Irregular Heart Beat: Causes, Diagnosis, & Prevention

Types of Irregular Heartbeat

• Atrial Fibrillation: This is the irregular heartbeat of the atrial chambers and almost always involves tachycardia. A-fib, or atrial fibrillation, is a prevalent condition that primarily affects persons over 65. The chamber rattles or fibrillates rather than contracting forcefully in one go, which frequently results in a fast heartbeat.
• Atrial Flutter: While fibrillation causes many random tremors in the atrium, atrial flutter usually comes from an area of the atrium that does not conduct properly. This produces a constant pattern in abnormal cardiac conduction.
• Supraventricular Tachycardia: A rapid but rhythmically normal heartbeat leads to the condition known as supraventricular tachycardia arrhythmias (SVT). A person may experience a burst of a racing heartbeat that can last from a few seconds to a few hours.
• Ventricular Tachycardia: This disorder corresponds to irregular electrical impulses that cause an abnormally rapid heartbeat originating in the ventricles. It also occurs if the heart has a wound from a recent heart attack.
• Ventricular Fibrillation: This is an irregular heart rhythm comprising fast, uncoordinated, fluttering contractions of the ventricles. The ventricles do not pump blood but tremble. Ventricular fibrillation is associated with heart disease and has the potential to be fatal. Usually, a heart attack sets it off.
• Long QT Syndrome: This condition is the name given to a cardiac rhythm abnormality that may result in an erratic and fast heartbeat. This can lead to fainting, which can be life-threatening. It can also occur because of genetic susceptibility or from taking certain medications.

Causes of Irregular Heartbeat

Any interruption of the electrical impulses that stimulate the heart's contractions can cause arrhythmia.

Several factors can cause the heart to malfunction, including:

• Alcohol abuse
• Diabetes
• Substance use disorder
• Drinking too much coffee
• Heart disease, such as congestive heart failure
• High blood pressure
• Hyperthyroidism or an overactive thyroid gland
• Stress
• Scarring of the heart, often because of a heart attack
• Smoking
• Certain dietary and herbal supplements
• Some medications
• Structural changes in the heart

Long-term arrhythmia is nearly never experienced by a person in a healthy heart until there's an external trigger, like an electric shock or a substance use issue. However, improper electrical impulse transmission across the heart may be the result of an underlying cardiac condition. This increases the risk of arrhythmia.

Common Symptoms of Irregular Heartbeats

• Fluttering in the chest (palpitations)
• Racing heartbeat (tachycardia)
• Slow heartbeat (bradycardia)
• Chest pain or discomfort
• Shortness of breath
• Lightheadedness or dizziness
• Fainting or near-fainting spells (syncope)
• Fatigue or weakness
• Anxiety or a feeling of panic
• Sweating without physical exertion
• Confusion (especially in older adults)
• Exercise intolerance
• Neck throbbing or pounding sensation

These symptoms may come and go or persist, depending on the type and severity of the arrhythmia. If the irregular heartbeat becomes frequent or is accompanied by fainting or chest pain, it's important to seek immediate medical attention.

People may also experience an irregular heartbeat at night, especially when lying down, or after eating, which may be linked to digestion and stimulation of the vagus nerve.

When to Visit a Doctor?

• Your symptoms persist or recur frequently.
• You suffer from diabetes, hypertension, heart failure, coronary artery disease, or a history of heart disease in your family.
• You feel dizzy, have chest pain, or have trouble breathing.

Risks of Untreated Irregular Heartbeats

• Stroke: Irregular heartbeats, especially atrial fibrillation (AFib), can cause blood to pool and form clots in the heart. These clots can travel to the brain and cause a stroke. AFib increases stroke risk by 5 times.
• Heart Failure: A persistently fast or erratic heartbeat forces the heart to work harder, weakening it over time. This can lead to heart failure, where the heart can't pump enough blood to meet the body's needs.
• Sudden Cardiac Arrest: Certain dangerous arrhythmias, like ventricular fibrillation, can cause the heart to stop beating suddenly, which is life-threatening without immediate treatment.
• Blood Clots: Abnormal heart rhythms can cause poor blood circulation, increasing the risk of deep vein thrombosis (DVT) or pulmonary embolism.
• Cognitive Decline & Dementia: Long-term arrhythmias, particularly AFib, can impair blood flow to the brain and may increase the risk of memory problems and dementia. This may be especially concerning during conditions such as irregular heartbeat during pregnancy, where both maternal and fetal health could be impacted.
• Damage to Other Organs: Inadequate blood supply due to inefficient heart function can affect the kidneys, liver, and lungs, leading to complications in multiple organs.
• Fatigue & Poor Quality of Life: Constant tiredness, shortness of breath, and anxiety can affect daily activities, work, and emotional well-being.

Irregular heartbeats are not always life-threatening, but leaving them untreated can lead to severe complications. Early diagnosis and management can prevent these risks and help you live a healthier life.

Diagnosis of Irregular Heartbeat

During your physical examination, your doctor will listen to your heart with a stethoscope. They may also use an electrocardiogram (EKG or ECG) to look at the electrical impulses in your heart. This will help them determine if your heart rhythm is abnormal and identify the cause.

• Echocardiography: This procedure also uses sound waves to capture photographs of the pulse, known as a cardiac echo.
• Holter monitor: Wear this monitor for at least 24 hours while doing your normal activities. It allows your doctor to track changes in your heart rate throughout the day.
• Stress test: Your doctor may also inquire if you experience irregular heartbeat anxiety, a common emotional reaction that may mimic or worsen palpitations.
• Tilt table test:It records blood pressure and heart rate minute by minute while the table is tilted in a head-up position at different levels.The test results can be used to estimate your heart rate, blood pressure, and sometimes other measurements as you change your position.

Treatment of Irregular Heartbeat

The etiology of an arrhythmia determines how to treat it. You might have to alter your diet or amount of activity in order to lead a healthier lifestyle.

You may also need medicine to control abnormal heartbeats and any secondary symptoms. These may include irregular heartbeat medication, which must be carefully prescribed and monitored by a healthcare professional.

• Cardiac catheterization to detect a cardiac condition
• Catheter ablation to destroy the tissue, causing abnormal rhythms
• Cardioversion with medications or an electric shock to the heart
• Implantation of a pacemaker or automatic defibrillator
• Surgery to correct an abnormality

Prevention of Irregular Heartbeat

Arrhythmias cannot always be prevented. Regular doctor checkups will help you avoid further heart rhythm problems. Make sure they know all the medicines you are taking. Any medications for colds and coughs can induce arrhythmias, so speak to the doctor before taking them.

They may also recommend some lifestyle changes:

• Eat a healthy diet. Eat plenty of fruits and vegetables, fish, and plant-based protein. Avoid saturated and trans fats.
• Keep cholesterol and blood pressure under control.
• Don't smoke
• Maintain a healthy weight.
• Exercise regularly
• Manage stress
• Limit alcohol and caffeine