Everything to Know About Irregular Heartbeat (Arrhythmia)

Introduction

Arrhythmia is a condition in which the heart beats irregularly. It happens due to the changes in the electrical activity of the heart controlling the heartbeat. This can occur because of damage due to an injury, an underlying condition or genetics^[1].

People with this heart problem experience their heart beating too slowly or too quickly. It happens when the electrical signals of the heart are not in proper sync. You might experience a fluttering or racing heart. Most Arrhythmias are harmless and can result from a damaged or weak heart.

Read on to find out more about the detailed meaning of arrhythmia, its causes, its signs and symptoms, risk factors, and treatments.

Understanding Arrhythmia

What is Arrhythmia?

Arrhythmia is a disorder of the heart that affects the rate at which it beats. It happens when the electrical impulses regulating and directing heartbeats don’t function as they need to. Arrhythmias can be classified depending on their characteristics. For instance:

• Too slow (Bradycardia)
• Too fast (Tachycardia)

Abnormal heart rates, if they happen for a short span of time, are usually harmless. However, in some cases, it can be problematic, especially when it interferes with the blood flow in the body. It can damage the lungs, brain and other important organs. That’s why it is essential to find the cause of arrhythmia at the earliest stages and eliminate the chances of complications thereon.

As per a report by the International Journal of Advances in Medicine, arrhythmia is more common in elderly females. The maximum number of patients were found in the age group of 60 – 70 years^[2].

Types of Arrhythmia

There are several types of arrhythmia, and they are categorised based on rhythm and speed abnormalities. They also vary depending on where the arrhythmia happens, like between the heart’s upper or lower chambers. Some common types of arrhythmia include:

• Ventricular Tachycardia: It is a fast and regular beating of ventricles that can last for a few seconds or a longer period. A few beats often might not cause any problem. But if it lasts for a long time, it can indicate a complication.
• Bradycardia: Bradycardia is a slow heart rate and is 60 beats per minute or lesser in adults.
• Supraventricular arrhythmias: This type of arrhythmia starts in the upper chambers of the heart, known as the atrium. 
• Different types of supraventricular arrhythmias include Atrial fibrillation, Atrial flutter and Paroxysmal supraventricular tachycardia (PSVT). 
• Ventricular fibrillation: It occurs when disorganized electrical signals let the ventricular quiver, preventing the heart from pumping blood effectively. Because of this condition, there can be sudden death or cardiac arrest^[3].

To Summarize

• Arrhythmia is when the heart starts beating irregularly, which may even be harmless at times but should always be evaluated by a doctor, preferably a cardiologist. 
• Sometimes, arrhythmia can be serious, so you must visit a doctor to understand heart’s condition.
• Indian statistics state that heart disease is more common in women compared to men.
• A few common factors that can lead to palpitations are anxiety, some asthma medicines, caffeine, cocaine, nicotine, and diet pills.
• Different types of arrhythmias are Ventricular Tachycardia, Supraventricular arrhythmias, Bradyarrhythmias, and Ventricular fibrillation.

Causes and Risk Factors Of Irregular Heartbeat

In some cases, arrhythmia can occur as a result of certain medications or substances. They include alcohol, caffeine, cocaine, nicotine, diet pills, inhaled aerosols, cold and cough remedies. Emotional states like stress, fright or even shock can also lead to arrhythmia.

Some other causes of arrhythmia include:

• High Blood Pressure: High BP can lead to the hardening of the inner walls in the ventricles. Because of this reason, it can cause symptoms of arrhythmia and increase the risk of accumulation of plague leading to CAD. The most common causes of high blood pressure include smoking, stress, lack of physical activity and being obese.
• Disorder in valves: A moderate to mild disorder in valves can cause various symptoms and lead to heart problems. In this situation, you might encounter chest pain with arrhythmia.
• Heart injuries from attack: rhythmia can occur as a reduced blood flow to the heart, damage to the heart’s electrical system and stiffening of the heart tissues. 
• Coronary artery disease: Previous heart surgeries to eliminate narrowed walls or a heart attack can give rise to heart rhythm abnormalities.
• Cardiomyopathy: It is a condition related to the heart muscle, which can lead to arrhythmia. So, it would help if you always were under the doctor’s guidance to eliminate the root cause of the problem^[4].
• Medical conditions affecting the heart and giving rise to racing heart causes: Certain medical conditions (hyperthyroidism, hypothyroidism, panic attacks, other hormonal imbalances) and some medications can lead to palpitations. Some medicines are the ones used to treat high blood pressure, psychosis and depression. Individuals also have to be careful when consuming certain over-the-counter medicines and antibiotics, like for colds and allergies^[5].
• Stress and anxiety
• Sleep apnea: This is a sleep disorder where your breathing erratically stops and starts while you sleep.
• Too much smoking and alcohol consumption
• Substance abuse

To Summarize

• The different causes of palpitations are medical conditions, anxiety, high blood pressure, Cardiomyopathy, Coronary artery disease, heart injuries from an attack and many more.
• Even several medical conditions like depression, psychosis and blood pressure can lead to too fast to slow heartbeats.
• Coronary Artery Disease is also another condition that can lead to an irregular rhythm.

Symptoms of Irregular Heartbeat

Understanding the early signs and symptoms of arrhythmia can help you know whether you should visit a doctor or opt for preventive methods instead. Learning about these signs in detail will help to avoid any unforeseen emergencies. The signs of an irregular rhythm are:

• Running Palpitations: You will experience heart palpitations or flutters frequently compared to normal. It is described as a skipped beat, a faster beat, an extra beat and a flip-flop beat than normal.
• Shortness of breath: Shortness of breath is another symptom of heart rhythm abnormalities. However, it can also happen due to non-heart-related conditions. But it is always better to rule out your diagnosis, especially if this symptom persists for longer than usual.
• Dizziness and lightheadedness: Arrhythmia causes the heart to beat fast or too slow, making you feel lightheaded and dizzy. It happens because your heart cannot pump blood properly when the heart rate is excessively slow or fast. This symptom can also occur when your blood sugar or blood pressure suddenly drops.
• Tiredness and Fatigue: Certain types of arrhythmia, like Atrial fibrillation, Afib or AF, can cause fatigue and tiredness. It happens when the outer chamber of the heart does not beat regularly.
• Uneasy pain in the chest: There is an uncomfortable pain that you might encounter in the chest. Whenever it happens, you will start sweating or might not be able to concentrate on your work. You will experience this symptom because of an irregular rhythm.
• Anxiety: Irregular heart rhythms can also be linked to feelings of anxiety, stress and restlessness.

To Summarize

• The symptoms of arrhythmia indicate that you might have a heart problem.
• The common signs are uneasiness in the chest, dizziness, fatigue, tiredness and many other things.
• Running palpitations is one such sign that you can experience most times, but some can be serious while others are harmless.

Methods Involved in the Diagnosis of Arrhythmia

To diagnose an irregular rhythm, your heart specialist may recommend a few tests. The results would help your doctor evaluate the present status of your heart and help determine the right treatment option for you. Some of these tests include:

1. ECG

Electrogram, EKG or ECG is a way to diagnose arrhythmia and heart palpitations. The doctor will attach electrodes to your arms, chest or legs that will measure the electrical activity of the heart. Based on that, the device will provide a graph that indicates if your heartbeat is slow, fast or irregular. It shows if you have poor or enlarged blood flow. Doctors prefer to take an ECG while patients are exercising on a stationary bicycle or resting. A portable monitor can also record irregularities of heartbeats over a span^[6].

2. Stress Test

A stress test is another way to diagnose the underlying cause of arrhythmia. In this test, patients have to either walk or jog on a treadmill where their breathing and blood pressure will be monitored.

3. Echocardiogram

It is a non-invasive way where sound waves measure the structure, size and motion of the heart. An echocardiogram is a hand-held portable device generally placed on the chest using sound waves to determine the heart’s functioning. An echocardiogram can detect an arrhythmia, and based on that, the cardiologist will prescribe the treatment to follow.

4. Ambulatory Monitors

Ambulatory monitor is also known as a Holter monitor, and this test is to detect atrial flutter symptoms. This is because sometimes the signs of arrhythmia can come and disappear, or it can be premature heartbeats, which is not a cause for concern. It helps the specialist to find out if you have a major heart problem. In this test, you need to wear a monitor around the neck for a few days while conducting your daily activities. It connects to EKG electrodes attached to the chest, and the device will record the heart rate continuously for 24 to 72 hours.

5. EPS (Electrophysiology)

It is to find out the heart’s electrical activity, and this study uses a wire to stimulate the heart electrically, triggering an arrhythmia. By chance, if the specialist has detected any other condition, it will help them in assessing the possibility behind this heart issue. The outcome of EPS will help in finding if the specialist can treat your condition through medications.

6. Tilt Table Test

It is a tilt table test to find the causes of the fainting spells. While conducting the procedure, you have to lie on the table and move from lying down to an upright position. While changing the position might cause you to faint, the doctors will keep a note of your symptoms, EKG reading, heart rate and blood pressure throughout the entire test. With that, it would be easier to find out the reason behind arrhythmia.

Some other tests that your doctor may conduct to evaluate your condition include:

• Taking a thorough medical history and clinical examination: Your doctor might ask you questions about some previous conditions, any medications or treatment plans you have been following, and your family’s medical history to accurately identify the cause of your arrhythmia.
• Blood and urine tests: Your doctor may also advise various blood and urine tests to understand the underlying reasons for your heart rhythm problems.
• Record of pulse and blood pressure: our doctor might take note of your vitals such as pulse and blood pressure parameters to further understand the cause of the condition.

To Summarize

• Different tests are available to find the reasons for heart palpitations, depending on which proper medications are given.
• The tests are a Stress test, Echocardiogram, Electrogram, EPS (Electrophysiology), Heal tilt test and Ambulatory monitors.
• The doctor will prescribe the tests to detect the causes and then the required treatment to follow.

Treatment and Lifestyle Changes to Manage Arrhythmia

The right treatment for irregular heartbeat can help you maintain a healthy heart in the long run. The treatment options may also vary on the type of arrhythmia and the intensity of the symptoms. Some of the treatment options that your doctor might recommend and underlying causes are:

1. Medications Prescribed by Your Cardiologist

Your cardiologist may prescribe certain medications to help control your heart rhythm and prevent erratic heartbeats. It is always advised to consult your cardiologist for the right medications suited to your symptoms and never self-medicate.

2. Permanent Pacemaker

Specialists might tell you to implant a pacemaker while undergoing minor surgery. They will make a small cut near the shoulder, guiding small wires through the veins. The pacemaker is placed in the heart, connecting the wires to a battery-powered generator. It is implanted near the collarbone, and the generator will detect the heart rhythm. It sends an electrical pulse via the wire to regulate the process.

3. ICD (Implantable Cardioverter Defibrillator)

Like a pacemaker, the implantation of ICD happens near the breastbone, collarbone or ribs. It is a suitable condition for patients whose arrhythmias are life-threatening or can lead to a heart attack. Implantable Cardioverter Defibrillator sends electric shocks correcting the rate when the heart stops beating. Different types of Implantable Cardioverter Defibrillators are:

• Simple-Chamber ICD: The specialist attaches a pacemaker to deliver energy when the heart needs it in the right ventricle. It helps in restoring the normal heart rhythm.
• Biventricular ICD: Biventricular ICD helps connect the right ventricle, atrium and coronary sinus to provide energy. The biventricular ICD will help the heart to beat efficiently and reduce the risk of heart failure.
• Dual-chamber ICD: In the right ventricle and atrium, leads are attached, and energy is first delivered to the right atrium and then to the ventricle. It helps the heart to beat in a normal sequence.

4. Heart Surgery (The Maze Procedure)

The maze procedure is a type of surgery that can be used for atrial fibrillation treatment. The specialist will make a maze or series of cuts in the upper chamber of the heart with the objective to normalise the heart’s electrical impulses. Depending on the condition of your heart, your doctor might also recommend other solutions like a coronary bypass.

5. Electrical Cardioversion

It is another way to treat arrhythmia by giving shocks to the heart. In this technique, the experts use paddles or patches attached to the chest known as electrodes. Firstly, medicines are given to make you fall asleep, and then specialists put paddles on the chest. At times, a mild electrical shock is also given on the back. Patients have permission to go home that day itself after getting this treatment. In most cases, only one session may be required.

6. Catheter Ablation

In catheter ablation, a cardiologist threads flexible tubes known as catheters via the blood vessels to the heart. In the end, one catheter will release radiofrequency waves through an electrode, creating a small scar. The scar tissue will block the electrical waves, causing arrhythmias.

To Summarize

• There are several treatment options available for arrhythmia in India, which include medications, permanent pacemaker, Implantable Cardioverter Defibrillator (ICD), heart surgery, electrical cardioversion and catheter ablation. 
• The different types of Implantable Cardioverter Defibrillators which help in the effective management of arrhythmia are Simple-Chamber ICD, Biventricular ICD and Dual-chamber ICD
• The treatment option recommended by your doctor depends on the type of arrhythmia and the intensity of your symptoms.

Checklists to Know You Have It Under Control

While the reasons for heart palpitations and arrhythmia are many, there are also several initiatives one can employ to help keep it in check. They include:

1. Regular Heart Monitoring

Regularly visiting the doctor to get your heart checked is one of the most important things to help maintain a healthy heart in the long run. Your doctor may evaluate the effects of your medication on your heartbeat rhythms and the proper functioning of implanted devices and ensure you’re not at risk of developing any other medical issues during your treatment plan.

2. Sticking to Medications Prescribed

Antiarrhythmic drugs are for patients suffering from heart rhythm abnormalities. It helps the arrhythmias to a normal rate and eliminates the issue. The other drugs are antiplatelet or anticoagulant drugs like warfarin or aspirin. It reduces the risk of developing blood clots and the risk of stroke. Make sure that you follow what the specialist has prescribed to recover soon.

3. Eating Right and Healthy

Eating right and healthy is important to avoid irregular heartbeats, and they are:

• Eat healthy fats: Not all kinds of fats are bad for your body, and that’s why you have to pick the best ones out of all. Products that contain monounsaturated fats like ghee, olive oil, seeds, and nuts, when taken in moderation, are good for these patients. They can also have products that contain omega-3 like flax seeds, albacore tuna, salmon, walnuts, sardines, etc.
• Opt for Heart-Smart Cooking Methods: Preparing heart-healthy foods is a good way to have a healthy heart. Steaming and poaching are suitable ways to cook vegetables with zero added fat.
• Avoiding foods that contain tyramine: Tyramine is a compound found in food items like cheese. Foods that contain tyramine can increase the risk of heart flutter feeling and blood pressure. That’s why you must avoid consuming those food products. They include cured meats, aged cheese, broad bean pods, fermented cabbage, yeast-extract spreads and certain sauces like fish sauce, soy sauce, shrimp sauce, etc.
• Prefer eating vegetables: Eat food that adds colour to the dinner plate, like green vegetables and fruits. Consuming healthy products will help in maintaining your weight and avoiding arrhythmia.
• Opt for spices and herbs instead of salt: Irrespective of whether it is sea or table salt, it is always better to avoid excessive consumption. Instead of that, you can increase spices and herbs.
• Go for Yogurt: Yoghurt is a good option to have instead of cheese. Some cheeses have over 1000 mg of sodium, and they are not good for your body. Yoghurt is a suitable replacement for the product, which can help in maintaining heart health and digestion.

4. Staying Hydrated

You must drink at least two to three litres of water daily to maintain a healthy heart. It will also help in eliminating the risk of developing other health issues.

5. Keep Your Lipid Profile, Blood Sugar and Blood Pressure in Check

Care should be taken to ensure your blood sugar, fats, and blood pressure are in the normal range at all times. Eating the right foods in the right quantities and exercising regularly can help keep these parameters in check.

6. Get Good-Quality Sleep

Getting 6 – 7 hours of undisturbed, quality sleep every night is essential for good heart health and general overall health. Sleep is shown to help improve cognitive function and mental health.

7. Practice Yoga, Meditation and Stress Management

Yoga and meditation have been shown to have many benefits for heart patients. Yoga and meditation involve flexibility and deep breathing and hence can not only lower stress levels and ease tension in the muscles but also improve blood circulation and blood-oxygen levels in those with heart conditions.

8. Quit Smoking and Limit Alcohol Intake

If you want to maintain a healthy heart, find proactive ways to quit smoking and limit your alcohol intake. If you feel like you need to smoke and drink, speak to your doctor about some initiatives you can take to help you quit^[7].

9. Exercise Regularly (As Advised by Your Doctor)

30 minutes of physical activity every day has shown to do wonders for your body. Exercise can aid weight loss, improve metabolism, improve blood circulation and blood-oxygen levels, control blood pressure and overall strengthen the heart and lungs to function at their best.

A few exercises may not be advisable for people with irregular heartbeats. Therefore, it is advised to consult with your doctor on what exercises are suitable for you to perform, depending on your condition.

How to Support a Loved One Dealing with Arrhythmia?

It’s hard to see a loved one deal with the effects of arrhythmia. You can offer help and support by encouraging them to:

• Quit smoking and limit their alcohol intake.
• Limit the usage of caffeine, and for that, avoid beverages like colas, tea, coffee, etc.
• Eliminate using stimulants in cold and cough medications.
• Follow the medication routine prescribed by the doctor for an irregular heartbeat.

Some ways that you can help them along their recovery journey is by exercising with them, lending a year whenever required and motivating them along the way, offering to join a support group with them, tagging along to doctor’s appointments and also keeping track of their health and progress. Help and support in this way can go a long way in showing that you care and that you desire to see them get better in every way.

To Summarize

• To have a good heart that beats normally, you must stop smoking and cut down on alcohol consumption. 
• Following the diet chart for heart patients is a crucial parameter, and you must eliminate too much salt, cheese, fried and processed food, etc.
• Checking with the doctor regularly will help in knowing if all parameters are in check.
• Drink at least two to three litres of water every day to keep your heart healthy.

Also Read: Everything To Know About Atherosclerosis Prevention

Frequently Asked Questions (FAQs)

References

1. National Heart, Lung, and Blood Institute. What Is an Arrhythmia? [Internet]. Bethesda (MD): National Institutes of Health; [cited 2025 Feb 27]. https://www.nhlbi.nih.gov/health/arrhythmias
2.  Patil, P. R., Khatana, P., & Patil, D. R. (2017). Incidence of cardiac arrhythmias in patients with acute myocardial infarction during the first 48 hours of the onset of chest pain. International Journal of Advances in Medicine, 4(4), 1144–1149. [cited 2025 Feb 27].  https://doi.org/10.18203/2349-3933.ijam20173248
3. American Heart Association. Ventricular Fibrillation [Internet]. Dallas (TX): American Heart Association; [cited 2025 Feb 27].  .https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia/ventricular-fibrillation 
4. Ref Shoureshi, P, Tan, A, Koneru, J. et al. Arrhythmia-Induced Cardiomyopathy: JACC State-of-the-Art Review. JACC. 2024 Jun, 83 (22) 2214–2232. [cited 2025 Feb 27].  https://doi.org/10.1016/j.jacc.2024.03.416
5. Ahmad M, Reddy S, Barkhane Z, Elmadi J, Satish Kumar L, Pugalenthi LS. Hyperthyroidism and the Risk of Cardiac Arrhythmias: A Narrative Review. Cureus. 2022 Apr 22 [cited 2025 Feb 27];14(4):e24378. doi: 10.7759/cureus.24378. PMID: 35619859; PMCID: PMC9126437. https://pmc.ncbi.nlm.nih.gov/articles/PMC9126437/
6. Luz EJ, Schwartz WR, Cámara-Chávez G, Menotti D. ECG-based heartbeat classification for arrhythmia detection: A survey. Comput Methods Programs Biomed. 2016 Apr [cited 2025 Feb 27];127:144-64. doi: 10.1016/j.cmpb.2015.12.008. Epub 2015 Dec 30. PMID: 26775139. Available from: https://pubmed.ncbi.nlm.nih.gov/26775139/
7. D’Alessandro A, Boeckelmann I, Hammwhöner M, Goette A. Nicotine, cigarette smoking and cardiac arrhythmia: an overview. Eur J Prev Cardiol. 2012 Jun [cited 2025 Feb 27];19(3):297-305. doi: 10.1177/1741826711411738. PMID: 22779085. https://pubmed.ncbi.nlm.nih.gov/22779085/

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