Symptoms and Signs of Arrhythmias (Heart Rhythm Disorders)

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 8/6/2021

Doctor's Notes on Arrhythmias (Heart Rhythm Disorders)

Arrhythmias are abnormal heartbeats. There are many types of arrhythmias, and they are sometimes classified by where they begin in the heart (the atria, AV node, or the ventricles). They may also be classified as one of four types - premature beats, supraventricular, ventricular, and bradyarrhythmias. Ventricular fibrillation and ventricular tachycardia are types of arrhythmias that can lead to death in minutes.

In many cases, arrhythmias cause minimal to no symptoms but in other cases, people can feel the arrhythmia when it happens. Symptoms of arrhythmias include palpitations, feeling "skipped beats," thumping or fluttering in the chest, a sensation of the heart racing, feeling faint or tired, lightheadedness or fainting, shortness of breath, and chest pain or discomfort. Many of these same symptoms may be due to anxiety, stress, or causes other than an abnormal heartbeat.

What Is the Treatment of Arrhythmias?

The treatment of arrhythmias depends on the cause and the type of arrhythmia. Some arrhythmias are self-limited and do not need treatment. Other arrhythmias are due to poor blood flow to the heart and require treatments for coronary artery disease to prevent them. The types and treatments of arrhythmias are listed below:

  • Premature beats can be treated with medications to control the heart rate such as beta-blockers or anxiety medications like benzodiazepines.
  • Supraventricular arrhythmias are usually “fast” or rapid heartbeats and can be treated with medications that slow the heart rate such as beta blockers or calcium channel blockers. A specific type of supraventricular arrhythmia called supraventricular tachycardia is treated with adenosine, an intravenous medication that helps reset the heart rhythm. Another specific type of supraventricular arrhythmia called atrial fibrillation can be treated medically with blood thinners and heart rate control medications (such as beta blockers or digitalis), electrical therapy (cardioversion), or procedural therapy with cardiac ablations.
  • Ventricular arrhythmias can vary from benign premature ventricular contractions (PVC) which often do not need treatment, to severe and life-threatening ventricular tachycardia or ventricular fibrillation, which both need emergency treatment. The treatment for severe ventricular arrhythmias is electrical shocks (defibrillation or cardioversion) or in some cases antiarrhythmic drugs such as flecainide, amiodarone, or lidocaine.
  • Bradyarrhythmias or “slow” arrhythmias are treated with medications such as atropine or epinephrine or require the use of a cardiac pacemaker.

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.