Cardiac arrhythmia

At HCA UK , we provide comprehensive care for all types of this condition from tests to treatment:

• Appointment confirmed with a cardiologist within 24 hours 
• Comprehensive arrhythmia diagnostics and treatment options
• Ranked no.1 in the UK for private cardiac care, including electrophysiology
• 99% of cardiac patients recommend us to friends and family

What is cardiac arrhythmia?

Cardiac arrhythmia, also known as cardiac dysrhythmia is a broad term for several conditions caused by an irregular heartbeat. Over a million people in the UK experience heart rhythm problems. 

Many people with heart arrhythmias are able to lead normal lives with proper diagnosis. But these conditions can be life-changing or life-threatening, requiring monitoring and treatment with medication, procedures and/or positive lifestyle changes. Whatever your symptoms or condition, we offer comprehensive testing and care for heart rhythm abnormalities.  

How do arrhythmias occur?

Knowing how your heart works can help with understanding arrhythmias. Your heart has four chambers:

• Two upper chambers known as the atria which collect blood  
• Two lower chambers called ventricles which receive blood from the atria and pump it to the rest of your body 

A group of cells in the right atrium called the sinus node act as your heart's natural pacemaker, providing electrical impulses that make your heart contract and pump blood. The lower chambers beat slightly after the upper chambers to ensure blood travels in the correct direction. This is controlled by the atrioventricular (AV) node, which is located between the atria and ventricles.

Arrhythmias occur when these impulses and beats don't work properly. You may feel like your heart skips or adds a beat or is beating too fast or too slow. You might not notice anything at all. 

What is a normal heart rate?

Familiarity with your regular heartbeat can help you notice cardiac arrhythmia symptoms. 

A regular heart rhythm should feel like a steady, consistent drum beat. A resting rate of around 60-100 beats per minute is normal for most adults, with some high-performance athletes having a rate in the 40s or even lower.

Different factors can change how electrical signals travel through your heart, causing it to pump faster, slower or in an inconsistent pattern. 

Is cardiac arrhythmia a heart attack?

Arrhythmias and heart attacks can have similar warning signs. Heart attacks often start slowly, with other symptoms including chest pain or pressure, discomfort in your upper body and shortness of breath. If you think you or someone you know may be having a heart attack, call 999 for emergency help.

What are the types of cardiac arrhythmia?

Arrhythmias can be grouped by where they start in your heart – ventricular in the lower chambers and supraventricular in the upper chambers – or by how they affect your resting heart rate. Tachycardia is a fast heartbeat of over 100 beats per minute. Bradycardia is a slow heartbeat of below 60 beats per minute.

The main forms of tachycardias are:

• Atrial fibrillation (AF): This is the most common arrhythmia and occurs when faulty signals from your heart's upper chambers cause it to beat irregularly and faster than normal.
• Atrial flutter: Similar to atrial fibrillation, but the upper chambers of the heart regularly beat out of rhythm with the lower chambers.
• Atrial tachycardia: A fast, irregular heart rhythm caused by abnormal signals from your heart's upper chambers.
• Supraventricular tachycardia: Episodes of a very fast heart rhythm, typically due to electrical impulses not travelling correctly between the top and bottom chambers of your heart. It's more prevalent in younger people. 
• Wolff-Parkinson-White (WPW) syndrome: A congenital heart condition (present from birth) which can cause the heart to suddenly develop an SVT.
• Ventricular extrasystoles: Also known as premature ventricular contractions (PVCs), these are extra beats that are typically harmless. 
• Ventricular tachycardia (VT): This is a rapid, irregular heartbeat caused by faulty signals in your lower heart chambers. 
• Torsades de pointes: A fast heart rhythm that starts in your heart's bottom chambers and typically develops in those with Long QT syndrome.
• Ventricular fibrillation: A rapid, disorganised heart rhythm that can lead to have serious complications without rapid treatment. It often occurs as a complication of other heart conditions. 

Bradycardia occurs when your heart isn't pumping enough blood around your body. It's more common in older people and athletes. This may not necessarily be an issue if you are physically fit. 

The two main forms of bradycardia are:

• Sick sinus syndrome: An issue with the sinus node that typically affects the heart's upper chambers, causing an overly slow heartbeat.
• Heart block: A slow heartbeat caused by a delay or blockage in your heart's electrical conduction. They're more frequent in older people and individuals with underlying heart conditions. 

Cardiac arrhythmia diagnosis

There are several tests that can confirm or rule out a heart arrhythmia diagnosis. Your doctor may carry out one or more of them depending on your symptoms, medical history and a physical examination which involves taking your pulse and listening to your heart. 

• An electrocardiogram (ECG), which measures the electrical activity of your heart while you rest through sensors attached to your body and connected to a machine.
• An ambulatory electrocardiogram, also known as a Holter monitor (though these devices are becoming outdated, typically replaced with a more discreet Zio patch). This is a portable ECG designed to be worn continuously for a day or more as determined by your consultant to record your heart's activity during your daily routine.
• An event recorder, an ECG designed to be worn for a longer period of time. You may be able to press a button when symptoms occur to provide further insight to your medical team.
• Echocardiogram, an ultrasound scan that checks the structure and function of your heart muscle and valves.
• Implantable loop recorder, a small device inserted under your skin to constantly record information about your heart's electrical activity over time. It's sometimes used when palpitations don't occur regularly.
• Electrophysiology (EP) studies that map your heart's electrical activity to help identify the source of the problem and determine appropriate cardiac arrhythmia treatments.
• Cardiac stress test, used to check how your heart reacts to exercise, such as gradually increasing the difficulty of walking on a treadmill.

You may repeat these tests over time to monitor how an arrhythmia responds to treatment. 

These tests may be available to people who have not experienced symptoms but are keen to understand their heart health. Risk factors such as age or family history may be considered. You can book an appointment or contact us if you would like more information on your cardiac condition.

There are a range of effective heart arrhythmia treatments available. The most suitable option(s) for you will depend on your type of arrhythmia, whether it's fast or slow, as well as any underlying causes, potential complications and how your arrhythmia has responded to other treatments. Some arrhythmias don't require treatment and may be safely monitored through check-ups instead.  

Common treatments for cardiac arrhythmia include medication, therapies, devices and surgery. 

Arrhythmia medication

Heart arrhythmia medications include: 

• Medicines to control your heart rate
• Blood thinners to prevent blood clots
• Medications for related conditions that may be causing your arrhythmia
  

Arrhythmia therapies

Therapies used to treat certain arrhythmias include: 

• Vagal manoeuvres, which are actions – such as coughing and placing an ice pack on your skin – used to slow your heart rate by affecting the vagus nerve.
• Electrical cardioversion, using paddles or patches on your chest to give your heart a safe electric shock and reset its rhythm. It's typically used to treat atrial fibrillation, atrial flutter and ventricular tachycardia.

Arrhythmia devices

Your consultant may recommend having a device safely inserted into your body to regulate your heartbeat:

• Pacemakers are small devices that send electrical impulses to your heart to keep it from beating too slowly.
• Implantable cardioverter defibrillators monitor your heart rhythm and provide shocks to return it to a normal rate when an abnormally fast rhythm is detected. 

Arrhythmia surgery

Surgery may be needed to stop or prevent irregular heartbeats when other treatments aren't suitable or successful. Procedures include:

• Catheter ablation, placing one or more catheters (small tubes) into your heart's blood vessels to block irregular heart signals and correct your heartbeat.
• A maze procedure can correct a fast heartbeat by creating scar tissue that faulty electronic signals can't pass through.
• Coronary artery bypass surgery is used to treat coronary heart disease, a potential cause of arrhythmia, by creating a new path for blood to flow around a blocked artery.
  

Potential complications of arrhythmia

Possible complications vary based on the type of arrhythmia you have and its underlying causes. If arrhythmia of the heart is left undiagnosed and/or untreated, risks include:

• Weakening of your heart muscle, known as cardiomyopathy
• Blood clots, possibly leading to stroke or pulmonary embolism
• Heart failure
• Sudden death 

Can you prevent arrhythmia? 

It's not always possible to stop arrhythmias occurring, but certain lifestyle changes can reduce your risk:

• Eating a heart-healthy diet, low in salt and saturated fat 
• Getting regular exercise
• Stopping smoking
• Maintaining a healthy bodyweight 
• Controlling your blood pressure and cholesterol 
• Limiting alcohol intake
• Getting good sleep 
• Managing stress

Your consultant will discuss any relevant options for you and how you can achieve them in greater detail.  

Living with heart arrhythmia

Many arrhythmias are manageable with the right diagnosis, treatment and lifestyle choices, allowing you to live largely as normal. You may need to consider practical elements such as driving and working. 

If your arrhythmia affects your ability to drive, you must tell your insurance company and the Driver and Vehicle Licensing Agency (DVLA). Any work implications will depend on your role, for example, if you operate machinery or work at height. Your cardiologist will be able to advise you on both fronts.