Your heart is the most important muscle in your body. This means that keeping it healthy should be a high priority.

But what are the implications for your health when your heart isn’t beating normally?

Specifically, what complications does an irregular heartbeat cause for your body, and what can you do to prevent them?

It’s a complex subject, but this article will strive to leave you with some answers.

What Is an Irregular Heartbeat?

When your heart is healthy, it works as the muscular pump in your body.

Each day, the average heart beats about 100,000 times, pumping over 2,000 gallons of blood throughout your body in the process. This means that the average 70-year-old heart has beat more than 2.5 billion times!

Usually, heart beats are steady and consistent. That’s because the heart rhythm is controlled by the heart’s electrical system. The electrical system of the heart keeps the beat regular and at an appropriate rate. However, in some cases, irregular rhythms can occur. Irregular heartbeats are one type of cardiac arrhythmia, which refers to any abnormal heart rhythm. Examples of cardiac arrhythmias include “tachycardia” (if the heart might be beating too fast), “bradycardia” (when the heart beats too slowly), or irregular beating. All of these can cause potential problems for your body because of changes in the blood flow.  The heart cannot pump as efficiently when the rhythm is abnormal.

Normal heart rates at rest tend to fall within 60 to 80 beats per minute, depending on fitness levels and physical activity.  Well-conditioned individuals can run resting heart rates of 50 or below. The heart rate can go much faster when someone exercises, and we can calculate a person’s “predicted maximal heart rate” at peak exercise pretty easily. The maximal heart rate is generally about 220 minus the patient’s age, so if you are 40 years old and start exercising strenuously, your heart rate should normally be able to get up to about 180 beats per minute.

Irregular heartbeats occur when the rhythm becomes erratic. Many different arrhythmias can cause irregular heartbeats. Some are more serious than others.  One common cause is known as atrial fibrillation, which is a continuous, rapid, disorganized electrical problem that affects the top chambers of the heart.  Almost a million people in the United States are hospitalized for this condition each year. Because oxygenated blood is essential for powering every part of your body, an irregular heartbeat can have profound implications for your other organs, too.

Irregular heartbeats may cause a symptom referred to as “palpitations,” which is any feeling that the heart is not beating right. Normally, we are not supposed to feel our heart beating (or else it could get to be very annoying).  Palpitations can feel like your heart skipped a beat or paused for a second, or it can feel like there’s an “extra” beat.  Some people refer to a “fluttering” sensation or feeling like butterflies in the chest. Other people sense a “nervous” feeling in the chest area. Rarely, irregular heartbeats can be very uncomfortable – almost painful – and can cause great anxiety. It’s also common to not feel any symptoms whatsoever even if the heart rhythm is abnormal. Because arrhythmias can be a sign of a serious heart problem, it’s important to understand what’s happening to your body so that you know whether to seek immediate treatment.

Common Causes of Irregular Heartbeats

The feeling of an irregular heartbeat can be normal in most adults.  However, it’s a good idea to tell your doctor if you suddenly start feeling palpitations.  An excessively slow or fast heart rate can be due to a serious electrical problem, or it may be a sign of underlying medical conditions such as:

  • Overactive thyroid gland
  • Abnormal concentration of electrolytes (like potassium, magnesium, or sodium) in your blood
  • Heart muscle problems
  • Coronary artery blockages
  • Problems with the heart valves
  • Side effects of certain medications

Sometimes, irregular heart rhythms are a sign of normal aging of the heart functioning and may not require any treatment, though you should still discuss this with your doctor.  Infrequent, brief feelings of an “extra” heartbeat are usually due to premature atrial contractions or premature ventricular contractions. In these cases, the extra or early heartbeats are usually “benign” or harmless and don’t require medical therapy other than reassurance.

Symptoms of Heart Arrhythmia

Heart palpitations or an irregular heartbeat may be the only symptom you have.  Some patients with heart rhythm disturbances have more subtle symptoms and may not even realize that their heart is at fault.

Often, it takes a physical exam or electrocardiogram test with a doctor to diagnose the condition. If you do experience symptoms, they are likely to include any or all of the following:

  • Heart palpitations (fluttering heart, feeling of skipped heartbeats)
  • Dizziness or lightheadedness
  • Chest pounding
  • Shortness of breath
  • Chest pain and tightness
  • Fainting
  • Inexplicable fatigue
  • Poor exercise tolerance

What are the Types of Heart Arrhythmias?

Several kinds of arrhythmias can affect your heart, some of which are more dangerous than others.

  • Premature atrial contractions (PACs): harmless early heartbeats that originate in the heart’s upper chambers.
  • Premature ventricular contractions (PVCs): early heartbeats that arise from the bottom chambers of the heart, often associated with a fullness in the head or neck and sometimes with a feeling of having to cough. They are generally harmless unless there is some underlying heart disease already present, like an old heart attack or weakness of the heart muscle, or a history of severe symptoms such as fainting.
  • Atrial flutter: Arrhythmia caused by a rapid electrical “short circuit” in the atrium, often found in people with heart disease (although it can occur in normal adults).  It can be regular or irregular and may come and go or become persistent.
  • Atrial fibrillation (A-Fib):  Similar to atrial flutter but always causes a continuously irregular pulse rate, because the electrical activity of the top chambers is chaotic or disorganized. It is important to diagnose atrial fibrillation or flutter because having either one can increase the risk of a stroke.
  • Paroxysmal supraventricular tachycardia (PSVT): Rapid, perfectly regular heart rate that starts suddenly and can last from seconds to days. This is caused by an abnormal electrical pathway within the heart’s electrical system. It amounts to a “short circuit” that allows impulses to travel quickly around in a circle within the heart.
  • Ventricular tachycardia (V-tach): a rapid heart rhythm arising from the lower heart chambers, almost always occurring in patients with significant damage to the heart muscle. This rhythm usually presents with severe symptoms like fainting or even cardiac arrest.
  • Ventricular fibrillation (V-Fib): Very rapid, disorganized electrical disturbance of the lower heart chambers, which causes the heart to stop pumping effectively (cardiac arrest). This is fatal unless it can be treated emergently, generally with a high-voltage shock across the chest (“defibrillation”) delivered by emergency medical personnel.

How to Diagnose an Irregular Heartbeat

Diagnosing an irregular heartbeat is difficult without the help of a cardiologist or internal medicine specialist. To narrow down the cause of an arrhythmia, doctors tend to use the following tests:

Electrocardiogram: usually abbreviated to ECG or EKG, this test is designed to record the electrical activity of your heart through the use of small electrode patches applied to your chest, arms and legs.

Holter monitor: used as a portable EKG device, Holter monitors are typically worn for 1 to 2 days before the recording is analyzed. These are generally only useful in patients who have symptoms every day. Otherwise, the recording may be completed and no arrhythmias show up (irregular heartbeats can be very unpredictable).

Event monitor: usually worn for 1 to 4 weeks, an event monitor is a device that is attached with stick-on wires to your chest (although newer “patch” models are wireless and resemble a giant “Band-Aid.”  These devices record and store your heart’s electrical activity whenever you push a button to start the recording process.  Most also have automatic detection capability that can record any abnormal heart rhythm that you might have, even if you don’t have symptoms.

Implantable Cardiac Monitor: also known as an implantable loop recorder or “ILR.”  These are miniaturized  monitoring devices about the size of a paper clip that are inserted under the skin on the left chest wall. They are undetectable most of the time and users don’t even know it’s there, but the battery can last up to 3 years and can record heart arrhythmias at any time. This device is most helpful when the symptoms occur on rare occasions, maybe once a month or longer.

Stress test: this physical challenge is designed to evaluate the amount of work that your heart can handle by having you conduct a physical activity (usually walking on a treadmill or pedaling on a stationary bike) while your ECG and blood pressure are monitored.  This is most useful in patients whose irregular heartbeats occur with exercise.

Echocardiogram:  this test uses special sound waves (ultrasound) to get a picture of the heart function. It allows your doctor to assess the underlying health of your heart. This may be important to obtain because some irregular heartbeats are only dangerous if the heart is not healthy.

You should seek medical attention if you develop new symptoms to make sure that your irregular heartbeat is harmless and not something that you need to worry about.

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