Cardiac Arrhythmia

ExitCare ImageYour heart is a muscle that works to pump blood through your body by regular contractions. The beating of your heart is controlled by a system of special pacemaker cells. These cells control the electrical activity of the heart. When the system controlling this regular beating is disturbed, a heart rhythm abnormality (arrhythmia) results.

WHEN YOUR HEART SKIPS A BEAT

One of the most common and least serious heart arrhythmias is called an ectopic or premature atrial heartbeat (PAC). This may be noticed as a small change in your regular pulse. A PAC originates from the top part (atrium) of the heart. Within the right atrium, the SA node is the area that normally controls the regularity of the heart. PACs occur in heart tissue outside of the SA node region. You may feel this as a skipped beat or heart flutter, especially if several occur in succession or occur frequently.

Another arrhythmia is ventricular premature complex (VCP or PVC). These extra beats start out in the bottom, more muscular chambers of the heart. In most cases a PVC is harmless. If there are underlying causes that are making the heart irritable such as an overactive thyroid or a prior heart attack PVCs may be of more concern. In a few cases, medications to control the heart rhythm may be prescribed.

Things to try at home:

  • Cut down or avoid alcohol, tobacco and caffeine.

  • Get enough sleep.

  • Reduce stress.

  • Exercise more.

WHEN THE HEART BEATS TOO FAST

Atrial tachycardia is a fast heart rate, which starts out in the atrium. It may last from minutes to much longer. Your heart may beat 140 to 240 times per minute instead of the normal 60 to 100.

  • Symptoms include a worried feeling (anxiety) and a sense that your heart is beating fast and hard.

  • You may be able to stop the fast rate by holding your breath or bearing down as if you were going to have a bowel movement.

  • This type of fast rate is usually not dangerous.

Atrial fibrillation and atrial flutter are other fast rhythms that start in the atria. Both conditions keep the atria from filling with enough blood so the heart does not work well.

  • Symptoms include feeling light-headed or faint.

  • These fast rates may be the result of heart damage or disease. Too much thyroid hormone may play a role.

  • There may be no clear cause or it may be from heart disease or damage.

  • Medication or a special electrical treatment (cardioversion) may be needed to get the heart beating normally.

Ventricular tachycardia is a fast heart rate that starts in the lower muscular chambers (ventricles) This is a serious disorder that requires treatment as soon as possible. You need someone else to get and use a small defibrillator.

  • Symptoms include collapse, chest pain, or being short of breath.

  • Treatment may include medication, procedures to improve blood flow to the heart, or an implantable cardiac defibrillator (ICD).

DIAGNOSIS

  • A cardiogram (EKG or ECG) will be done to see the arrhythmia, as well as lab tests to check the underlying cause.

  • If the extra beats or fast rate come and go, you may wear a Holter monitor that records your heart rate for a longer period of time.

SEEK MEDICAL CARE IF:

  • You have irregular or fast heartbeats (palpitations).

  • You experience skipped beats.

  • You develop lightheadedness.

  • You have chest discomfort.

  • You have shortness of breath.

  • You have more frequent episodes, if you are already being treated.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have severe chest pain, especially if the pain is crushing or pressure-like and spreads to the arms, back, neck, or jaw, or if you have sweating, feeling sick to your stomach (nausea), or shortness of breath. THIS IS AN EMERGENCY. Do not wait to see if the pain will go away. Get medical help at once. Call 911 or 0 (operator). DO NOT drive yourself to the hospital.

  • You feel dizzy or faint.

  • You have episodes of previously documented atrial tachycardia that do not resolve with the techniques your caregiver has taught you.

  • Irregular or rapid heartbeats begin to occur more often than in the past, especially if they are associated with more pronounced symptoms or of longer duration.