Arrhythmia

An arrhythmia is a problem with the rate or rhythm of the heartbeat. During a arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm.

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What Causes an Arrhythmia?

An arrhythmia can occur if the electrical signals that control the heartbeat are delayed or blocked. This can happen if the special nerve cells that produce electrical signals don't work properly, or if electrical signals don't travel normally through the heart.

An arrhythmia also can occur if another part of the heart starts to produce electrical signals. This adds to the signals from the special nerve cells and disrupts the normal heartbeat.

Smoking, heavy alcohol use, use of certain drugs (such as cocaine or amphetamines), use of certain prescription or over-the-counter medicines, or too much caffeine or nicotine can lead to arrhythmias in some people.

Strong emotional stress or anger can make the heart work harder, raise blood pressure, and release stress hormones. In some people, these reactions can lead to arrhythmias.

A heart attack or an underlying condition that damages the heart's electrical system also can cause arrhythmias. Examples of such conditions include high blood pressure, coronary heart disease, heart failure, overactive or underactive thyroid gland (too much or too little thyroid hormone produced), and rheumatic heart disease.

In some arrhythmias, such as Wolff-Parkinson-White syndrome, the underlying heart defect that causes the arrhythmia is congenital (present at birth). Sometimes, the cause of an arrhythmia can't be found.

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Who Is At Risk for an Arrhythmia?

Millions of Americans have arrhythmias. They're very common in older adults. About 2.2 million Americans have atrial fibrillation (a common type of arrhythmia that can cause problems).

Most serious arrhythmias affect people older than 60. This is because older adults are more likely to have heart disease and other health problems that can lead to arrhythmias.

Older adults also tend to be more sensitive to the side effects of medicines, some of which can cause arrhythmias. Some medicines used to treat arrhythmias can even cause arrhythmias as a side effect.

Some types of arrhythmia happen more often in children and young adults. Paroxysmal supraventricular tachycardias (PSVTs), including Wolff-Parkinson-White syndrome, are more common in young people. PSVT is a fast heart rate that begins and ends suddenly.

Major Risk Factors

Arrhythmias are more common in people who have diseases or conditions that weaken the heart, such as:

Heart attack, Heart failure or cardiomyopathy, which weakens the heart and changes the way electrical signals move around the heart

Other conditions also can increase the risk for arrhythmias, such as:

• High blood pressure

• Infections that damage the heart muscle or the sac around the heart

• Diabetes, which increases the risk of high blood pressure and coronary heart disease

• Sleep apnea (when breathing becomes shallow or stops during sleep), which can stress the heart because the heart doesn't get enough oxygen

• An overactive or underactive thyroid gland (too much or too little thyroid hormone in the body)

Also, several other risk factors can increase risk for arrhythmias. Examples include heat surgery, certain drugs (such as cocaine or amphetamines), or an imbalance of chemicals or other substances (such as potassium) in the bloodstream.