Arrhythmia is a condition caused by abnormalities in the generation and conduction of electrical impulses within the heart, resulting in the heart beating too fast, too slow, or irregularly, which affects the blood pumping to the body. If not properly diagnosed and treated, this condition may progress to ischemic cardiomyopathy, heart failure, and sudden cardiac arrest, which can be life-threatening.
What is a normal heart rhythm?
Generally a normal human heart beats about 60 – 100 times per minute but when arrhythmia occurs, the heart rate may be abnormal in 3 main types:
- Bradycardia – less than 60 beats per minute
- Tachycardia – more than 100 beats per minute
- Irregular Rhythm – fluttering or skipping beats
Causes of Arrhythmia
- Internal factors
- Genetic abnormalities and heart structure inherited genetically
- Underlying diseases such as coronary artery disease, cardiomyopathy, thyroid disease, obesity, diabetes, kidney failure
- Obstructive Sleep Apnea
- Behavioral and psychological factors
- Smoking or regular alcohol consumption
- Consumption of high caffeine beverages such as coffee, tea, soda, energy drinks
- Stress, anxiety, or insufficient rest
- Other external factors
- Side effects from certain medications such as cold medicines containing pseudoephedrine, weight loss drugs containing sibutramine, or stimulants
- Side effects from certain vaccines
- Use of substances such as amphetamines, cannabis
Warning signs: If you have these symptoms, consult a doctor immediately
- Feeling palpitations, fluttering, or strong heartbeats
- Easily fatigued or weak
- Feeling shortness of breath or difficulty breathing deeply
- Sharp or tight chest pain
- Dizziness, vertigo, or lightheadedness
- Fainting or loss of consciousness
Types of Arrhythmia
- Tachycardia (fast heart rate)
- Atrial Fibrillation (AFib) – fluttering and irregular beating of the atria
- Atrial Flutter (AFlut) – fluttering of the atria but with a regular rhythm
- Supraventricular Tachycardia (SVT) – abnormal electrical impulses from the atria causing rapid heartbeats
- Ventricular Tachycardia (VT) – abnormal rapid beating of the ventricles that may cause cardiac arrest
- Ventricular Fibrillation (VFib) – chaotic beating of the ventricles not coordinated with other chambers, life-threatening
- Bradycardia (slow heart rate)
- Sick Sinus Syndrome – malfunction of the electrical impulse origin causing abnormally slow heartbeats
- Conduction Block – blockage of electrical impulses causing slow or temporary heart stoppage
To diagnose arrhythmia, doctors will select tests based on symptoms and severity, such as:
- Electrocardiogram (EKG)
- 24-hour Holter Monitoring
- Exercise Stress Test
- Echocardiogram
- Coronary Angiography (CAG)
Treatment of Arrhythmia
Treatment depends on the cause and type of arrhythmia and is divided into 5 main methods
- Use of heart rhythm control medications such as Amiodarone, Flecainide (under medical supervision)
- Electrical cardioversion to restore normal rhythm
- Catheter ablation therapy to destroy tissue causing arrhythmia
- Pacemaker implantation for patients with slow heart rate
- Automatic Implantable Cardioverter Defibrillator (AICD) implantation to help in ventricular fibrillation or tachycardia
- Coronary artery dilation in cases where arrhythmia is caused by coronary artery stenosis or blockage
What to do
- Drink enough water, 6–8 glasses per day
- Get enough rest, 6–8 hours
- Eat nutritious, low-fat food
- Exercise appropriately
- Take medications as prescribed by your doctor
- Attend follow-up appointments with your doctor
What to avoid
- Avoid caffeine and alcoholic beverages
- Avoid sleep deprivation or insufficient rest
- Avoid excessive exercise
- Do not neglect scheduled health check-ups
Prevention of Arrhythmia
- Manage stress and mental health
- Exercise regularly but not excessively
- Choose heart-healthy foods
- Annual health check-ups
- Consult a doctor if there is a family history of heart disease and consider genetic testing (Heart Genome)
If you experience palpitations, easy fatigue, or suspect arrhythmia, you should undergo examination and diagnosis by a specialist. Heart Center, Phyathai 2 Hospital
Dr. Nithipol Piyasirisilp
Cardiology Specialist
Phyathai 2 Hospital
