Normally, the heart muscle squeezes and relaxes in a steady, predictable pattern, controlled by electrical signals. When something goes wrong with the heart’s electrical system, the heart may feel like it’s beating too fast (sinus tachycardia), too slow (bradycardia), or out of rhythm.

There are lots of different types of arrhythmias, depending on their exact cause. Two common types are atrial fibrillation and atrial flutter.

Many arrhythmias are harmless, and don’t need special care. But some can lead to health problems, and need to be treated. So it’s always important to have them checked out by a heart doctor.

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What Are the Signs and Symptoms of Arrhythmia?

Sometimes, an arrhythmia doesn’t have any obvious signs or symptoms. When symptoms do appear, they can include:

  • Racing heart beat
  • Slow heart beat
  • Uneven or irregular heart beat
  • Pounding heart beat
  • Fluttering feeling in chest (“atrial flutter”)
  • Chest pain or discomfort
  • Dizziness or feeling lightheaded
  • Trouble breathing
  • Unusual sweating
  • Feeling very tired
  • Passing out
     

What Causes Arrhythmia?

Sometimes, a baby is born with an arrhythmia. Sometimes it appears later in life.

The following can cause arrhythmias.

  • Congenital heart defect, including problems with the heart’s electrical system
  • Changes to the heart’s structure, such as from cardiomyopathy
  • Overactive or underactive thyroid gland
  • Electrolyte levels that are too high or too low
  • Certain infections, including COVID-19
  • Unusual reaction to medications
  • The healing process after heart surgery

How is Arrhythmia Treated?

In some cases, arrhythmias go away on their own or don’t require any special treatment.

When arrhythmias do require treatment, the approach depends on the specific type of arrhythmia, how serious it is, and the patient’s weight and anatomy.

  • Vagal maneuvers: Exercises that slow the heart rate
  • Medication to control the heart rate or return it to a normal rhythm
  • Medication to prevent blood clots
  • Cardioversion: Electric shock procedure to restore the heart’s normal rhythm
  • Catheter ablation: Procedure using a long, thin tube (catheter) to stop the path of electrical signals that cause arrhythmia
  • Pacemaker: Using a catheter, device placed through the vein to control the heart rhythm
  • Cardioverter-defibrillator (ICD): Using a catheter, device placed through the vein to watch for and control abnormal heart rhythms
  • Pacemaker: Device placed directly on the heart to control the heart’s rhythm
  • Cardioverter-defibrillator (ICD): Device placed in the chest to watch for and control abnormal heart rhythms
  • Maze procedure: Incisions in heart’s upper chambers to correct heart rhythm

Some patients with arrhythmias, especially those caused by a congenital heart defect, need lifelong care from heart experts. Connecticut Children’s Heart Center keeps patients connected to cardiologists who understand their unique anatomy, provides follow-up tests like echocardiograms at locations close to home, and continues congenital heart care in adulthood.