Could I have an arrhythmia? What to know and how to spot them

What is arrhythmia?

An arrhythmia means your heart is not beating properly. Your heart rate might be too fast, too slow, or skipping beats entirely. About 5 percent of the U.S. population has an arrhythmia. There are dozens of kinds — some are benign while others can be quite serious.

When it comes to your heart health, do not wait. If you feel like your heart is racing or you are experiencing any symptoms of an arrhythmia walk into your neighborhood CityMD urgent care for an immediate evaluation. No appointment is needed.

“The term arrhythmia means the heart isn't beating in a normal organized fashion,” explains CityMD emergency physician Amy Lazarides, MD. “The heart pumps blood out to the body by contracting, or squeezing, first in the atria (top chambers of the heart) followed by the ventricles (bottom chambers of the heart). This occurs because there are electrical signals being transmitted through the heart muscle. If something affects the electrical impulse, you get a change or disruption in how the heart chambers contract.”

A normal heart rate for an adult is between 60 and 100 beats per minute. For some people, such as serious athletes, a resting heart rate below 60 is normal. Your heart rate will often rise above 100 beats per minute when you are exerting yourself.

Two common types of arrhythmias are:

• Tachycardia is a fast heart rate — more than 100 beats per minute
• Bradycardia is a slow heart rate — less than 60 beats per minute

Symptoms of arrhythmia

When your heart rate is different from your normal rhythm, you should pay attention, explains Francesco Santoni-Rugiu, MD, a cardiac electrophysiologist who specializes in heart rhythm disorders. “A sudden change in heart rate and a sudden resolution is a strong indicator of a rhythm disturbance,” he adds.

Here’s the problem, though: You may not always feel it. Some arrhythmias are silent and only discovered during annual exams. Interestingly, many of Dr. Santoni-Rugiu’s patients found out they had arrhythmias during the pandemic.

“With COVID-19, we have uncovered a lot of diagnoses because people had pulse oximeters,” he says. “We could see the skipped beats.” You can also measure your heart rate by feeling the pulse in your wrist or neck.

The main symptom of arrhythmia is heart palpitations or a sensation that the heart is skipping a beat. Other signs include:

• Shortness of breath
• Dizziness
• Chest pain
• Nausea
• Fainting

Anyone experiencing a mixture of these symptoms should see a doctor immediately.

Benign arrhythmias

Not all arrhythmias are dangerous or need to be treated. For instance, Dr. Lazarides explains that a “sinus arrhythmia is a term for when there is variability in the timing between beats. However, the contractions are still efficient, so blood flow to the body is normal.”

In addition, she notes that some people have occasional extra beats called premature atrial contractions and premature ventricular contractions. These arrhythmias do not typically require treatment.

Atrial fibrillation

Some arrhythmias, however, are meaningful and problematic, Dr. Santoni-Rugiu says. Atrial fibrillation (A-fib) is an irregular and often very rapid heart rhythm that affects about 20 percent of the population. “This arrhythmia typically affects us in the seventh or eighth decade of life,” he says.

A-fib causes blood to sit stagnant in the upper chamber of the heart. This makes the blood clot. If the clot escapes, it can lead to stroke, heart failure, and other complications.

How to detect and treat A-fib and other arrhythmias

With a significant number of Americans at risk for severe damage, Dr. Santoni-Rugiu encourages all patients to wear devices like the Apple Watch and Fitbit because they can catch rhythms that might otherwise go undetected. For patients who feel symptoms, both physicians encourage patients to try and capture an arrhythmia with a pulse oximeter and to see a health care professional for an evaluation.

“If one million people were diagnosed with A-fib today, we could prevent 10,000 to 15,000 strokes,” he says.

Treatment depends on the type of arrhythmia, explains Dr. Santoni-Rugiu. There are many options that can help increase your quality of life.

Lifestyle factors have a big impact on the development of A-fib. You can reduce your risk by establishing healthy habits such as exercising more, drinking less alcohol, getting restorative sleep, losing weight, and cutting down on caffeine.

Cardiovascular exercise is particularly beneficial. “Exercise is cheap, available to everybody, and tremendously impactful when it comes to protection from A-fib,” he says. “Ninety minutes a week of real aerobic exercise — not 10,000 steps, but running on the treadmill, playing tennis, or chasing your three-year-old — changes the future of patients with A-fib.”

Summit Health’s Cardiology department has the expertise and advanced tools to help diagnose and treat the entire spectrum of arrhythmias. Our physicians work with patients to develop a treatment plan that will help them achieve long-term health and wellness. Learn more about our providers who specialize in cardiac electrophysiology.