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Understanding Heart Rhythm Disorders

Getting to know the hearts electrical system

From NIH, for About.com

Updated: August 22, 2006

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What is an arrhythmia?

An arrhythmia is a change in the regular beat of the heart. The heart may seem to skip a beat or beat irregularly or very fast or very slowly.

Does having an arrhythmia mean that a person has heart disease?

No, not necessarily. Many arrhythmias occur in people who do not have underlying heart disease.

Are arrhythmias serious?

The vast majority of people with arrhythmias have nothing to fear. They do not need extensive exams or special treatments for their condition.

In some people, arrhythmias are associated with heart disease. In these cases, heart disease, not the arrhythmia, poses the greatest risk to the patient.

In a very small number of people with serious symptoms, arrhythmias themselves are dangerous. These arrhythmias require medical treatment to keep the heartbeat regular. For example, a few people have a very slow heartbeat (bradycardia), causing them to feel lightheaded or faint. If left untreated, the heart may stop beating and these people could die.

How common are arrhythmias?

Arrhythmias occur commonly in middle-age adults. As people get older, they are more likely to experience an arrhythmia.

What are the symptoms of an arrhythmia?

Most people have felt their heart beat very fast, experienced a fluttering in their chest, or noticed that their heart skipped a beat. Almost everyone has also felt dizzy, faint, or out of breath or had chest pains at one time or another. One of the most common arrhythmias is sinus arrhythmia, the change in heart rate that can occur normally when we take a breath. These experiences may cause anxiety, but for the majority of people, they are completely harmless.

You should not panic if you experience a few flutters or your heart races occasionally. But if you have questions about your heart rhythm or symptoms, check with your doctor.

Arrhythmia Types

Originating in the Atria

  • Sinus arrhythmia. Cyclic changes in the heart rate during breathing. Common in children and often found in adults.
  • Sinus tachycardia. The sinus node sends out electrical signals faster than usual, speeding up the heart rate.
  • Sick sinus syndrome. The sinus node does not fire its signals properly, so that the heart rate slows down. Sometimes the rate changes back and forth between a slow (bradycardia) and fast (tachycardia) rate.
  • Premature supraventricular contractions or premature atrial contractions (PAC). A beat occurs early in the atria, causing the heart to beat before the next regular heartbeat.
  • Supraventricular tachycardia (SVT), paroxysmal atrial tachycardia (PAT). A series of early beats in the atria speed up the heart rate (the number of times a heart beats per minute). In paroxysmal tachycardia, repeated periods of very fast heartbeats begin and end suddenly.
  • Atrial flutter. Rapidly fired signals cause the muscles in the atria to contract quickly, leading to a very fast, steady heartbeat.
  • Atrial fibrillation. Electrical signals in the atria are fired in a very fast and uncontrolled manner. Electrical signals arrive in the ventricles in a completely irregular fashion, so the heart beat is completely irregular.
  • Wolff-Parkinson-White syndrome. Abnormal pathways between the atria and ventricles cause the electrical signal to arrive at the ventricles too soon and to be transmitted back into the atria. Very fast heart rates may develop as the electrical signal ricochets between the atria and ventricles.

Originating in the Ventricles

  • Premature ventricular complexes (PVC). An electrical signal from the ventricles causes an early heart beat that generally goes unnoticed. The heart then seems to pause until the next beat of the ventricle occurs in a regular fashion.
  • Ventricular tachycardia. The heart beats fast due to electrical signals arising from the ventricles (rather than from the atria).
  • Ventricular fibrillation. Electrical signals in the ventricles are fired in a very fast and uncontrolled manner, causing the heart to quiver rather than beat and pump blood.

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