A Steady Rhythm Keeps Your Heart on Beat

By Benita Philip, DO

Have you ever felt as if your heart skipped a beat?

Unfortunately, it’s not love. It’s arrhythmia.

And while many people may experience an irregular heartbeat every now and then, it is important to see a doctor for a proper diagnosis.

What is Arrhythmia?

In a healthy heart, electrical signals coordinate a steady heartbeat.

However, changes or disruptions in the electrical system can cause an irregular heartbeat or arrhythmia.

Two of the most common types of arrhythmias are atrial fibrillation (Afib) and its sister heart rhythm, atrial flutter.

Both cause similar symptoms that can be occasional, persistent or permanent, and both can reduce the heart’s efficiency, which in turn may impact blood flow to the rest of the body.

The difference is where in the heart’s electrical system the irregularity originates.

Who’s at Risk?  

Though arrhythmias can affect adults of all ages, certain factors can increase the risk, including:

• Heart disorders.
• Coronary artery disease.
• Hypertension.
• Chronic conditions, such as diabetes; kidney, lung or thyroid disease; and sleep apnea.
• Excessive caffeine, alcohol or stimulants.
• Some medications and supplements.
• Inflammation or illness.
• Obesity.
• Electrolyte imbalance.
• Nicotine use.

What are the symptoms?

Afib and atrial flutter do not always cause noticeable symptoms, but when symptoms do occur, they may include:

• Palpitations or a fluttering sensation in the chest.
• Shortness of breath.
• Fatigue or feeling faint.
• Chest pain, which may worsen with exertion (particularly in Afib).

If you notice any of these symptoms, especially if they persist, make an appointment to see your healthcare provider.

In patients with few or no symptoms, arrhythmias may be discovered only after a routine electrocardiogram (EKG) or while the patient is hospitalized and on a heart monitor.  

What are the complications?

Afib and atrial flutter can increase the risk for stroke, heart failure, and other heart-related complications.

If blood isn’t moving regularly, it can become stagnant in the heart and form a clot. The next heartbeat can cause the clot to travel to the brain, where it can block blood flow and lead to a stroke.

In fact, people with Afib are five times more likely to experience a stroke than those without Afib, according to the American Heart Association.

It’s important to note, however, that people have different risks for forming clots depending on their age, gender and other health conditions and should review those risks with their doctor.

In addition, a rapid heartbeat can weaken the heart over time, leading to heart failure.

How Are Arrhythmias Diagnosed and Treated?

Your healthcare provider can diagnose Afib and atrial flutter with a physical exam and confirmatory EKG, a quick and pain-free test to measure the heart’s rhythm. They may also refer you to a cardiologist or electrophysiologist (or heart rhythm specialist) for further evaluation.  

In some cases, the cardiologist may recommend further testing with a Holter monitor, which is a wearable heart monitor to record the heart’s rhythm during daily activities.

Treatment approaches vary depending on the specific diagnosis. Treatment may include medications to slow the heart or normalize heart rhythm, using cold or heat energy (ablation) to disrupt electrical signals, and/or mild shock therapy (cardioversion) to reset the heart rhythm.

How Can You Prevent Arrythmias?

Keeping your heart healthy and reducing your risk for heart disease can also help reduce your risk for Afib and atrial flutter.

Here are some steps you can take to protect your heart health:

• Exercise regularly. The American Heart Association recommends getting at least 150 minutes of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, or a combination of both, preferably spread throughout the week. Add moderate- to high-intensity muscle-strengthening activity (such as resistance or weights) on at least two days per week.

• Eat a healthy diet that includes plenty of fruits and vegetables, fiber-rich whole grains, fish, nuts, legumes and seeds. Choose lower fat dairy products and foods low in saturated fat, trans fat and sodium. Limit red meat and sugar, including sweetened beverages.

• Do not smoke and avoid secondhand smoke. The dangers of smoking are well known. Even exposure to secondhand smoke increases a person’s risk of heart disease.

• Limit alcohol and caffeine. Both alcohol and caffeine can trigger irregular heart rhythms, especially if consumed in excess.

• Manage stress. Sustained stress increases heart rate and blood pressure and can damage artery walls. Learn tips for managing stress including mindfulness, breathing exercises, or by making time for hobbies and activities you enjoy.

• Get annual physicals. Schedule a routine physical each year and have your blood pressure and blood sugar level checked as well as other heart-health screenings. Talk with your doctor about additional tests or concerns, including if you snore to rule out sleep disorders such as sleep apnea.

• Manage chronic conditions. High blood pressure, high cholesterol and diabetes can all contribute to heart disease. Be sure to follow your doctor’s instructions, including taking medication as prescribed, to manage these conditions and keep your numbers in healthy ranges.

Atrial fibrillation and atrial flutter can both cause serious risks if not diagnosed and treated appropriately. Recognizing the symptoms and seeking care can help prevent complications like stroke and heart failure.

If you are diagnosed with Afib or atrial flutter, work closely with your cardiologist to find a treatment plan that is right for you and adopt healthy habits to keep your heart beating regularly.

To find a physician affiliated with Penn Medicine Princeton Health, (800) 789-7366, or visit www.princetonhcs.org

Benita Philip, DO, is a cardiologist and a member of Penn Medicine Princeton Health Medical Staff.