In many instances, cardiac arrhythmia may not produce any signs or symptoms. An abnormal heart rhythm gets diagnosed during a routine checkup, much before signs and symptoms appear. However, when symptoms are experienced, they include pain in chest, dyspnea, onset of tachycardia or bradycardia, flutter in chest, lightheadedness accompanied by dizziness and fainting.

Condition such as ventricular tachycardia can be life threatening causing cardiac arrest, or sudden death and increasing risks for embolisation and stroke [6].

• Fatigue

  Tachycardias can cause symptoms such as palpitations, chest pain, shortness of breath and fatigue, which reduce the quality of life. Fast tachycardias can cause hemodynamic collapse and sudden cardiac d... [intechopen.com]

  A 45-year-old woman with no previous history of cardiac disease woke up one morning with an irregular heartbeat and fatigue. [ncbi.nlm.nih.gov]

  Tachycardias can cause symptoms such as palpitations, chest pain, shortness of breath and fatigue, which reduce the quality of life. Fast tachycardias can cause hemodynamic collapse and sudden cardiac death. [web.archive.org]

  When she felt fatigued and lost energy, she turned to Gopi Dandamudi, MD a cardiologist at CHI Franciscan's Harrison Medical Center in Bremerton. Dr. Dandamudi diagnosed an arrhythmia in Andrea's heart. [youtube.com]

  If the patient also experiences chest pain, dizziness, shortness of breath, fatigue or even loses consciousness, they should be immediately examined by a doctor. Different diseases can cause cardiac arrhythmia. [hirslanden.ch]

• Congestive Heart Failure

  failure I50.1 Left ventricular failure, unspecified I50.2 Systolic (congestive) heart failure I50.20 Unspecified systolic (congestive) heart failure I50.21 Acute systolic (congestive) heart failure I50.22 Chronic systolic (congestive) heart failure I50.23 [icd10data.com]

  The advanced heart rhythm management equipment and technology in our cath lab allows us to diagnose and care for conditions including: Atrial fibrillation (A-Fib) Heart arrhythmia Sudden cardiac arrest Congestive heart failure Nationally renowned cardiac [dignityhealth.org]

  AFib is not usually life-threatening but can cause stroke or congestive heart failure if not properly diagnosed or treated with medication. [trinityhealthma.org]

  Secondary analyses were subset to men without calcium channel/β-adrenergic medication usage, and stratified by congestive heart failure or myocardial infarction history. [ncbi.nlm.nih.gov]

• Falling

  In 2 patients cardiac rhythm disturbances clearly caused falls and hip fractures. [ncbi.nlm.nih.gov]

  On the ECG, junctional tachycardia often presents with abnormal morphology P-waves that may fall anywhere in relation to a regular, narrow QRS complex. It is often due to drug toxicity. [en.wikipedia.org]

  Others feel: Palpitations or a galloping or sluggish heartbeat; Shortness of breath; Chest pain or discomfort; Fatigue or weakness; Dizziness; or Unexplained falls or fainting. [augustahealth.org]

  Despite the fact that there are many different kinds, the noticeable symptoms caused by arrhythmias generally fall into four major categories, including: Depending on the type and severity of your arrhythmia, you may notice symptoms such as sweating [verywellhealth.com]

• Anemia

  Arrhythmias are caused by: Infection or fever Physical or emotional stress Diseases such as anemia or thyroid disease Drugs and other stimulants, such as caffeine, tobacco, alcohol, cocaine, amphetamines, and certain over-the-counter and prescription [webmd.com]

  Reversible causes of the heart failure also need to be addressed (e.g. infection, alcohol ingestion, anemia, thyrotoxicosis, arrhythmia, hypertension). [en.wikipedia.org]

• Unconsciousness

  The majority of patients was unconscious of the whole procedure and did not recollect experiencing pain. Procedural pain was reported by 7.7% of the patients and 16% reported adverse effects, e.g., postprocedural nausea and episodes of headache. [ncbi.nlm.nih.gov]

  The patient is unconscious, not breathing, and doesn’t have a pulse. If available, electrical cardioversion must be administered as soon as possible. If not available, then cardiopulmonary resuscitation (CPR) should be started. [2minutemedicine.com]

  The patient is unconscious, not breathing, and doesn't have a pulse. If available, electrical cardioversion must be administered as soon as possible. If not available, then cardiopulmonary resuscitation (CPR) should be started. [drugs.com]

  Respiratory sinus arrhythmia reflects an imbalance in the autonomic nervous system -- the unconscious control system that regulates internal bodily functions such as heart beat and breathing. [sciencedaily.com]

• Dyspnea

  In case 1, a 44-y-old previously healthy male presented with chest tightness, dyspnea, diaphoresis and palpitation immediately after chewing 1 betel quid. He soon became breathless and died despite immediate cardiopulmonary resuscitation. [ncbi.nlm.nih.gov]

  Symptoms depend on the type of arrhythmia; we will explain the most common below: Symptoms of tachycardia Tachycardia is when the heart beats quicker than normal; symptoms include: breathlessness (dyspnea) dizziness syncope (fainting, or nearly fainting [medicalnewstoday.com]

  However, when symptoms are experienced, they include pain in chest, dyspnea, onset of tachycardia or bradycardia, flutter in chest, lightheadedness accompanied by dizziness and fainting. [symptoma.com]

• Tachycardia

  In patients without ECG‐documented tachycardia, clinically relevant arrhythmia was induced in 73% (8/11). In 30 of 32 patients (94%) with an inducible tachycardia during invasive EPS, it was also possible to induce the tachycardia by TAS. [doi.org]

  Types of supraventricular tachycardia include: Atrial fibrillation Atrial flutter Atrial tachycardia Atrioventricular nodal reentrant tachycardia Atrioventricular reentrant tachycardia, also known as Wolff-Parkinson-White syndrome Expand All Collapse [scripps.org]

  Ventricular tachycardia: tachycardia due to additional impulses in the ventricle. Ventricular tachycardia is serious because it can transition to life-threatening ventricular flutter or fibrillation. [ims.uniklinik-freiburg.de]

  Fast tachycardias can cause hemodynamic collapse and sudden cardiac death. The causes, mechanisms, and origins of tachycardias are various. The diagnosis of tachycardias is made by electrocardiograms and electrophysiological testing. [intechopen.com]

  Ablation of Atrioventricular Junctional Tachycardias: Atrioventricular Nodal Reentry, Variants and Focal Junctional Tachycardia 22. [elsevier.com]

• Heart Disease

  Even people who look healthy and free of heart disease can have arrhythmias(abnormal heart rhythms), but those with heart disease are at the highest risk. So, reducing heart disease is important to lowering the risk of arrhythmias. [hrsonline.org]

  Cardiac arrhythmias in coronary heart disease. SIGN 152. Edinburgh: SIGN, 2018. [guidelinesinpractice.co.uk]

  A common ca ... use is coronary artery disease, the most common type of heart disease that affects adults. An injury from a heart attack and changes in your heart muscle can also cause an arrhythmia. [sharecare.com]

• Chest Pain

  Tachycardias can cause symptoms such as palpitations, chest pain, shortness of breath and fatigue, which reduce the quality of life. Fast tachycardias can cause hemodynamic collapse and sudden cardiac d... [intechopen.com]

  The authors describe a young Indo-Asian man with cardiac sarcoidosis who presented acutely with chest pain and malignant cardiac arrhythmias. [ncbi.nlm.nih.gov]

  pain Rate This Content: < Back Next >> July 1, 2011 [web.archive.org]

  When to Call a Doctor EMERGENCY Call an ambulance if you experience severe chest pain, shortness of breath, or prolonged palpitations. EMERGENCY Call an ambulance if someone loses consciousness. [healthcommunities.com]

  Symptoms of arrhythmias include fast or slow heart beat skipping beats lightheadedness or dizziness chest pain shortness of breath sweating your doctor can run tests to find out if you have an arrhythmia. [icd9data.com]

• Thrombosis

  Conditions We Treat A referral to the clinic may be beneficial to you if you are a patient with: Atrial fibrillation Mechanical heart valve replacement Deep vein thrombosis (DVT) Pulmonary embolism (PE) Transient ischemic attack (TIA) Stroke (CVA) Myocardial [advocatehealth.com]

  Hormonal contraceptives: Venous thrombosis NSAIDs: Hypertension and edema Opioids: Constipation Severe An ADR is potentially life threatening and requires discontinuation of the drug and specific treatment of the ADR. [msdmanuals.com]

  Venous thrombosis Cerebral venous sinus thrombosis leads to stroke due to locally increased venous pressure, which exceeds the pressure generated by the arteries. [en.wikipedia.org]

  Effect of risk factors on the mechanism of acute thrombosis and sudden coronary death in women. Circulation. 1998 ; 97 :2110–2116. Crossref Medline Google Scholar 15 James TN, St Martin E, Willis PW III, Lohr TO. [doi.org]

• Anxiety Disorder

  Social anxiety disorder in genuine halitosis patients. Health Qual Life Outcomes 2011; 9: 94. 24 Whittle C L, Fakharzadeh S, Eades J, Preti G. Human breath odours and their use in diagnosis. [nature.com]

  The incidence of SCD is higher in regions with lower socioeconomic status, and this gradient in risk is more exaggerated below age 65. 144 Chronic psychological stressors such as anxiety disorders and depression have also been associated with SCD in population-based [doi.org]

• Dizziness

  […] common ones are: Palpitations (feelings that your heart is skipping a beat, fluttering, or beating too hard or fast) A slow heartbeat An irregular heartbeat Feeling pauses between heartbeats More serious signs and symptoms include: Anxiety Weakness, dizziness [web.archive.org]

  Cardiac arrhythmia: Symptoms Possible symptoms of cardiac arrhythmia include: palpitations, rapid heartbeat, dizziness, drowsiness, confusion, fainting, brief loss of consciousness, seizures, chest pain and angina. [ims.uniklinik-freiburg.de]

  Symptoms of arrhythmias include fast or slow heart beat skipping beats lightheadedness or dizziness chest pain shortness of breath sweating your doctor can run tests to find out if you have an arrhythmia. [icd9data.com]

  Symptoms Symptoms of specific arrhythmias include: Sinus node dysfunction – There may not be any symptoms, or it may cause dizziness, fainting and extreme fatigue. [2minutemedicine.com]

  Symptoms Symptoms of specific arrhythmias include: Sinus node dysfunction - There may not be any symptoms, or it may cause dizziness, fainting and extreme fatigue. [drugs.com]

• Confusion

  Are you confused as to their similarities and differences? This lesson describes the practical and the more subtle similarities and differences between the two. Practically Similar Words Elevator and lift. Apartment and flat. [study.com]

  Symptoms of Cardiac Arrhythmias Palpitations or irregular-feeling heartbeats Shortness of breath Chest pain Dizziness, lightheadedness, and fainting Mental confusion Loss of consciousness In some cases there may be no symptoms Prevention of Cardiac Arrhythmias [healthcommunities.com]

  Cardiac arrhythmia: Symptoms Possible symptoms of cardiac arrhythmia include: palpitations, rapid heartbeat, dizziness, drowsiness, confusion, fainting, brief loss of consciousness, seizures, chest pain and angina. [ims.uniklinik-freiburg.de]

  Similarly, if you notice numbness on one side of your body, confusion, facial drooping and muscular weakness, these symptoms could be a sign of a stroke. To make an appointment with Dr. [geisinger.org]

• Vertigo

  […] confusion, hypersexual gestures (with involvement of frontal lobe) lack of insight of his or her, usually stroke-related, disability If the cerebellum is involved, ataxia might be present and this includes: altered walking gait altered movement coordination vertigo [en.wikipedia.org]

A preliminary physical examination, along with a careful review of medical history would be done. This will be followed by various tests, which include:

• Electrocardiogram: With the help of electrocardiogram, the time and duration of each and every electrical activity in the heart can be measured.
• Holter monitor: This portable device is meant for recording the heart beats and is worn for a 24 hour period, which would help in determining the heart beat as one carries out daily routine tasks.
• Event monitor: This is useful for individuals experiencing sporadic episodes of arrhythmia. The device is kept handy, and used for recording the heart beats when one is experiencing the symptoms.
• Echocardiogram: This is a non-invasive procedure, wherein a transcuder is placed in the chest for determining the size of the heart, its motion and structure.

In cases, when arrhythmia cannot be diagnosed with the above mentioned tests, then additional methods may be required. These include stress test, tilt table test and electrophysiological testing [7].

• Torsades De Pointes

  […] known to promote torsade de pointes. [ncbi.nlm.nih.gov]

  de Pointes ; QTe, absolute QT interval just before the onset of Torsade de Pointes ; QTp, absolute Q-T peak interval just before the onset of Torsade de Pointes and SLS, short-long-short sequence pattern. [dx.doi.org]

• Right Bundle Branch Block

  Heart block is most often accompanied by left bundle branch block or right bundle branch block. 3. Tachycardia: These are arrhythmias that make the heart rate too fast, which is defined as a resting heart rate of over 100 beats per minute. [verywellhealth.com]

  The proposed algorithm can classify six beat types: normal beat, left bundle branch block, right bundle branch block, premature ventricular contraction, atrial premature beat, and paced beat. [dx.doi.org]

  branch block; msec = millisecond; RBBB = right bundle branch block; VT = ventricular tachycardia. [merckmanuals.com]

• T Wave Inversion

  The left ventricle and ventricular septum can be involved in 50% to 67% of cases, often later in the disease, confirming a poor prognosis. 52 ECG during sinus rhythm often exhibits T-wave inversion in V 1 to V 3 or complete or incomplete right bundle-branch [doi.org]

• Ventricular Hypertrophy

  Influence of Patern and Degree of Left Ventricular Hypertrophy on Cardiac Arrhythmias By Juraj Kunisek 2507 Open access peer-reviewed 12. [intechopen.com]

  Left Ventricular Hypertrophy Left ventricular hypertrophy, whether established by ECG or by cardiac echo, is a strong independent risk factor for cardiovascular deaths and, in particular, sudden cardiac death in patients who also had a history of hypertension [doi.org]

  Ventricular tachyarrhythmias are an important cause of cardiac arrest and sudden cardiac death, and people with left ventricular dysfunction and heart failure are similarly at risk. [guidelinesinpractice.co.uk]

• Abnormal ECG

  Because arrhythmia represents abrupt and abnormal ECG beats, physicians diagnose arrhythmia based on long-term ECG data using an ECG recording system like the Holter recorder. [dx.doi.org]

Often, arrhythmia would not require any treatment, unless the condition is causing severe symptoms which can eventually lead to serious complications. Treatment would depend on the type of arrhythmia that has set in. The following methods are employed:

Treatment for bradycardia: This is treated with pacemaker, if an underlying condition cannot be found. There are no medications for improving the heart beats and therefore pacemaker is the best option [8].

Treatment for tachycardia: Vagal maneuvers such as coughing, holding breath and straining, can help in normalizing the fast heartbeat. If this does not work, medications may be administered for lowering the heartbeat. Anti-arrhythmic medications are given to prevent onset of complications. In case of atrial fibrillation, cardioversion can be employed [9].

In addition to these methods, catheter ablation can also be conducted. In this, with the help of radiofrequency energy, a small part in heart tissue is ablated in order to destroy the point of arrhythmia origination [10].

Prognosis of the condition significantly depends on the type of arrhythmia that has set in. In addition, if prompt treatment is not initiated then cardiac arrhythmia can give rise to life threatening conditions. Individuals who have developed arrhythmia due to underlying condition such as, congestive heart failure or valvular disease have a poor prognosis if the condition is not effectively managed. When there is no structural deformity present, the prognosis is excellent [5].

Cardiac arrhythmia can be caused by several factors, which include hypothyroidism, hyperthyroidism, myocardial infarction, congenital heart disease, scarring of the myocardium due to myocardial infarction, cardiomyopathy and electrolyte imbalance [2].

In addition to these factors, some other conditions can favor cardiac arrhythmia. These include stimulant drugs, overuse of products containing caffeine, alcohol consumption, medications taken for management of hypertension and other heart problems, smoking and drugs used for treatment of psychiatric disorders. Medications used for treating a type of arrhythmia can also pave way for development of another type of arrhythmia.

Cardiac arrhythmia is a common phenomenon and strikes the majority of the population across the globe. According to the statistics provided by the Center for Disease Control and Prevention, it was found that more than 600,000 sudden cardiac deaths are recorded each year. It has also been estimated that, about 50% of patients experienced sudden death as a preliminary manifestation of heart disease.

Irrespective of the type of arrhythmia that has set in, the pathophysiology follows any one of the 3 mechanisms; which include triggered activity, enhanced or suppressed automaticity and re-entry. Under normal conditions, the rhythm of heart is controlled by the sinus node, situated in the right atrium. The electrical impulses produced by the sinus node initiate each heart beat. Factors that interfere with the production of electrical impulses, favor the development of arrhythmia [3].

Tachycardias that originate in the atria include supraventricular tachycardia, atrial fibrillation, Wolff-Parkinson-White syndrome and atrial flutter. The ones which originate in the ventricles include long QT syndrome, ventricular tachycardia and ventricular fibrillation [4].

Adopting a healthy lifestyle can help in preventing occurrence of cardiac arrhythmia. Individuals can improve their heart health by following an active lifestyle, along with consuming a healthy diet and maintaining healthy weight. Avoiding smoking, alcohol and limiting consumption of caffeine can also reduce the risk of developing cardiac arrhythmias.

In cardiac arrhythmia the heart may beat either too fast, too slow or it might beat irregularly. When the heart beat is more than 100 beats per minute, the condition is termed as tachycardia; when the rate is slower than 60 beats per minutes, the condition is termed as bradycardia. In majority of instances, arrhythmias are not life threatening; however, if it causes impairment of cardiac function it can lead to cardiac arrest [1].

Definition: Cardiac arrhythmia is defined as onset of abnormal heart rhythm or rate that occurs when there is some problem with the electrical impulses of the heart. In such a type of condition, the heart can either beat too fast, too slow or can be irregular.

Cause: Several factors that favor the development of arrhythmia include conditions of hyperthyroidism, hypothyroidism, diabetes, and heart attack, damage to heart tissue due to heart attack, alcohol abuse, stress, medications and hypertension.

Symptoms: Symptoms include pain in chest, followed by shortness of breath along with dizziness and lightheadedness.

Diagnosis: Cardiac arrhythmia is usually diagnosed with help of electrocardiogram. In addition, devices such as holter monitor and event monitor can also help detect abnormal heart beats for a 24 hour period or when symptoms are occurring. Echocardiogram is indicated to determine the size, motion and structure of heart.

Treatment: Bradycardia is treated with pacemaker, as no medications are available to treat slow heartbeat. Tachycardia is treated with help of vagal maneuvers, medications and cardioversion techniques. In many cases, catheter ablation can also be carried out.

1. Seferović PM, Ristić AD, Maksimović R, et al. Cardiac arrhythmias and conduction disturbances in autoimmune rheumatic diseases. Rheumatology (Oxford) 2006; 45 Suppl 4:iv39.
2. Francis GS. Development of arrhythmias in the patient with congestive heart failure: pathophysiology, prevalence and prognosis. Am J Cardiol 1986; 57:3B.
3. Podrid PJ, Fogel RI, Fuchs TT. Ventricular arrhythmia in congestive heart failure. Am J Cardiol 1992; 69:82G.
4. Newman BJ, Donoso E, Friedberg CK. Arrhythmias in the Wolff-Parkinson-White syndrome. Prog Cardiovasc Dis 1966; 9:147.
5. Holmes J, Kubo SH, Cody RJ, Kligfield P. Arrhythmias in ischemic and nonischemic dilated cardiomyopathy: prediction of mortality by ambulatory electrocardiography. Am J Cardiol 1985; 55:146.
6. Teerlink JR, Jalaluddin M, Anderson S, et al. Ambulatory ventricular arrhythmias in patients with heart failure do not specifically predict an increased risk of sudden death. PROMISE (Prospective Randomized Milrinone Survival Evaluation) Investigators. Circulation 2000; 101:40.
7. Milner PG, Dimarco JP, Lerman BB. Electrophysiological evaluation of sustained ventricular tachyarrhythmias in idiopathic dilated cardiomyopathy. Pacing Clin Electrophysiol 1988; 11:562.
8. McMullan J, Valento M, Attari M, Venkat A. Care of the pacemaker/implantable cardioverter defibrillator patient in the ED. Am J Emerg Med. Sep 2007;25(7):812-22.
9. Mason JW. A comparison of seven antiarrhythmic drugs in patients with ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators. N Engl J Med 1993; 329:452
10. Morady F. Radio-frequency ablation as treatment for cardiac arrhythmias. N Engl J Med 1999; 340:534.