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Irregular Heartbeat

An irregular heartbeat can be corrected with medication or surgically.

Noticing an irregular heartbeat may be cause to seek medical advice. [©Shutterstock, 2010]
©Shutterstock, 2010
Noticing an irregular heartbeat may be cause to seek medical advice.

Irregular Heartbeat

An irregular heartbeat, or heart arrhythmia, occurs when the electrical impulses in the heart do not function properly, causing the heart to beat too slowly, too quickly or in an irregular rhythm. Many healthy people have occasional irregular heartbeats that may feel like a racing heart.

According to the American Heart Association, about 2.2 million Americans live with irregular heartbeats. A normal heart beats 60 to 100 times per minute. An irregular heartbeat or heart arrhythmia feels like palpitations, pounding or racing in the chest, throat and neck. Continuous irregular heartbeats can become dangerous and lead to heart disease, stroke, heart attack or death.

Symptoms of Irregular Heartbeat

There are several types of cardiac arrhythmia. According to the American College of Cardiology, 3 to 5 percent of Americans have atrial fibrillation, making it the most common type. Atrial fibrillation occurs when electrical signals in the heart cause the two upper atrial chambers of the heart to quiver rather than pump blood. As a result, blood may pool or clot. Blood clots may then travel to the brain and cause a stroke. Atrial fibrillation occurs most often in people over age 65.

Other forms of irregular heartbeats are premature beating, when the heart flip-flops; bradycardia, when the heart rate is too slow; tachycardia, when the heart rate is too rapid; and extrasystole, when there are extra heartbeats.

A deadly form of irregular heartbeat is ventricular fibrillation, when the heart beats rapidly and erratically, causing the ventricles in the heart to shake or quiver and stop the flow of blood. A normal heartbeat must be restored within 3 to 5 minutes or else the person will suffer brain damage, heart damage or death.

When to Call a Doctor

Heart palpitations can occur due to exercise, stress, fever, caffeine, nicotine, overactive thyroid, anemia, low oxygen levels in the blood or various prescription medications. People should immediately call a doctor if they experience serious conditions accompanying irregular heartbeats such as loss of consciousness, shortness of breath, chest pain, sweating, dizziness or lightheadedness.

Other indications of trouble are experiencing more than 6 heartbeats per minute; heartbeats in groups of 3 or more; more than 100 heartbeats per minute; and a history of heart disease, high cholesterol, high blood pressure or diabetes.

Treatment for Irregular Heartbeat

If a person is unconscious, immediate treatment should be cardiopulmonary resuscitation (CPR) to help maintain blood flow to vital organs. The best treatment is use of a defibrillator, which administers an electrical shock to get the heart beating again and in the correct rhythm. More and more public places, such as airplanes and shopping malls, as well as police and rescue vehicles, are carrying defibrillators for emergency use.

Numerous prescription medications on the market for arrhythmia can prevent heart attacks, strokes and complications, and can slow the progression of coronary heart disease. Anti-arrhythmic drugs regulate the impulses of the tissues that pace the heartbeat. These types of drugs can be taken daily or for the rest of the patient's life.

Anticoagulants, or blood thinners, are used to prevent blood clots from forming and possibly from causing a stroke. Beta blockers limit the stimulating effects of adrenaline on the heart and slow the heart rate. Calcium channel blockers interrupt the movement of calcium into the heart, slow the heart rate and treat high blood pressure and chest pain.

Radiofrequency ablation is a nonsurgical procedure for tachyarrhymias, or too-fast heartbeats, in which a catheter with an electrode is guided to the heart and mild radiofrequency energy is transmitted. The transmission kills the cells that are causing the fast heartbeat, and the heartbeat returns to normal.

Surgical Treatment for Arrhythmia

One surgical option for irregular heartbeat is implantation of a pacemaker, a battery-operated device, under the skin. When the pacemaker detects the heart rate as too slow or not beating at all, it sends an electrical impulse that stimulates the heart into beating regularly again. Another implantable device is the cardioverter-defibrillator, which monitors the heart continuously.

Other surgical techniques are the maze procedure, which purposely creates scars in the atria that guide electrical impulses to the heart; ventricular aneurysm surgery, which removes an aneurysm or bulge in blood vessels; and coronary bypass surgery, which improves blood supply to the heart.

Prevention

To reduce the risk of heart disease, the U.S. National Library of Medicine and the National Institutes of Health recommends eating a low-fat diet, exercising regularly, managing stress through meditation or yoga, keeping blood pressure and cholesterol under control and not smoking.

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