What is Heart Rhythm Disorder (Arrhythmia)? Symptoms and Causes

What is Heart Rhythm Disorder (Arrhythmia)?

The heart has a specialized electrical conduction system that ensures its regular beating. This system determines how fast, slow, or regular the heart beats. Any disruption or irregularity in the electrical conduction is referred to as a heart rhythm disorder (arrhythmia). Arrhythmias can manifest in different ways. Some originate in the upper chambers of the heart (atrial), while others originate in the lower chambers (ventricular). Therefore, arrhythmias are classified into groups based on their source and severity.

What Causes Heart Rhythm Disorder (Arrhythmia)?

The causes of heart rhythm disorders can vary from person to person. In some individuals, genetic factors may be involved, while in others, congenital heart structural features may lead to this condition. For example, extra electrical conduction pathways in the heart that should not normally be present can cause arrhythmias to develop. Additionally, conditions that develop later in life, such as heart attack, heart valve disease, obesity, or sleep apnea, can also cause rhythm disorders.

However, rhythm disorders can sometimes occur even in individuals with completely normal heart structures. In these cases, genetic predisposition and environmental factors come to the fore.

What Are the Symptoms of Heart Rhythm Disorders?

The most common symptom of heart rhythm disorders is palpitations, which is the sensation of the heart beating rapidly, irregularly, or strongly. In addition, some people may experience weakness, fatigue, and tire easily during exercise. In some people, the pulse may drop significantly due to the arrhythmia. In this case, complaints such as dizziness, feeling faint, or actual fainting may occur.

Some rhythm problems manifest themselves with premature beats called extrasystoles. In this case, the patient may feel their heart skip a beat, followed by a short pause.

Therefore, symptoms and complaints may vary depending on the type and severity of the patient's arrhythmia. For this reason, any palpitations or irregularities must be evaluated by a physician for a definitive diagnosis.

Who Gets Heart Rhythm Disorders?

Heart rhythm disorders can be seen in different age groups depending on their type and cause. For example, the frequency of atrial fibrillation, the most common rhythm disorder, increases with age. It reaches a prevalence of approximately 20 percent in people in their 70s. In contrast, some rhythm problems can be seen at younger ages or even in the womb. However, it should be noted that, in general, the prevalence of heart rhythm disorders increases with age, but they can also be seen in young people.

What Are the Types of Heart Rhythm Disorders?

While there are dozens of types of heart rhythm disorders, the most common is atrial fibrillation. Atrial fibrillation is a rhythm disorder originating in the upper chambers of the heart (atria) and is also the most common cause of stroke. Atrial fibrillation is a problem that seriously affects a person's quality of life. In some cases, it can even shorten life expectancy and lead to serious conditions such as heart failure. Another type of arrhythmia is ventricular tachycardia. This type of arrhythmia, which originates in the lower chambers of the heart (ventricles), is particularly common after structural heart disease or heart attack and can be life-threatening.

In summary, heart rhythm disorders can be simple and harmless, but they can also be serious and life-threatening. Symptoms and severity can vary from person to person; therefore, every rhythm disorder should be taken seriously.

How is Heart Rhythm Disorder Diagnosed?

The most commonly used method for diagnosing heart rhythm disorders is an ECG (electrocardiogram). Commonly known as a “heart strip,” an ECG shows the heart's electrical activity in a recording lasting a few seconds. However, it may not always be possible to detect an arrhythmia in such a short time. In such cases, a Holter monitor is used. A Holter monitor is a portable device that is attached to the patient and continuously records the heart rhythm for 24-48 hours or longer. This allows for detailed observation of when palpitations occur and how the rhythm changes. In recent years, smartwatches have also begun to assist in the diagnosis of arrhythmias. Watches with an ECG feature can be particularly useful for people who experience palpitations infrequently. The user can activate the ECG function on the watch to take a recording of approximately 10 seconds. These recordings can help the physician obtain information in practice.

How Are Heart Rhythm Disorders Treated?

One of the most important messages that patients with heart rhythm disorders need to know is that they are treatable. Many patients who have lived with palpitations for 40-50 years can regain their health thanks to appropriate treatment methods.

The treatment approach can be summarized as follows, based on the type of arrhythmia and the patient's overall health:

Medication: Helps regulate heart rhythm or control palpitations.

Ablation (burning) treatment: A catheter is inserted into the heart to burn the focus or extra electrical pathways causing the arrhythmia. This method can be curative (completely therapeutic) for some arrhythmias.

What is Catheter Ablation?

Catheter ablation is a treatment method performed by inserting thin catheters into the heart through the veins or arteries in the groin. These catheters record the heart's electrical activity to identify the source of the palpitations. Three-dimensional mapping systems are used to identify the problem area, which is then removed in a controlled manner.

Ablation can be performed using heat (radiofrequency), cold (cryotherapy), or, in recent years, electrical energy (pulsed field ablation). The success rate is quite high in suitable patients.

Who is Eligible for Catheter Ablation?

Catheter ablation can be performed for almost all arrhythmias. Successful results are achieved in atrial arrhythmias, atrial fibrillation, ventricular tachycardias, and some arrhythmias accompanied by fainting.

Frequently Asked Questions About Heart Rhythm Disorders

Is Early Diagnosis Important in the Treatment of Arrhythmia?

Early diagnosis is extremely important in the treatment of cardiac arrhythmia. Early diagnosis is particularly important for atrial fibrillation, the most common arrhythmia in the general population. Early diagnosis makes it possible to prevent serious complications such as stroke and heart failure, and effective treatments can lead to very good results.

In addition, changes that patients make in their own lifestyle also increase the success of treatment. For example, losing excess weight, eating a regular and balanced diet, adopting a healthy lifestyle, and exercising regularly are extremely important for both controlling arrhythmias and preventing their recurrence.

Does Obesity Trigger Arrhythmia?

Yes, obesity significantly increases the incidence of atrial fibrillation in particular. Therefore, maintaining a healthy lifestyle is extremely important in preventing and controlling arrhythmias.

Regular exercise: At least 3 days a week, each lasting at least 30 minutes, should be included in daily life. Aerobic exercises (such as walking, cycling) and muscle strengthening exercises should be included.

Limiting alcohol: Reducing alcohol consumption, if present, lowers the risk of arrhythmia.

Treatment of sleep apnea: Sleep apnea is a problem closely related to atrial fibrillation. Therefore, sleep apnea must be treated if present.

When these factors are controlled, managing atrial fibrillation becomes much easier. When patients actively participate in lifestyle changes, the recurrence rate of arrhythmia also decreases significantly.

Can Arrhythmia Be Confused with Other Diseases?

Yes, arrhythmias can sometimes be confused with other diseases. Panic attacks are the most common example of this. Panic attacks are usually accompanied not only by palpitations but also by additional symptoms such as shortness of breath, numbness in the body, intense anxiety, and fear of death. In arrhythmias, however, palpitations and increased heart rate that start suddenly without any warning are usually the main symptoms. However, these palpitations often cannot be detected during an examination. Therefore, some patients may be misdiagnosed with a panic attack. Consequently, it should be investigated whether the problem is actually caused by an arrhythmia.

Do arrhythmias occur in children?

Yes. Congenital arrhythmias, accessory pathways, or supraventricular tachycardia can also occur in children. These arrhythmias are treatable. Some arrhythmias can even be detected in the womb.

What is the Role of Genetic Factors in Arrhythmia?

Genetic factors play a significant role in some arrhythmias. For example, arrhythmogenic right ventricular dysplasia (ARVD) is a rhythm problem associated with genetic transmission. In patients with genetic predisposition, genetic counseling and, if necessary, genetic screening using IVF (in vitro fertilization) can prevent the intergenerational transmission of the disease. Thus, the transmission of genetic arrhythmias to children can be prevented.

This content was prepared by Yeditepe University Hospitals Medical Editorial Board.