What can be done for an irregular heartbeat?

Dear Alice,

I recently went for my yearly physical and my doctor said my heart skipped a beat, so she is going to place me on a halter monitor. What causes the heart to skip, is it a common problem, and can it be cured?

Dear Reader,

A heartbeat that races, goes too slowly, or stutters — any sort of irregular heartbeat — is called an arrhythmia. Arrhythmias affect about five percent of people and are more common in adults over 65 years of age. Symptoms of an arrhythmia include:

  • An abnormally quick or slow heartbeat
  • Chest pain
  • Dizziness
  • Lightheadedness
  • Fainting
  • Chest palpitations

Biologically speaking, the human heart follows a precise sequence when it beats: one chamber of the heart, called the right atrium, acts as the heart’s metronome, sending out an electrical signal that causes different parts of the heart to contract, one after another. When everything is timed right, blood flows properly through the heart to the rest of the body but, when the sequence is disturbed or interrupted in some way the rhythm of the heart can get thrown off. There are different kinds of arrhythmias — many are harmless, while others can cause serious health risks. Arrhythmias can be dangerous because vital organs might not receive enough oxygen to function. If the brain doesn’t receive enough oxygen, for example, a stroke can occur, possibly causing brain damage or death. If the heart pumps inefficiently for an extended period of time, a patient can have congestive heart failure, a condition that can be fatal.

Certain risk factors increase the chances of developing an arrhythmia:

  • Genetics. Being born with a heart abnormality or having a family history of heart problems can increase the risk of an arrhythmia.
  • High blood pressure. This might increase the thickness of the walls of the heart, interfering with electrical signals being properly transmitted.
  • Age. The heart muscle weakens when it gets older, possibly affecting how electrical signals are transmitted and received.
  • Alcohol and other drugs, and herbal supplements. Caffeine and nicotine can alter a regular heartbeat, as can amphetamines and cocaine. Likewise, heavy alcohol consumption can interfere with electrical impulses. Some over-the-counter cough and cold medicines and the herbal supplement ephedra (now banned in the United States) also have been shown to disrupt regular heartbeats.
  • Diabetes. Episodes of low blood sugar can cause an arrhythmia.
  • Thyroid problems. The thyroid produces hormones that regulate metabolism. If the thyroid produces too much or too little hormones, the result can be an abnormally fast, slow, or irregular heartbeat.

You mentioned that your doctor is going to give you a Holter (not halter, but close) monitor. A Holter monitor is a portable electrocardiogram (ECG) device. ECGs detect and record electrical impulses in your heart. About the size of a deck of cards, the monitor is attached by wires to small pads that are placed on your chest near the heart. You can clip the monitor to your belt and have it record while you work, eat, relax, commute, and exercise, so your health care provider can understand how your heart behaves in the course of your everyday life. In some instances, you may be asked to wear a wireless Holter that can record your heart’s activity over a longer span of time — multiple days or weeks at a time.

When symptoms associated with arrhythmias are more serious (e.g., dizziness, chest pain, or fainting) or you are at increased risk for heart failure, stroke, or sudden cardiac arrest, a health care provider may suggest treatment. The good news is that a variety of effective treatments mean that many cases of arrhythmia can be safely managed or eliminated. If your health care provider sees a problem after looking at the results of your ECG, s/he might suggest treatment with medication, or possibly a pacemaker. Usually implanted somewhere near the collarbone, a pacemaker is a small device with a battery. Electrodes extend from the pacemaker to the heart and send electric impulses to help normalize an irregular heartbeat. Another form of treatment is a catheter ablation, a process in which the cells that cause an arrhythmia are destroyed.

In addition, many lifestyle changes can help prevent and reduce arrhythmias. You could try the following options to keep your heart as healthy as possible by:

  • Following a healthy, well balanced diet — including a variety of fruits and vegetables, whole grains, lean meats, low-fat dairy, nuts and seeds.
  • Keeping salts, sugars, and processed foods to a minimum.
  • Finding physical activities you enjoy and being physically active on a regular basis.
  • Quitting smoking.
  • Maintaining healthy blood pressure and cholesterol levels.
  • Aiming for a healthy weight for your body.
  • Managing feelings of anger.
  • Limiting and managing stressors.

In some cases, it may also be also helpful to avoid substances that can increase your heart beat like alcohol and cold medication.

Hope this helps!

Last updated Apr 09, 2015
Originally published Jun 04, 2004

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