Medically Reviewed by James Beckerman, MD, FACC on October 21, 2021 An arrhythmia is an irregular heartbeat. It means your heart is out of its usual rhythm. It may feel like your heart skipped a beat, added a beat, or is "fluttering." It might feel like it’s beating too fast (which doctors call tachycardia) or too slow (called bradycardia). Or you might not notice anything. Arrhythmias can be an emergency, or they could be harmless. If you feel something unusual happening with your heartbeat, get medical help right away so doctors can find out why it's happening and what you need to do about it. An arrhythmia can be silent, meaning you don't notice any symptoms. Your doctor may spot an uneven heartbeat during a physical exam. If you have symptoms, they may include: You could have an arrhythmia even if your heart is healthy. Or it could happen because of: Things that may make you more likely to have an arrhythmia include your: Arrhythmias are divided up by where they happen. If they start in the ventricles, or lower chambers of your heart, they’re called ventricular. When they begin in the atria, or upper chambers, they’re called supraventricular. Doctors also group them by how they affect your resting heart rate. Bradycardia is a heart rate of fewer than 60 beats per minute. Tachycardia is more than 100 beats per minute. Supraventricular arrhythmias include:
Ventricular arrhythmias include:
Another type of arrhythmia, bradyarrhythmia, is a slow rhythm because of disease in your heart's electrical system or because of medication. It may make you pass out or feel like you will. Types of bradyarrhythmia include:
To diagnose an arrhythmia or find its cause, doctors use tests including: Treatment will depend on what type of arrhythmia you have. Your doctor may recommend one or more of these. Medications Medicines that treat uneven heart rhythms include: Vagal maneuvers These techniques trigger your body to relax by affecting your vagus nerve, which helps control your heart rate. Your doctor might tell you to:
Electrical cardioversion If drugs can't control an uneven heart rhythm (such as atrial fibrillation), you might need cardioversion. For this, doctors put you under and then send an electrical shock to your chest wall to trigger your heart’s regular rhythm. Pacemaker This device sends small electrical impulses to your heart muscle to keep a safe heart rate. It includes a pulse generator, which houses the battery and a tiny computer, and wires that send impulses to the heart muscle. Implantable cardioverter defibrillator (ICD) Doctors mainly use ICDs to treat ventricular tachycardia and ventricular fibrillation, two life-threatening heart rhythms. The ICD constantly tracks your heart rhythm. When it detects a very fast, unusual rhythm, it delivers an electric shock to the heart muscle to make it beat in a regular rhythm again. The ICD has two parts: the leads and a pulse generator. The leads are made up of wires and sensors that monitor the heart rhythm and deliver energy used for pacing or defibrillation. The generator houses the battery and a tiny computer. Energy is stored in the battery until it is needed. The computer receives information from the leads to determine how the heart is beating. Your doctor programs the ICD to include one or all of the following functions:
There are different types of ICDs, including: Your doctor will determine which type of ICD is best for you. Before you have your ICD implanted, ask your doctor what medications you can take. Your doctor may ask you to stop taking certain medications before the procedure. You will receive specific instructions. After it’s implanted, you might not notice a low-energy shock. Or it may feel like a flutter in your chest. The high-energy shock lasts just a second, but it can hurt. Some people say it feels like being hit with a baseball bat or being kicked by a horse. Most people feel it more in their back than their chest. If you feel a shock, sit or lie down because you may pass out. Talk to your doctor about what to do if you ever get shocked. If you do get shocked, call your doctor immediately. Catheter ablation Think of this procedure as rewiring to fix an electrical problem in your heart. Your doctor will insert a catheter through your leg. It delivers high-frequency electrical energy to a small area inside your heart that causes the unusual rhythm. This energy "disconnects" the pathway of the unusual rhythm. Doctors use ablation to treat most PSVTs, atrial flutter, atrial fibrillation, and some atrial and ventricular tachycardias. Heart surgery for arrhythmias The maze procedure is a type of surgery to correct atrial fibrillation. Your surgeon makes a series, or "maze," of cuts in your heart's upper chambers. The goal is to keep your heart's electrical impulses only on certain pathways. Some people need a pacemaker afterward. Your doctor might recommend other procedures, such as a coronary bypass, to treat other forms of heart disease. Without treatment, an uneven heart rhythm could cause dangerous problems such as: If you have an arrhythmia, you could faint behind the wheel. This could put you, other motorists, pedestrians, and property at great risk. To figure out whether you can drive safely, your doctor will consider:
If you have no symptoms and you haven't had any serious heart rhythm problems, you should be able to drive as you always have. If meds keep your arrhythmia under control, your doctor may give you the green light to drive, too. In addition to meds to help manage your heart rhythm, you may have two other treatments. Both would keep you out of the driver's seat for a while: Ablation: This treatment will usually restrict you to the passenger's seat for about a week. It may keep you there longer, depending on your medical history. Implantable cardioverter defibrillator: Usually after you get an ICD, you'll be asked not to drive for a week. If you got an ICD after fainting or surviving cardiac arrest, you may have to wait several months before you get back behind the wheel. You can't drive commercially (as in a delivery truck or a taxi) at all if you have an ICD. You can’t always prevent arrhythmias. Regular checkups with your doctor can help keep you from having more heart rhythm problems. Be sure they know all of the medications you’re taking. Some cold and cough medicines can trigger an arrhythmia, so talk to your doctor before using them. They may also recommend some lifestyle changes: |