What is a Heart Arrhythmia?

Bernard Gros, M.D., F.A.C.C.

Heart arrhythmia is a collective condition that describes a heart rhythm disorder (irregular heartbeat.)

Arrhythmias are caused by a disconnect in the electric signals that control the heartbeat. When too many or too few electrical signals are sent from the heart to the rest of the body, this causes the heart to beat too fast, too slow or in an abnormal rhythm. 

While some arrhythmias are harmless, others can be life-threatening. A person experiencing minor arrhythmias may feel as though their heart skipped a beat, while a more serious case could cause sudden cardiac arrest. 

Arrhythmias may also be indicative of a more serious underlying condition such as coronary artery disease (heart disease) or cardiomyopathy (heart muscle disease.) 

Treatment of heart arrhythmias is essential for identifying causes and triggers, managing symptoms, knowing how to strengthen the heart and preventing other life-threatening conditions.

Types of Arrhythmias

When a person’s resting heart rate is above or below the normal range, this can indicate a type of heart arrhythmia. A healthy resting heart rate ranges from 60 to 100 beats per minute (BPM.) 

Different types of arrhythmias¹ include:

• Bradycardia describes conditions where the resting heart rate is slower than normal, below 60 BPM. Types of bradycardia include:
  • Sick sinus syndrome
  • Heart block
  • Tachy-brady syndrome
  • Sinus arrest
• Tachycardia describes conditions where the resting heart rate is higher than normal, greater than 100 BPM. Types of tachycardia include:
  • Atrial fibrillation (AFib)
  • Atrial flutter
  • Supraventricular tachycardia
  • Ventricular fibrillation
• Premature heartbeats, also called premature contractions, are characterized by an additional heartbeat. This condition is commonly described as the heart skipping a beat. Types of premature heartbeat conditions include:
  • Premature atrial contractions (PACs) 
  • Premature ventricular contractions (PVCs)

Arrhythmias are also categorized based on the cause of arrhythmias and the locations in which they originate. For example:

• Ventricular arrhythmias originate in the ventricles, which are the lower chambers of the heart. 
• Supraventricular arrhythmias in the atria, which are the two upper chambers of the heart. 

How Electrical Activity in the Heart Causes Arrhythmia

The sinus node is the heart’s natural pacemaker (heartbeat regulator) and it’s located in the atria (top chambers of the heart.) Every heartbeat originates in the sinus node² at the top of the heart, which then sends an electrical signal that travels to the ventricles at the bottom of the heart. 

These signals prompt the heart muscles to contract and pump blood through the ventricles, which fill with blood. This then causes the ventricles to pump blood to the lungs and throughout the rest of the body. 

When electrical signals in the heart are blocked or restricted due to a heart condition or other contributing factor, this causes an arrhythmia. 

Causes of Heart Arrhythmia

Causes of an abnormal heart rhythm include:

• Coronary artery disease (heart disease)
• Overactive thyroid gland (hypothyroidism)
• Cardiomyopathy (heart muscle disease)
• Obstructive sleep apnea
• High blood pressure
• Excessive alcohol or caffeine intake
• Excess body fat
• Weak or damaged heart
• Smoking
• Poor stress management
• Living a sedentary life
• Electrolyte imbalance
• Certain medications (cardiovascular drugs, corticosteroids, chloroquine, hydroxychloroquine and azithromycin)

Risk Factors for Heart Arrhythmia

Factors that may increase the risk of heart arrhythmia include:

• Being 65 years old or older
• Having a cardiovascular condition
• Having previous heart attacks or heart surgery
• Genetics and family history

Diagnosis of Abnormal Heartbeat

If you experience an abnormal heartbeat, frequent heart palpitations, pounding heart, chest pain or fainting, we encourage you to schedule an appointment with our experienced Cardiologist and Cardiology Site Director, Dr. Bernard Gros.

Dr. Gros is a board-certified cardiologist who is highly-experienced in diagnosing and treating heart rhythm disorders, as well as other conditions related to the heart.

When diagnostic testing is necessary, UCF Health’s East Orlando location is equipped with a noninvasive cardiovascular lab, where your doctor can perform or administer any of the following tests:

• ECG (electrocardiogram) – An ECG tests the heart’s rhythm and electrical signals.
• Echocardiogram – An echocardiogram is an ultrasound test that provides a visual of the heart’s chambers and vessels, which enables our cardiologist to assess how well the heart is pumping blood.
• Stress test – During a stress test, the patient exercises on a stationary bike or treadmill while our cardiologist assesses blood pressure and blood flow.
• ECG event recorder – The event recorder is a portable device that a patient may wear for a few weeks to a month in order to record arrhythmia events.
• Holter monitor – Holter monitors are devices worn anywhere from 24 to 72 hours to monitor and record heart activity. 

Once the type of heart arrhythmia is detected and diagnosed, treatment is focused on protecting the heart, preventing life-threatening conditions such as stroke and cardiac arrest, regulating the heart rhythm and minimizing risk factors.

Treatment of Heart Arrhythmias

Your UCF Health doctor will create a personalized treatment plan that may include oral medications, medical procedures and/or implanted devices to regulate the heartbeat and strengthen the heart. 

Treatment is determined on a case-by-case basis depending on a number of factors, such as the severity of arrhythmias, the presence of other health conditions and risk factors.

Oral Medications for Abnormal Heart Rate

For patients with premature heartbeats, atrial fibrillation and other tachycardia conditions that increase the heart rate, prescribed medications may include:

• Anticoagulants/blood thinners to reduce the risk of blood clots and stroke
• Beta blockers to slow the heart rate and lower blood pressure
• Antiarrhythmic drugs to regulate the heart rate via electrical signals
• Calcium channel blockers to dilate blood vessels and support proper blood flow

Minor bradycardia cases may only require lifestyle changes to help regulate the heartbeat. It is known that athletes with high heart rate variability tend have low resting heart rates and are more likely to need a permanent pacemaker years down the road⁴. 

Patients with severe bradycardia conditions require immediate treatment to prevent heart failure. They may be administered atropine (a nervous system blocker) or epinephrine (adrenaline) to stimulate the heart.

Devices to Regulate Heart Rate

Permanent pacemakers are devices implanted under the skin to help regulate the heart rate in place of the heart’s natural pacemaker when it is defective⁵. This device is effective as a long-term solution for many patients with bradycardia. 

Pacemakers may be surgically-implanted into the chest and are designed to deliver electrical signals to the heart to stimulate it when it is beating too slowly or out of rhythm.

An implantable cardioverter defibrillator (ICD) is a device implanted through the chest into the heart to continuously monitor heart rate and defibrillate (stop the heart from spasming and beating rapidly) when necessary. The ICD delivers low or high energy shock to ‘reset’ the heart rate during atrial fibrillation and tachycardia.

Lifestyle Changes to Support Normal Heart Rhythm

Healthy lifestyle changes are an essential part of treating heart arrhythmias, preventing active symptoms and protecting the heart against heart disease or heart failure. (Learn how to prevent heart disease.)

At UCF Health, we place heavy emphasis on healthy lifestyle modifications, including living active lifestyles, practicing healthy stress management techniques and eating a balanced diet to protect the heart. Treatment plans for heart arrhythmias aim to minimize risk factors and prevent related health conditions before they arise.

Heart-healthy lifestyle tips

1. Be proactive in choosing heart-healthy snacks. Limit fast food, high amounts of salt and sodium, saturated fat and refined carbs.
2. Commit to an active lifestyle with at least 30 minutes of physical activity, 5 days a week. Walking, running, biking and swimming are great exercises to improve heart health.
3. Moderate or eliminate alcohol consumption. Studies show that consuming one small alcoholic drink a day increases your risk of atrial fibrillation; heavy drinking over a short span of time also triggers arrhythmias⁶.
4. Practice healthy stress management and relaxation techniques to help regulate the heart rate and support proper blood flow throughout the body.

Schedule an appointment with an experienced Orlando cardiologist today.

Our board-certified cardiologist in Orlando, Dr. Bernard Gros, treats a variety of conditions related to the heart. 

Dr. Bernard Gros is a Level 3-trained echocardiography physician—the highest level achievable. He has also received a number of recognitions throughout his career, including being chosen as one of “America’s Top Physicians.” 

When you choose UCF Health’s cardiology team, you can rest assured that your heart and health are in great hands. Dr. Gros is dedicated to helping patients improve their quality of life through sustainable, heart-healthy lifestyle changes. 

We are here to provide you with the resources, information and treatment solutions you need to achieve optimal heart health and know how to strengthen your heart.

Our physicians work with each other across specialties to provide comprehensive treatment and ensure that you get the seamless treatment experience you deserve.

Schedule an appointment today.

Citations:

1. “About Arrhythmia.” Www.heart.org, 20 Dec. 2021, https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia. 
2. “How the Heart Works – How the Heart Beats.” National Heart Lung and Blood Institute, U.S. Department of Health and Human Services, https://www.nhlbi.nih.gov/health/heart/heart-beats#:~:text=Your%20heart%20has%20a%20special,to%20contract%20and%20pump%20blood. 
3. Papadopoulos, Constantinos H., et al. “Echocardiography and Cardiac Arrhythmias.” Hellenic Journal of Cardiology, Elsevier, 5 Dec. 2017, https://www.sciencedirect.com/science/article/pii/S1109966617304104. 
4. D’Souza, Alicia, et al. “Crosstalk Opposing View: Bradycardia in the Trained Athlete Is Attributable to a Downregulation of a Pacemaker Channel in the Sinus Node.” The Journal of Physiology, BlackWell Publishing Ltd, 15 Apr. 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4405729/. 
5. “Pacemaker.” Www.heart.org, 15 June 2021, https://www.heart.org/en/health-topics/arrhythmia/prevention–treatment-of-arrhythmia/pacemaker. 
6. “One Small Alcoholic Drink a Day Is Linked to an Increased Risk of Atrial Fibrillation.” European Society of Cardiology, https://www.escardio.org/The-ESC/Press-Office/Press-releases/One-small-alcoholic-drink-a-day-is-linked-to-an-increased-risk-of-atrial-fibrillation#:~:text=Studies%20have%20shown%20that%20heavy,alcohol%20can%20trigger%20arrhythmia%20episodes.