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Congestive Heart Failure Congestive Heart Failure Basics

Arrhythmias: An Introduction

A cardiac arrhythmia refers to any abnormality in the heart's rate or rhythm. There are many different types of arrhythmias, some much more serious than others. A minor arrhythmia may cause you to feel a single "skip" in your heartbeat. Almost all people have felt this type of sensation at some point in their lives and this generally does not require treatment.

On the other end of the spectrum, much more dangerous arrhythmias may cause cardiac arrest, or sudden death. In the United States, more than half of all deaths from heart disease occur suddenly. In total, it is estimated that more than 300,000 Americans die each year from sudden death related to heart disease.

Symptoms of an arrhythmia

The symptoms of cardiac arrhythmias are highly variable from person to person. My patients usually complain about heart palpitations, lightheadedness, and fainting spells. In some cases, there may be no symptoms at all. A palpitation is a sensation of the heart beating within your chest. You may feel palpitations during a normal heart rhythm, particularly when nervous or exercising. They can vary in intensity, speed, and regularity. If palpitations seem unusually fast, frequent, or are accompanied by other symptoms such as dizziness, it is important to mention them to your primary care provider.

Lightheadedness and fainting are symptoms that may or may not be due to an arrhythmia. When the cause is an arrhythmia, these symptoms signify that the heart is not pumping enough blood to the brain. Cardiac arrest is the most severe symptom of any arrhythmia. In general, survival is only possible if someone present knows cardio-pulmonary resuscitation (CPR). Prompt attention of an ambulance (in the United States, dial 911) and transport to a nearby hospital is essential. Even today, the chance of surviving a cardiac arrest is only about two percent in most large American cities.

Diagnosis of arrhythmias

Many arrhythmias are detected during a routine physical examination. If you have symptoms or physical exam findings that suggest an arrhythmia, your doctor will perform additional testing to evaluate the heart's rhythm. The first test is almost always an electrocardiogram (also called an ECG or EKG). This will reveal some, but not all, arrhythmias. Special monitors can be used to detect arrhythmias that are only present occasionally. A Holter monitor is a small portable tape recorder (like a Walkman) that is worn for 24 hours and provides your doctor with a recording of every heartbeat during an entire day. A small button can be pushed to mark when you experience symptoms. You should then write a brief description of the symptoms in a diary, which is provided along with the monitor.

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