You can’t beat a healthy heart!

By: Parinita Dherange, MD
MUSC Health - Cardiology

Let's have a Heart-to-Heart about Heart Arrhythmias

Just like a home, your heart has rooms (chambers), walls (heart muscles), doorways (valves), plumbing (heart vessels), and an electrical system (conduction system). Any abnormalities in the electrical system of the heart can cause arrhythmias leading to abnormal heart rhythms. Arrhythmias may be either completely harmless or bothersome or sometimes even life threatening. They can affect the heart's pumping function and, as a result, can cause other organ failures. With arrhythmias, the heart can beat either too fast, too slow, or erratically. Certain arrhythmias may increase your risk of developing conditions such as stroke, heart failure and, in some cases, can cause sudden cardiac death.

What are the common causes of arrhythmias?

Some of the common causes or risk factors for arrhythmias include an active heart attack or scarring from a previous heart attack, high blood pressure, blocked arteries in the heart (coronary artery disease), structural changes in the heart from cardiomyopathy, overactive or underactive thyroid gland, diabetes, sleep apnea, covid-19 infection, side effects of medications, electrolyte imbalance, or genetics. Other lifestyle risk factors include drug abuse, smoking, drinking too much alcohol or caffeine, stress or anxiety.

What are the signs and symptoms of arrhythmias?

Arrhythmias may not cause any signs or symptoms. Some arrhythmias may have noticeable symptoms, including a fluttering sensation in the chest, racing heartbeat, slow heartbeat, chest pain, shortness of breath, feeling of anxiety, fatigue, lightheadedness or dizziness, sweating, fainting, or near fainting. These symptoms could be due to premature heartbeats or your heart racing or beating too slowly. Other signs and symptoms could be due to ineffective pumping of your heart because it beats too slow, or too fast.

How can we identify and treat arrhythmias?

Arrhythmias can be detected by conducting invasive or non-invasive heart-monitoring tests. These tests include an electrocardiogram (ECG), Holter monitor, event recorder, echocardiogram, implantable loop recorder, stress test, or electrophysiological testing and mapping.

Treatment for arrhythmias may or may not be necessary. Usually, treatment is required if the arrhythmia is causing significant symptoms or if it puts you at life-threatening risk. Slow heartbeats can be treated by implanting a pacemaker, a small device that sends electrical impulses to your heart and can speed up your heart rate. Fast heartbeats can be treated with medications or cardioversions. Sometimes it may require catheter ablation. This procedure uses extreme cold or radiofrequency energy in which a small spot of heart tissue is damaged (ablated) to create an electrical block along the pathway causing an arrhythmia. Individuals who are at high risk of sudden cardiac death may require an implantable cardioverter-defibrillator (ICD). An ICD detects abnormal heart rhythm and sends out low- or high-energy shocks to reset the heart to a normal rhythm.

Dr. Parinita Dherange is an electrophysiologist at MUSC Health – Cardiology, specializing in cardiac arrhythmias. To schedule an appointment, please call at 843-674-4787.