Cardiac arrhythmia: Overview
A cardiac arrhythmia is a change in the normal rhythm of the heart. Your heart may beat too fast or too slow or beat with an irregular or skipping rhythm. A change in the heart's rhythm may feel like a really strong heartbeat or a fluttering in your chest. A severe heart rhythm problem can keep the body from getting the blood it needs. This can result in shortness of breath, lightheadedness, and fainting.
You may take medicine to treat your condition. Your doctor may recommend a pacemaker or recommend catheter ablation to destroy small parts of the heart that are causing a rhythm problem. Another possible treatment is an implantable cardioverter-defibrillator (ICD). An ICD is a device that gives the heart a shock to return the heart to a normal rhythm.
Abnormal heartbeat (arrhythmia)
An abnormal heartbeat (arrhythmia) is any variation in the normal heartbeat. Abnormal heartbeats occur when the heart has an irregular heart rhythm, beats too fast (tachycardia), or beats too slow (bradycardia).
The electrical system of the heart creates signals that trigger the heart to pump. These electrical signals control the heart rate and rhythm. Normally, the heart beats in a regular rhythm and at a rate that is appropriate for the work the body is doing. An arrhythmia results from a problem in the electrical system of the heart.
How long does syncope caused by a heart rhythm problem last?
Syncope is transient. That means you wake up soon after you faint. You may wake up because the arrhythmia stops on its own and your heart rhythm and blood pressure go back to normal. Even if the arrhythmia doesn't stop, you may still regain consciousness.
How is an arrhythmia treated?
Treatment depends on the type of arrhythmia. You may take medicines that slow your heart rate or stop the arrhythmia. Procedures such as cardioversion and catheter ablation may be done. Other options include a pacemaker or an implantable cardioverter-defibrillator (ICD). A pacemaker helps your heart beat normally. An ICD can stop a dangerous arrhythmia.
Arrhythmia: Living With a Pacemaker
How is an arrhythmia diagnosed?
Your doctor will ask about your symptoms and past health and will do a physical exam. You will have an electrocardiogram (EKG or ECG). This test checks for problems with the heart's electrical activity. You may also have other tests to check the health of your heart.
How can you care for yourself when you have cardiac arrhythmia?
Caring for yourself includes taking your medicines as prescribed and having a heart-healthy lifestyle. This includes eating healthy foods, being active, staying at a weight that's healthy for you, and not using tobacco. Your doctor may recommend other things, such as keeping a symptom diary and limiting caffeine if it causes symptoms.
How safe is sexual activity when you have an arrhythmia?
If you have an arrhythmia and your doctor says that it's okay for you to do moderate activity, like brisk walking, then it's probably safe for you to have sex.
If you have any concerns, ask your doctor. Your doctor can check the health of your heart and help you know if it's safe to have sex.
Tell your doctor if you have symptoms, like palpitations, when you have sex or when you exercise.
Talk honestly with your partner about your concerns and feelings. You can also try professional counseling to help you to understand and deal with feelings of worry or fear.
What if you have a pacemaker?
Most people who have a pacemaker can have an active sex life. If your doctor says that you can exercise and be active, then it's probably safe for you to have sex.
After you get your pacemaker implanted, you'll let the incision heal for a short time before resuming sex.
What if you have an ICD?
Most people who have an ICD (implantable cardioverter-defibrillator) can have an active sex life. If your doctor says that you can exercise and be active, then it's probably safe for you to have sex.
After you get your ICD implanted, you'll let your chest heal for a short time before resuming sex. If you or your partner are worried about resuming sex, talk with your doctor about your concerns. Your doctor or another health professional can give you support and advice.
What if you get shocked?
Many people who have ICDs worry that the ICD might shock them during sex. The risk of getting a shock during sex seems to be the same as during any other similar level of exercise. If you get a shock during sex, you will follow your plan about when to call your doctor.
Will your partner get shocked?
Some people worry that if they get shocked during sex, their partners might be hurt. But your partner will not be shocked or feel any pain if you get shocked.
Being active and safe when you have a heart rhythm problem
- Make a plan with your doctor before you start a new activity or exercise program.
Your doctor can tell you what type and amount of exercise is safe for you. This will depend on the cause of your abnormal heart rhythm and whether you have other forms of heart disease. Regular activity can help keep your heart and body healthy.
- Get tests, if you need them, before you get active.
Your doctor may do tests to check how much activity your heart can safely handle. These tests may include an electrocardiogram (ECG or EKG) and maybe a stress test. Then your doctor can suggest a safe level of exercise based on your condition and the stage of your disease.
- Choose activities that you enjoy or want to try.
Your doctor can help you choose activities that will help your heart and are safe for you. An exercise program usually consists of stretching, activities that increase your heart rate (aerobic exercise), and strength training (lifting light weights). You may try things like walking, swimming, biking, or jogging. Any activity you enjoy will work, as long as it gets your heart rate up.
- Plan how you will start to get active.
With your doctor, plan how often, how long, and how hard you will be active. Even if you can only do a small amount of exercise, it is better than not doing any exercise at all.
- Learn how to check your pulse or use a heart rate monitor.
Your doctor may give you a range of how fast your heart rate should be when you exercise. Your doctor can also help you find out what your target heart rate is. Your target rate may be different from a person's who does not have a heart rhythm problem. This is especially true if you take medicine that affects your heart rate, such as beta-blockers.
- Know when to avoid exercising outside.
Avoid exercising outdoors in extreme temperatures or high humidity or poor air quality. Have a plan for indoor activities. For example, when the weather is bad, try exercising indoors at a gym or walking at a mall.
- Know the warning signs that mean you should stop and rest.
For example, stop and rest if you have palpitations, angina symptoms (such as chest pain or pressure), dizziness, or lightheadedness. Call 911 or other emergency services immediately if these symptoms don't go away.
How can you help your doctor diagnose a heart rhythm problem?
If you see a doctor about your symptoms, it's very helpful if you can show the doctor the rhythm and speed of your palpitations by tapping your fingers on a desk or table. The pattern of the palpitations can help the doctor figure out the type of arrhythmia that caused them.
How can keeping a diary of symptoms help monitor heart rhythm problems?
If your doctor thinks you might have a heart rhythm problem, your doctor may ask you to keep a diary of symptoms. This information can help your doctor find out what type of rhythm problem you have.
And if you have a rhythm problem, a symptom diary can help you keep track of your condition. You can then discuss your symptoms with your doctor at your next appointment.
In your diary, include the following:
- How fast or slow was your heart beating? Be aware that if your heart is beating very fast, you may not be able to accurately determine your heart rate.
- Was your heart rhythm regular or irregular?
- What symptoms did you have?
- What time of day did your symptoms occur?
- How long did your symptoms last?
- What were you doing when your symptoms started (such as drinking alcohol or smoking)?
- What may have helped your symptoms go away?
How can you safely start exercising when you have an arrhythmia?
If you have an irregular heartbeat (arrhythmia), it's important to talk to your doctor about what type and level of exercise is safe for you. Regular activity can help keep your heart and body healthy.
The type and amount of exercise that's is safe for you will vary depending on the cause of your abnormal heart rhythm and whether you have other forms of heart disease. If your irregular heartbeat is caused by another type of heart disease (such as cardiomyopathy or a valve problem), you may need to limit your activity because of the other heart disease.
What are the risks of syncope due to a heart rhythm problem?
Fast or slow arrhythmias may cause you to pass out. You may fall and injure your head, break an arm or leg, or get other injuries. If you're driving, you may crash. Also, passing out (syncope) may be a sign that you're at risk for a life-threatening arrhythmia.
What is an arrhythmia?
An arrhythmia is a change in the normal rhythm of the heart. Your heart may beat too fast or too slow or beat with an irregular or skipping rhythm.
Using a symptom diary for heart rhythm problems
If you have a rhythm problem, your doctor may ask you to keep a diary of your symptoms. A symptom diary can help you keep track of your condition. You can then discuss your symptoms with your doctor at your next appointment.
- Choose a way to track symptoms.
Find a method that works for you. Use a calendar, a notebook, a computer, or an app on your phone.
- Keep track of your heart rate.
Learn how to check your pulse or use a heart rate monitor.
- How fast or slow was your heart beating? (Be aware that if your heart is beating very fast, you may not be able to accurately check your heart rate.)
- Was your heart rhythm regular or irregular?
- Keep track of your other symptoms.
Include the following:
- What symptoms did you have?
- What time of day did your symptoms occur?
- How long did your symptoms last?
- Record things that could be triggers.
Note anything that you ate or did that could have triggered your symptoms. For example, did you drink alcohol or caffeine? Did you forget to take your medicine?
- Note anything you did that helped your symptoms go away.
For example, did resting or doing deep breathing exercises help?
- Take your symptom record to doctor visits.
Your record can help you and your doctor see how well your treatment is working or if you need changes.
Cardiac arrhythmia: When to call
Call 911 anytime you think you may need emergency care. For example, call if:
- You have symptoms of sudden heart failure. These may include:
- Severe trouble breathing.
- A fast or irregular heartbeat.
- Coughing up pink, foamy mucus.
- You passed out.
- You have symptoms of a stroke. These may include:
- Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
- Sudden vision changes.
- Sudden trouble speaking.
- Sudden confusion or trouble understanding simple statements.
- Sudden problems with walking or balance.
- A sudden, severe headache that is different from past headaches.
Call your doctor now or seek immediate medical care if:
- You have new or changed symptoms of heart failure, such as:
- New or increased shortness of breath.
- New or worse swelling in your legs, ankles, or feet.
- Sudden weight gain, such as more than 2 to 3 pounds in a day or 5 pounds in a week. (Your doctor may suggest a different range of weight gain.)
- Feeling dizzy or lightheaded or like you may faint.
- Feeling so tired or weak that you cannot do your usual activities.
- Not sleeping well. Shortness of breath wakes you at night. You need extra pillows to prop yourself up to breathe easier.
Watch closely for changes in your health, and be sure to contact your doctor if:
- You have new or worse symptoms.
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