The rhythm of life

Q: What is an arrhythmia?

A: An arrhythmia is a problem with the heart’s electrical system, which controls how fast or slow the heart beats. Normally, steady electrical signals cause the heart to beat in a regular, coordinated rhythm, keeping everything in check and working in perfect harmony across the body. If a patient develops an arrhythmia, these signals become disrupted, causing the heart to beat irregularly - too fast, too slow, or in an uneven pattern - affecting how well the heart pumps blood around the body, and consequently, how the other organs can function.

Q: What are the main types of arrhythmia?

A: There are three main types of arrhythmias:

• Atrial fibrillation (AF): This is the most common and severe form of arrhythmia, where the upper chambers (atria) of the heart beat in a rapid and irregular way. AF can significantly increase the risk of stroke or brain injury, and often occurs without noticeable symptoms, making early screening important in some individuals.
• Bradycardia: This is where the heart beats too slowly, causing general lethargy, tiredness, dizziness, or fainting.
• Tachycardia: This is where the heart beats too fast, and can originate from the upper chambers (supraventricular tachycardia) or the lower chambers (ventricular tachycardia), which can be more dangerous. Patients who experience this will often sweat profusely and also experience severe fatigue.

Other arrhythmias we see include premature atrial or ventricular contractions (where the heart has extra beats), and more rare and life-threatening conditions like ventricular fibrillation that results in cardiac arrest and requires CPR and the use of a defibrillator.  

Q: What factors can cause or increase the risk of heart rhythm problems?

A: Typically, patients that have an arrhythmia will often also have a long-term condition. These tend to include patients that have:

• Coronary heart disease: With experience of previous heart attacks, heart failure, or valve problems
• High blood pressure: Which puts strain on the heart over time
• Thyroid problems: Can often be an overactive thyroid (hyperthyroidism)
• Lifestyle factors: Excessive alcohol intake, too much caffeine, smoking, and recreational drugs
• Stress and anxiety: That can trigger palpitations or regular arrhythmias
• Certain medications: Some prescription and over-the-counter drugs can affect heart rhythm
• Age and genetics: Older age and family history can increase risk.

However, sometimes arrhythmias occur without an obvious cause and are referred to as idiopathic.

Q: What are some of the most common symptoms and signs of arrhythmia to look out for?

A: We regularly see the following symptoms in patients, so it’s worth keeping an eye out for:

• Palpitations: A fluttering, racing, pounding, or irregular heartbeat
• Dizziness or light-headedness: Due to reduced blood flow to the brain
• Shortness of breath: Especially during physical activity
• Chest discomfort: Regular aches across the ribcage or sharp pains
• Fatigue or weakness: This is from inefficient heart pumping.
• Fainting: This can appear as light-headedness or temporary blackouts.  

Q: When should people get in touch with their GP about these symptoms?

A: If you experience any of these symptoms regularly, especially if they worsen or interfere with daily life or during or after exercise, you should speak to your GP. Keeping a diary of symptoms and noticing patterns can help, and you may need tests or scans performed such as an ECG or a 24-hour heart monitor, all of which can help investigate further.

Q: When should people call 999 or go to A&E about these symptoms?

A: It’s imperative to seek emergency help if you experience:

• Severe chest pain or pressure
• Sudden collapse or loss of consciousness
• Severe breathlessness
• Weakness or numbness on one side of the body or difficulty speaking (possible stroke)
• Palpitations accompanied by dizziness or fainting.

Q: How can heart rhythm conditions be treated and managed? And what medications or lifestyle changes are often suggested?

A: The treatment suggested will often depend on the type and severity of arrhythmia but will likely include either:

• Medications: These may include beta blockers or calcium channel blockers to slow the heart rate, anti-arrhythmic drugs to restore normal rhythm, and anticoagulants (blood thinners) to reduce the risk of stroke, particularly in AF.
• Lifestyle changes: Reducing alcohol and caffeine intake, stopping smoking, managing stress, maintaining a healthy diet, exercising regularly, and controlling other conditions like high blood pressure or diabetes.

It’s also likely that your consultant would suggest regular and ongoing follow-ups with healthcare professionals to monitor your condition and adjust treatment as needed.

Q: When is surgery considered and what does it involve?

A: If medications prescribed have been ineffective or for other reasons they have not been recommended due to allergies or other issues, procedures that may be recommended include:

• Pacemaker implantation: A small device placed under the skin to regulate slow or irregular heartbeats. This is incredibly common nowadays.
• Catheter ablation: A minimally-invasive procedure using heat (radiofrequency), cold (cryoablation), or pulsed field ablation (PFA) is a newer technique to destroy small areas of abnormal heart tissue causing arrhythmias. This can often cure or significantly improve symptoms.
• Implantable cardioverter-defibrillator (ICD): Used to detect and correct dangerous arrhythmias.

If you’re looking for more information on arrhythmias, click here to search for whatever your need. Our cardiac specialists are here to help, and if you’re to ready to book an appointment, just call +44 (0)207 616 4988