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Arrhythmias


Definition:

An arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregularly.

Alternative Names:

Abnormal heart rhythms; Bradycardia; Tachycardia

Exams and Tests:

The doctor will listen to your heart with a stethoscope and feel your pulse. Your blood pressure may be low or normal.

Heart monitoring devices are often used to identify the rhythm problem, such as a:

  • Holter monitor (used for 24 hours)
  • Event monitor or loop recorder (worn for 2 weeks or longer)

Other tests may be done to look at heart function:

A special test, called an electrophysiology study (EPS), is done to take a closer look at the heart's electrical system. 

Treatment:

When an arrhythmia is serious, you may need urgent treatment to restore a normal rhythm. This may include:

  • Electrical "shock" therapy (defibrillation or cardioversion)
  • Implanting a short-term heart pacemaker
  • Medicines given through a vein (intravenous) or by mouth

Sometimes, better treatment for your angina or heart failure will lower your chance of having an arrhythmia.

Medicines called anti-arrhythmic drugs may be used:

  • To prevent an arrhythmia from happening again
  • To keep your heart rate from becoming too fast or too slow

Some of these medicines can have side effects. Take them as prescribed by your health care provider. Do not stop taking the medicine or change the dose without first talking to your health care provider.

Other treatments to prevent or treat abnormal heart rhythms include:

  • Cardiac ablation, used to destroy areas in your heart that may be causing your heart rhythm problems
  • An implantable cardiac defibrillator, placed in people who are at high risk of sudden cardiac death
  • Pacemaker, a device that senses when your heart is beating irregularly, too slowly, or too fast. It sends a signal to your heart that makes your heart beat at the correct pace.
Outlook (Prognosis):

The outcome depends on several factors:

  • The kind of arrhythmia you have. (Some abnormal heart rhythms may be life threatening if not treated right away, or do not respond well to treatment.)
  • Whether you have coronary artery disease, heart failure, or valvular heart disease
When to Contact a Medical Professional:

Call your health care provider if:

  • You develop any of the symptoms of a possible arrhythmia.
  • You have been diagnosed with an arrhythmia and your symptoms worsen or do not improve with treatment.
Prevention:

Taking steps to prevent coronary artery disease may reduce your chance of developing an arrhythmia.

 
References:

Tracy CM, Epstein AE, Darbar D, et al. 2012 ACCF/AHA/HRS Focused Update of the 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities. J Am Coll Cardiol. 2012;60(14):1297-1313.

Olgin SE. Approach to the patient with suspected arrhythmia. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 62.

Rubart M, Zipes DP. Genesis of cardiac arrhythmias, electrophysiologic considerations. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 35.


Review Date: 5/13/2014
Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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