Abnormal Heart Rhythm (Arrhythmia)

What is abnormal heart rhythm (arrhythmia)?

Arrhythmia means an irregular or abnormal heartbeat. In some cases, an arrhythmia can be so brief that it barely affects the heart’s rhythm at all, while in other cases, it can cause a severe disruption.

What are the different types of arrhythmias?

  • Atrial fibrillation: Irregular contraction of the heart’s upper chamber
  • Ventricular fibrillation: Irregular contraction of the heart’s lower chamber
  • Bradycardia: Slow heartbeat (< 60 beats per minute)
  • Tachycardia: Very fast heartbeat (> 100 beats per minute)
  • Premature contraction: Early heartbeat

In all cases of arrhythmia, the heart does not beat or pump blood properly. This deprives other organs, such as the brain and lungs, of blood flow, which can lead to organ damage and potentially organ failure.

What are the causes of arrhythmias?

  • Blocked arteries in the heart (coronary artery disease)
  • High blood pressure
  • Changes in the structure of the heart, often due to cardiomyopathy
  • Hyperthyroidism: overactive thyroid gland
  • Hypothyroidism: underactive thyroid gland
  • Drug abuse
  • Certain supplements and medications, such as cold and allergy drugs without a prescription from a healthcare professional
  • Scarring of the heart’s tissue due to prior heart attack

What are the symptoms of arrhythmias?

  • Palpitations
  • Fainting
  • Fatigue and weakness
  • Rapid, pounding heartbeat
  • Chest pressure or pain
  • Anxiety and shortness of breath
  • Feeling dizzy

In extreme cases of arrhythmia, collapse and sudden cardiac arrest can occur.

What are the risk factors of arrhythmias?

  • Stress
  • Excessive use of caffeine or alcohol
  • Genetics/Family history
  • Diabetes
  • Smoking
  • Older age
  • Being overweight
  • Past illness e.g., heart attack and heart failure

How is an arrhythmia diagnosed?

  • Electrocardiogram (ECG)
  • Ambulatory monitor e.g., Holter monitor
  • Stress test
  • Cardiac event recorder
  • Electrophysiological (EP) study
  • Echocardiogram
  • Cardiac catheterisation

What are the treatment options for arrhythmias?

The treatment of your arrhythmia depends on whether it is a fast or slow arrhythmia or heart block. The treatments may involve:

  • Medications
  • Electrical cardioversion
  • Catheter ablation
  • Pacemaker
  • Implantable cardioverter defibrillator (ICD)

What are the prevention tips for arrhythmias?

  • Stop smoking or quit tobacco use
  • Reduce alcohol intake
  • Limit caffeine consumption
  • Do not take stimulants (e.g., used in cough and cold medications or herbal supplements)
  • Keep your blood pressure in control
  • Try to reduce some weight (if you are overweight)
  • Control blood sugar level


  1. Arrhythmia. Available at https://www.nhs.uk/conditions/arrhythmia/ [Accessed on 29 April 2022]
  2. Arrythmia. Available at https://my.clevelandclinic.org/health/diseases/16749-arrhythmia [Accessed on 29 April 2022]
  3. About arrythmia. Available at https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia [Accessed on 9 May 2022]
  4. Heart arrhythmia. Available at https://www.mayoclinic.org/diseases-conditions/heart-arrhythmia/symptoms-causes/syc-20350668 [Accessed on 9 May 2022]
  5. Understand your risk for arrhythmia. Available at https://www.heart.org/en/health-topics/arrhythmia/understand-your-risk-for-arrhythmia [Accessed on 9 May 2022]
  6. Risk factors for arrhythmias (heart rhythm disturbances). Available at https://www.winchesterhospital.org/health-library/article?id=19102 [Accessed on 9 May 2022]
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