What is Heart Arrhythmia? Symptoms and causes

Your heart doesn’t just beat—it follows a carefully timed electrical pattern to keep blood flowing efficiently. When this rhythm is disrupted, either by being too fast, too slow, or erratic, it’s called an arrhythmia. These disruptions can occur in a healthy heart or in one already affected by disease. 

The condition may arise from problems in the heart's electrical conduction system, certain medications, high blood pressure, or underlying conditions like diabetes or thyroid disorders. While not always dangerous, any irregular heartbeat warrants attention—primarily if it occurs frequently or causes noticeable symptoms. Let’s explore the topic.

Different Types of Arrhythmia

Arrhythmias are generally classified based on the speed and origin of the irregular heartbeat. They fall into two main categories: tachycardia, where the heart beats way too fast (over 100 beats per minute), and bradycardia, where it beats too slowly (under 60 beats per minute). Within these, several distinct types exist:

• Atrial Fibrillation (AFib): The most common form, marked by rapid, chaotic electrical signals in the upper chambers (atria). It increases the possibility of stroke & heart failure if untreated.
• Atrial Flutter: Similar to AFib but with a more organized rhythm pattern. It can occasionally switch into AFib over time.
• Supraventricular Tachycardia (SVT): A broad term for arrhythmias that start above the ventricles, often causing sudden bursts of rapid heart rate.
• Ventricular Tachycardia (VT): A fast rhythm originating in the lower chambers (ventricles). It can become life-threatening if sustained.
• Ventricular Fibrillation (VF): A medical emergency where the ventricles quiver instead of pumping blood, requiring immediate defibrillation.
• Premature Heartbeats: Early beats that interrupt the regular rhythm, often harmless but may feel like a skipped or extra beat.
• Bradyarrhythmias: These include sinus node dysfunction (a slow or paused natural pacemaker) and heart block (interrupted electrical signals between atria and ventricles).

Symptoms of Arrhythmia

• Fluttering in the chest – A sensation of the heart skipping, racing, or pounding unexpectedly.
• Rapid heartbeat (tachycardia) – Feeling like the heart is beating too fast, often out of proportion to activity level.
• Slow heartbeat (bradycardia) – Unusually slow pulse, especially when accompanied by fatigue or dizziness.
• Chest pain or discomfort – Pressure, tightness, or pain in the chest, especially in more serious arrhythmias.
• Shortness of breath – Difficulty in breathing even while resting or during light activity.
• Lightheadedness or dizziness – A feeling of being off-balance, faint, or unsteady.
• Fainting (syncope) or near-fainting – Sudden loss of consciousness or feeling like you might pass out, which can be a sign of reduced flow of blood to the brain.
• Fatigue or weakness – Unusual tiredness that doesn't improve with rest, sometimes caused by inefficient heart pumping.
• Sweating – Cold, clammy sweat during an episode, especially when accompanied by other symptoms.
• Anxiety or a sense of impending doom – A vague but intense feeling that something is wrong, sometimes linked to sudden heart rhythm changes.
• Palpitations – Awareness of the heartbeat that feels abnormal, irregular, or forceful.
• Exercise intolerance – Inability to perform physical activities that were previously manageable due to breathlessness or heart symptoms.

What Causes an Arrhythmia

• Coronary artery disease – Blocked or narrowed arteries reduce blood flow to the heart, which can damage tissue and interfere with electrical signals.
• Heart attack or scarring from a previous heart attack – Damaged heart tissue can create abnormal pathways for electrical signals.
• High blood pressure increases the workload on the heart and can cause the heart muscle to thicken, which in turn affects electrical conduction.
• Congenital heart defects – Abnormal heart structure present at birth can interfere with normal electrical signaling.
• Electrolyte imbalances – Uneven levels of potassium, calcium, magnesium, or sodium can disrupt the heart’s electrical system.
• Heart valve disorders – Malfunctioning valves can stretch or strain the heart, thereby increasing the risk of arrhythmias.
• Hyperthyroidism or hypothyroidism – Overactive or underactive thyroid glands can alter heart rhythm.
• Excessive alcohol consumption – Heavy drinking can trigger episodes of atrial fibrillation and other rhythm disturbances.
• Caffeine, nicotine, and recreational drug use – These stimulants can increase heart rate and provoke abnormal rhythms.
• Sleep apnea – Interrupted breathing during sleep puts stress on the heart and can contribute to irregular heartbeats or arrhythmias.
• Certain medications and supplements – Some prescription drugs, over-the-counter cold remedies, and herbal products can affect heart rhythm.
• Sick sinus syndrome – A malfunction in the heart’s natural pacemaker (sinus node) can cause alternating fast and slow rhythms.
• Diabetes – Often associated with high blood pressure and heart disease, increasing arrhythmia risk.
• Stress or strong emotional reactions – Acute stress can influence heart rhythm through hormone surges and nerve responses.
• Genetic conditions – Inherited syndromes, such as Long QT syndrome or Brugada syndrome, can predispose individuals to dangerous rhythm abnormalities.

Who Is at Risk for Arrhythmia?

Anyone can experience an arrhythmia, but certain groups carry a significantly higher risk. Older adults are more prone to natural changes in heart tissue and increased likelihood of conditions like diabetes, high blood pressure, or coronary artery disease.

Individuals with a family history of arrhythmias or inherited heart conditions are also at higher risk. Lifestyle factors such as heavy alcohol use, frequent caffeine intake, smoking, and use of stimulant drugs can increase vulnerability. 

People with untreated thyroid disorders, sleep apnea, or electrolyte imbalances face elevated risk, as do those who have undergone heart surgery or suffered a heart attack. Additionally, certain medications—especially when misused or combined—can provoke rhythm disturbances.

Even athletes engaged in extreme endurance training may develop arrhythmias due to structural changes in the heart.

How Arrhythmias Are Diagnosed

• Physical examination – Includes checking pulse blood pressure and listening to heart sounds for irregularities.
• Electrocardiogram (ECG or EKG) – A standard, painless test that records the heart’s electrical activity and can detect many types of arrhythmias.
• Holter monitor – It is a portable ECG device worn for 24 to 48 hours that tracks heart activity during everyday daily routines.
• Event monitor – A lot similar to a Holter monitor but it is used over several weeks; records only when triggered by symptoms or abnormal rhythms.
• Implantable loop recorder – A small device placed under the skin to continuously monitor rhythms of the heart for months or years, helpful for infrequent symptoms.
• Echocardiogram – This device uses ultrasound to create images of the heart’s structure and motion, helping identify underlying causes like valve issues or weak heart muscle.
• Stress test (exercise test) – Monitors the heart’s rhythm during physical exertion to assess how it handles increased workload.
• Tilt table test – Used for people who experience fainting; measures heart rate and blood pressure while the body is tilted at different angles.
• Electrophysiological (EP) study – A specialized invasive test where catheters are threaded into the heart to map electrical activity and pinpoint the origin of the arrhythmia.
• Blood tests – Used to check for thyroid problems, electrolyte imbalances, or other conditions that may trigger arrhythmias.
• Cardiac MRI or CT scan – Provides detailed images of the heart’s structure and blood vessels when more information is needed about anatomy or blood flow.
• Coronary angiogram – This may be used when coronary artery disease is suspected as a contributing factor; it involves the injection of dye and X-ray imaging of the heart arteries.

Treating Arrhythmia

• Lifestyle changes – Reducing caffeine & alcohol intake, quitting smoking, managing stress, & treating sleep apnea can help control or prevent arrhythmias.
• Treating underlying conditions – Managing high blood pressure, thyroid issues, heart disease, or diabetes can reduce arrhythmia risk and severity.
• Vagal maneuvers – Techniques such as holding your breath and bearing down, coughing, or applying cold stimuli may help slow certain types of fast heartbeats.
• Cardioversion – A controlled electric shock is sent to the chest to reset the heart to a normal rhythm, typically used for atrial fibrillation or flutter.
• Catheter ablation – A minimally invasive procedure in which flexible tubes are inserted through blood vessels to deliver energy that destroys small areas of heart tissue, causing abnormal signals.
• Pacemaker implantation – A small device placed under the skin near the collarbone that sends electrical signals to maintain a regular heartbeat, often used for slow rhythms.
• Implantable cardioverter-defibrillator (ICD) – A device similar to a pacemaker that detects and corrects dangerously fast rhythms by delivering shocks when needed.
• Surgical interventions – Procedures like the Maze surgery, often done during open-heart surgery, create scar tissue to block faulty signals and restore normal rhythm.
• Ongoing monitoring and follow-up – Regular check-ups, device monitoring, and symptom tracking are crucial for assessing treatment success and adjusting the approach as needed.
• Cardiac rehabilitation programs – Supervised exercise, education, and counseling programs that support heart health and recovery post-treatment.

Life with Arrhythmia

Treatment for arrhythmia can significantly improve quality of life, but it may come with side effects or long-term adjustments. After procedures like catheter ablation or device implantation, temporary soreness, swelling, or bruising at the insertion site is common. 

Some individuals may experience fatigue or chest discomfort during the recovery period. There are also risks, such as bleeding, infection, or blood clots, which depend on the type of procedure and the individual's health.

For individuals with pacemakers or ICDs, living with a device entails regular follow-ups and some lifestyle adjustments. These may include avoiding strong magnetic fields or specific electronic devices that can interfere with function. 

Adjusting to the emotional impact—like anxiety about shocks from an ICD or the mental weight of having a lifelong implant—is also part of long-term management for some.

If treatment includes long-term medical management, it may occasionally cause dizziness, digestive issues, or changes in blood pressure or energy levels. However, these effects vary and often improve with dose adjustments or time.

Importantly, living with arrhythmia doesn’t mean giving up a whole life. With proper care, symptom control, and monitoring, many people can return to their regular work, exercise, and social life—while remaining alert to any warning signs that may require attention.

Managing and Preventing Arrhythmia

Long-term management of arrhythmia involves more than treating symptoms—it means consistently supporting your heart’s health and reducing risk factors that can worsen the condition. Regular check-ups, especially if you’ve had prior episodes or procedures, help track changes and adjust treatment early. 

Sticking to a heart-healthy routine is central: this includes a balanced diet low in salt and saturated fats, regular physical activity approved by your doctor, and maintaining a healthy weight.

Preventing arrhythmias also involves identifying and addressing triggers. Managing high blood pressure, cholesterol, thyroid issues, and diabetes is crucial. If you have sleep apnea, using the recommended breathing devices consistently can reduce nighttime strain on the heart. 

Limiting caffeine, avoiding alcohol binges, and staying away from tobacco and recreational drugs are also essential steps.

Stress management techniques—such as meditation, deep breathing, or structured counseling—can help calm the nervous system, which plays a role in some rhythm disturbances. 

Always use medications exactly as prescribed, and consult your doctor before starting any new over-the-counter drug or supplement.

For those at high risk, early intervention can be lifesaving. Knowing your family history, recognizing early symptoms, and not ignoring changes in heartbeat can lead to faster diagnosis and better outcomes. 

While not all arrhythmias can be prevented, many can be effectively managed with a proactive approach and proper medical support.

Sterling Hospital is Your Partner in Heart Health Across Gujarat

At Sterling Hospital, we provide you with the utmost care and comfort throughout your journey to a healthier heart. If you are looking for the best  cardiovascular surgeons in Ahmedabad, Vadodara, Rajkot, or  Gandhidham, we've got you. With considerable years of experience, we have built a team of the best cardiologists in these regions to provide you with premium treatment and the best results. Contact Sterling Hospital to schedule a consultation and embark on a journey towards a healthier heart.