Information on the underlying causes of irregular heartbeats and cardiac arrhythmias.

There are a number of different types of arrhythmias, differing in severity, point of origin and the speed at which they cause the heart to beat. There are three main categories according to rate:

• Tachycardia - A fast heartbeat (greater than 100 beats a minute)
• Bradycardia - A slow heartbeat (less than 60 beats a minute)
• Premature heartbeats - an extra beat between two normal heartbeats

Not all of these arrhythmias are dangerous, and some are quite normal. For example, a heart rate greater then 100 beats per minute may be the normal response to exercise, anxiety or fear. However, when arrhythmias occur unexpectedly, there may be cause for concern.

Arrhythmias also occur in different chambers of the heart. In general, arrhythmias that start in the lower chambers of the heart (the ventricles) are more serious than those that start in the upper chambers (the atria).

• Arterial fibrillation: occurring in the atria, this arrhythmia causes the heart to beat too fast and irregularly. A potentially dangerous condition.
• Sick sinus syndrome: This occurs when the SA node (usually responsible for regular electrical impulses in your heart) is not working properly, causing the heart to beat too fast, too slowly, or both.
• Paroxysmal atrial tachycardia: this causes the heart to have periods where it beats regularly but very fast. While it may
  sometimes feel uncomfortable, this condition is usually not harmful.
• Ventricular tachycardia: this arrhythmia originates in the ventricles and causes the heart to beat too fast. As a result, the body doesn’t get enough blood and the consequences are very serious. This type of arrhythmia needs immediate medical attention.

For many people, arrhythmias usually do not cause any signs or symptoms. Doctors sometimes identify heart arrhythmias for the first time at a routine check-up. For others, the signs and symptoms of heart arrhythmias are very noticeable and may cause some distress. These may include:

• Sensation of fluttering in the chest
• Racing heartbeat
• Noticeably slow heartbeat
• Chest pain
• Fatigue
• Shortness of breath
• Lightheadedness or dizziness
• Fainting or near fainting spells
• Paleness
• Excessive sweating

When symptoms are noticeable, people often fear the worst. However, the severity of the symptoms does not necessarily correlate with the severity of the problem. Some people who experience arrhythmias may not have a serious problem at all, while others who don’t notice the symptoms may have a life-threatening condition.

Screening will include extensive questions regarding duration and onset of symptoms and possible triggers. Be sure to mention if you or any family members have a history of heart conditions or thyroid problems.

Once your health care provider has listened to your heart, other passive heart monitoring tests such as an Electrocardiogram (ECG), a holter or event monitor, or an Echocardiogram may be used.

In some cases, your doctor will try to induce an arrhythmia, which may include tests such a stress test, tilt table test, or Electrophysiologic testing and mapping.

Other common conditions known to result in arrhythmias include:

• Obesity
• Sleep apnea
• Diabetes
• Thyroid problems
• High blood pressure
• Electrolyte imbalance (a common symptom of an eating disorder)

In addition, lifestyle factors such as stress, excessive caffeine or alcohol intake, smoking, and the use of certain illicit drugs or medications (commonly weight loss pills, cough syrups and cold medicines) can all cause arrhythmias.

Conventional Medical Treatments

Once the need has been verified for medical treatment, your doctor will advise which treatment will suit your specific condition. Make sure to ask your physician about all possible options and possible consequences of each procedure. Unfortunately, some people with arrhythmias receive unnecessary medical treatment, which can result in cardiac problems.

Lifestyle Modifications

For harmless or sporadic arrhythmias, sometimes all that is needed is the implementation of heart-healthy behaviors. For those with more serious arrhythmias, in addition to the prescribed medical treatment, lifestyle changes are an essential part of a holistic treatment plan.

Note: Remember that you should always consult your doctor before making changes in prescription medication.

While many arrhythmias are harmless, some can be very serious. For this reason, it is essential to have any suspected arrhythmias evaluated by a medical professional.

Complications that may arise from severe arrhythmias include:

• Loss of consciousness
• Congestive heart failure
• Stroke
• Sudden death

Many arrhythmias can be attributed to poor lifestyle choices and underlying heart problems. For this reason, it is important to make the appropriate heart-healthy lifestyle changes that will keep all organs and systems functioning at optimal levels, including:

• Eat a healthy diet high in vegetables, fruit and fiber.
• Keep saturated fats to a minimum, and limit your daily intake of meat (especially red meat) to no more than 170g per day.
• Stay physically active and try to get at least 30 minutes of exercise per day. Take advantage of movement opportunities throughout the day such as taking the stairs or parking further away than you need to.
• If you do smoke, then you should try to quit.
• Reduce your intake of alcohol.
• Manage stress levels and learn to relax. Don’t take on more responsibilities than you can handle.
• Avoid stimulants such as caffeine and certain medications.

Note: You should always inform your physician before taking new medications to ensure that they do not interfere with your condition.