electrical impulses.

How can One Prevent Arrhythmias?

Unless the arrhythmia is due to an underlying chronic disorder or a genetic disorder, arrhythmias can be prevented by taking precautions.
Choosing a healthier lifestyle and eating a balanced diet allows the patients to avoid the occurrence of these irregularities in the heartbeats.
Some of the ideal preventative measures include:

• Avoiding excess caffeine intake,
• Avoiding recreational drugs in excess,
• Tackling and managing stress,
• Tracking regular blood glucose levels to avoid further metabolic disorders,
• Eating a balanced and nutritious diet,
• Ditching your sedentary lifestyle, and becoming more active.

If you are at risk of developing arrhythmias, it is ideal that you see necessary medical interventions. Sometimes, regular testing can prevent the further progression of an underlying disease.

FAQs

Is arrhythmia caused by stress?

Stress can be a prevalent contributor to arrhythmias in the heart. Excess and unregulated stress often contributes to atrial fibrillation, an irregular heartbeat.

Can anxiety cause arrhythmia?

Anxiety often leads to restlessness, stress, and panic, which can cause the person to hyperventilate, leading to excess heart muscle contraction and arrhythmias.

Can Arrhythmia be serious?

Yes, certain sudden or uncontrolled arrhythmias can be fatal and lead to heart failure or strokes in the patient.

Conclusion

Arrhythmia is progressing and increasing at an alarming rate among the population. With cardiovascular diseases being the #1 reason behind people’s death globally, being vigilant of the concerns and getting regular screening is the need of the hour. Don't hesitate to get tests done if you feel something amiss with your heart activity or overall health. It is always better to be safe than sorry.