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Image of heart showing SA node, AV node, and right and left atrium

Electrical impulses cause the normal heart to beat 60 to 100 times a minute. These impulses come from a natural pacemaker deep inside the heart muscle. Each impulse causes the heart muscle to contract. This causes the blood to flow through the heart and out to the tissues and organs of your body.

An arrhythmia is a change from the normal speed or pattern of these electrical impulses. This can cause the heart to beat too fast (tachycardia); or too slow (bradycardia); or in an unsteady pattern (irregular rhythm).

Symptoms of arrhythmias

Different people experience arrhythmias differently. Sometimes they may not have symptoms, but just notice a change in their pulse. Symptoms can include:

  • Fluttering feeling in the chest

  • Shortness of breath

  • Chest pain or pressure

  • Lightheadedness or dizziness

  • Fainting or almost fainting

  • Palpitations (the sense that your heart is fluttering or beating fast or hard or irregularly)

  • Tiredness, fatigue, or weakness

Causes of arrhythmias

Arrhythmias are most often due to heart disease such as:

  • Coronary artery disease (arteriosclerosis)

  • Disease of the heart valves

  • Enlarged heart

  • High blood pressure

  • Heart failure

Other causes of  arrhythmia include:

  • Certain medicines (such as asthma inhalers and decongestants)

  • Some herbal supplements

  • Cardiac stimulant drugs (such as cocaine, amphetamine, diet pills, certain decongestant cold medicines, caffeine, and nicotine)

  • Excessive alcohol use

  • Medical conditions such as thyroid disease, anemia, anxiety, and panic disorder

Arrythmias can often be prevented. The cause and type of arrhythmia determines the best treatment. Sometimes your doctor may want to monitor your heart rate over a 24-hour period or longer. This can help identify the cause of your arrhythmia and find the best treatment. This can be done with a Holter monitor, a portable EKG recording device attached by wires to your chest. You can carry this with you as you perform your routine activities during the monitoring period.

Home care

The following guidelines will help you care for yourself at home:

  1. Avoid cardiac stimulants (such as cocaine, amphetamine, diet pills, certain decongestant cold medicines, caffeine, and nicotine).

  2. If you smoke, stop smoking. Contact your doctor or a local stop-smoking program for help.

  3. Tell your doctor about any prescription, over-the-counter, or herbal medicines you take. These may be affecting your heart rhythm.

Follow-up care

Follow up with your health care provider or as advised by our staff. If a Holter monitor has been recommended, contact the cardiologist you have been referred to as soon as you can pick up the device. Other outpatient tests may also be arranged for you at that time.

Call 911

This is the fastest and safest way to get to the emergency department. The paramedics can also start treatment on the way to the hospital, if needed.

Don't wait until your symptoms are severe to call 911. Other reasons to call 911 besides chest pain include:

  • Chest, shoulder, arm, neck, or back pain

  • Shortness of breath

  • Feeling lightheaded, faint, or dizzy

  • Rapid heart beat

  • Slower than usual heart rate compared to your normal

  • Very irregular heartbeat

  • Angina with weakness, dizziness, heavy sweating, nausea, or vomiting

  • Extreme drowsiness, or confusion

  • Weakness of an arm or leg or one side of the face

  • Difficulty with speech or vision

When to seek medical care

Remember, things are not always like they are on TV. Sometimes it is not so obvious. You may only feel weak or just "not right." If it is not clear or if you have any doubt, call for advice.

  • Seek help for chest pain, or it feels different from usual, even if your symptoms are mild.

  • Don't drive yourself. Have someone else drive. If no one can drive you, call 911.

  • If your doctor has given you medicines to take when you have symptoms, take them, but do not delay getting help while trying to find them.

  • Don't delay. Fast diagnosis and treatment can prevent or limit the amount of heart damage during a heart attack or stroke.

  • Don't go to your doctor's office or a clinic because they will not be able to provide all of the testing or treatment needed for this condition.


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