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What to do about cardiac arrhythmias: Causes and Help

Cardiac arrhythmias can be harmless or serious. Learn which immediate measures help and when urgent medical attention is required.

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Things worth knowing about "What to do about cardiac arrhythmias"

Cardiac arrhythmias can be harmless or serious. Learn which immediate measures help and when urgent medical attention is required.

What are cardiac arrhythmias?

Cardiac arrhythmias are irregularities in the normal heartbeat. The heart may beat too fast (tachycardia), too slowly (bradycardia), or in an irregular pattern. Some arrhythmias are harmless and temporary, while others may indicate serious underlying conditions and require medical treatment.

Causes

Cardiac arrhythmias can have many causes, including:

Stress and exhaustion
Caffeine, alcohol or nicotine
Electrolyte imbalances (e.g., low potassium or magnesium)
Thyroid disorders
Heart conditions such as coronary artery disease or heart failure
Certain medications (e.g., antiarrhythmics, diuretics)
Congenital heart defects
High blood pressure

Symptoms

Common signs of cardiac arrhythmias include:

Palpitations or racing heart
Irregular heartbeat
Dizziness or light-headedness
Shortness of breath
Chest tightness or chest pain
Fainting or loss of consciousness
General weakness and fatigue

What to do about cardiac arrhythmias

Immediate measures for mild symptoms

For mild, temporary arrhythmias, the following steps may help:

Stay calm and sit or lie down
Breathe slowly and deeply to calm the nervous system
Drink cold water or splash cold water on your face
Valsalva maneuver: Bear down as if having a bowel movement to stimulate the vagus nerve and slow the heart rate
Avoid caffeine, alcohol and nicotine
Ensure adequate fluid and electrolyte intake

When to call emergency services immediately

Call emergency services (911 or your local emergency number) or go to the nearest emergency room immediately in these situations:

Severe chest pain or pressure
Loss of consciousness or sudden fainting
Persistent severe shortness of breath
Very fast or very slow heartbeat accompanied by severe dizziness
Signs of a stroke (paralysis, speech difficulties, vision disturbances)

Diagnosis

Doctors use various diagnostic methods to identify the type of arrhythmia:

ECG (electrocardiogram): Records the electrical activity of the heart
Holter monitor (24-48 hour ECG): Continuous heart rhythm monitoring over one to two days
Exercise stress ECG: Heart monitoring during physical exertion
Echocardiography: Ultrasound examination of the heart
Blood tests: Checking electrolyte levels, thyroid function and cardiac markers
Electrophysiology study (EPS): Specialized test to precisely locate abnormal electrical pathways

Treatment

Treatment depends on the type and severity of the arrhythmia:

Medications: Antiarrhythmics, beta-blockers or calcium channel blockers to regulate heart rhythm
Electrical cardioversion: Restoring normal heart rhythm using controlled electrical shocks
Catheter ablation: Minimally invasive procedure to destroy abnormal heart tissue causing arrhythmias
Pacemaker: Device implanted to regulate a heart that beats too slowly
Implantable cardioverter-defibrillator (ICD): Device used to treat life-threatening ventricular arrhythmias
Lifestyle changes: Stress reduction, regular exercise, healthy diet, and avoiding alcohol and tobacco

Prevention

The following measures can help reduce the risk of cardiac arrhythmias:

Regular moderate physical activity (e.g., walking, swimming, cycling)
Balanced diet rich in magnesium and potassium
Avoiding smoking and excessive alcohol consumption
Stress management techniques (e.g., yoga, meditation)
Regular medical check-ups
Treatment of underlying conditions such as high blood pressure or thyroid disorders

References

European Society of Cardiology (ESC): 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation. European Heart Journal, 2021.
Zipes DP et al.: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th edition. Elsevier, 2022.
World Health Organization (WHO): Cardiovascular diseases (CVDs). Fact Sheet. Available at: www.who.int (accessed 2024)

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