Arrhythmias

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Information about arrhythmias is available in Bengali, Polish, Punjabi, Romanian, Urdu and Welsh.

Arrhythmia explained

An arrhythmia is an abnormal heart rhythm.

Your heart needs to beat regularly to help pump blood around your body. There is an electrical system in your heart that sends out electrical impulses to help it to beat regularly and in time.

If the electrical impulses are not working properly, you’ll have an abnormal heart rhythm. This can cause your heart to beat too slowly, too quickly or not regularly.

Types of arrhythmias

There are different types of arrhythmias, the most common are:

• Atrial fibrillation is when your heart does not beat regularly. Your heart may also beat too quickly, or too slowly.
• Supraventricular tachycardia (SVT) is a very fast heart rhythm. There are different types of SVT. Most are caused by electrical impulses not travelling normally from the top chambers of your heart to the bottom chambers of your heart.
• Atrial flutter is usually a fast heart rhythm where the top chambers of your heart contract quicker than the lower chambers. This can cause the top chambers to beat extremely fast, sometimes up to 300 beats per minute (bpm).
• Tachybrady syndrome (sick sinus syndrome) causes periods of very fast (tachycardia) or very slow (bradycardia) heartbeats. This is because the heart’s electrical system is not working as it should.
• Heart blocks are caused by a delay or blockage in your electrical system between the top and bottom chambers of your heart which can cause a slow heart rate.

Is your heart rate fast or slow?

• Sinus tachycardia is when your heart beats in a regular way but it’s faster than 100 bpm.
• Sinus bradycardia is when your heart beats in a regular way but it’s slower than 60 bpm.

If you have sinus tachycardia or bradycardia it does not mean there's something wrong with your heart and you might not need treatment. Sometimes it can be caused by another condition which you may need treatment for. Your doctor might want to send you for tests to find out more.

Symptoms of arrhythmia

The symptoms you have depend on what type of arrhythmia you have. The most common symptoms include:

• palpitations (a thumping or fluttering sensation in your chest)
• dizziness
• feeling as if you may faint or ‘black out’
• feeling like you cannot breathe
• chest discomfort
• feeling tired.

Are arrhythmias dangerous?

Most arrhythmias are not dangerous, but some can be. That’s why it’s important to get help if you need it.

Dial 999 for an ambulance if:

• you have palpitations, feel like you cannot breathe and you have chest pain or feel faint or dizzy.

Speak to your GP about your symptoms if:

• your palpitations last a long time, do not improve or get worse
• you have a history of heart problems
• you're concerned about the palpitations.

Causes of an arrhythmia

Some conditions can cause an arrhythmia, such as:

• a heart attack
• heart failure
• cardiomyopathy
• coronary heart disease.

You can sometimes develop arrhythmias after some types of heart surgery.

Some arrhythmias can be caused by inherited conditions, such as Long QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia (CPVT) or progressive cardiac conduction defect (PCCD).

If this is the case for you, your doctor will talk to you about having family members tested. Although this can be scary, it can help them know if they need treatment now or in the future.

Other common triggers of an arrhythmia include:

• viral illnesses such as flu, the common cold or norovirus
• recreational drugs
• alcohol
• smoking
• caffeine
• medicines (over the counter and prescribed).

Diagnosing an arrhythmia

Your GP might refer you for tests including:

• an ECG
• an echocardiogram
• an electrophysiological (EP) study.

An ECG may include different tests such as a 24hr ECG, exercise ECG, and an implantable loop recorder.

Treating an arrhythmia

Your treatment will depend on your type of arrhythmia. Common treatments include:

• medicine
• cardioversion
• catheter ablation
• having an implantable cardioverter defibrillator (ICD) or pacemaker fitted.

Living with an arrhythmia

Most arrhythmias are manageable. This means that with the right treatment you can carry on living as you were before you were diagnosed.

Living with an abnormal heart rhythm can be emotionally challenging for you and your family. It's important to manage anxiety and stress and get support from your GP or loved ones if needed.

You might have to think about practical matters like driving, going on holiday and returning to work after being diagnosed with an arrhythmia.

Talk to your manager or occupational health department if you have one, if you think your work may be affected.

• Read our expert tips on living with atrial fibrillation, a type of arrhythmia.

Heart Helpline and other support

• Speak to our cardiac nurses by phone, call back, email or online chat on Heart Helpline (Monday to Friday, 9am to 5pm).
• Sign up to Heart Matters magazine for online information packed with health and lifestyle advice.