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How’s your rhythm? Four heartbeat irregularities and what you can do

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You could have an irregular heartbeat and not know it — but that doesn’t mean it’s not dangerous. “The vast majority of people don’t feel an irregular heartbeat,” says Rajinder P. Singh, MD, a cardiac electrophysiologist.

Most of the time, doctors diagnose these too-fast, too-slow or irregular heartbeats, also called heart arrhythmias, in physical exams or tests before an operation for an unrelated condition. People who do notice symptoms might experience chest pain, shortness of breath, dizziness, anxiety or heart palpitations — the feeling of your heart racing, pounding or fluttering.

Here are four common types of rhythm disorders and what you can do.

Premature ventricular contractions (PVCs)

Beat: Skipping or fluttering

Danger risk: Low

Meaning: PVCs start in the heart’s lower chambers, disturbing the electrical signals and causing an irregular, or “extra,” beat. Symptoms of premature ventricular contractions include heart pounding, sinking sensation, difficulty catching breath or chest pain. “It can feel like your heart is stopping suddenly,” Dr. Singh says.

Solution: Sleep apnea, electrolyte abnormalities or coronary artery disease can cause PVCs, and sometimes there is no underlying cardiac cause. If no reversible cause can be found, doctors can treat premature ventricular contractions with medication or, in stubborn cases, an ablation procedure that treats the tissue in your heart that’s triggering the abnormal rhythm.

Atrial fibrillation

Beat: Racing, uncomfortable and irregular

Danger risk: Medium

Meaning: In atrial fibrillation, also known as A-fib, symptoms include abnormal electrical pulses in the heart’s upper chambers cause part of the heart to quiver instead of beat effectively. Atrial fibrillation can cause a blood clot, making you five times more likely to have a stroke. It can also cause congestive heart failure.

Solution: “The most important reason to treat A-fib is to prevent stroke and congestive heart failure,” Dr. Singh says. Most people take blood thinners to prevent stroke. Treatment options for atrial fibrillation include medications, a procedure called cardioversion that restores normal heart rhythm, ablation or implantation of a device that blocks off a section of the heart to prevent blood clots for people who cannot take blood thinners.

“With atrial fibrillation, lifestyle modification is also very important,” Dr. Singh says. That means controlling weight, diabetes, high blood pressure and sleep apnea.

Bradycardia

Beat: Unnaturally slow

Danger risk: Medium

Meaning: With bradycardia symptoms, your resting heartbeat falls below 60 beats per minute. Blood flow to the brain may be insufficient and cause fatigue, dizziness or fainting. It’s more common as you get older. Although treatment isn’t always necessary, people with prolonged or repeated symptoms should seek medical care.

Solution: “You want to rule out reversible causes,” Dr. Singh says. This could be thyroid issues, medications or sleep apnea. If those causes aren’t behind bradycardia, tests can evaluate whether you need a pacemaker to speed up your heart rhythm and treat for bradycardia.

Ventricular tachycardia

Beat: Dangerously fast

Danger risk: High

Meaning: Ventricular tachycardia is caused by abnormal electrical pulses in the heart’s lower chambers. This rhythm can become irregular and fast without warning with one symptom being insufficient oxygen delivery to the brain. It can be caused by heart attack, coronary artery disease, use of some drugs or an electrolyte imbalance. When this happens, people experience sudden cardiac arrest unless medical help is provided immediately. “It can be life-threatening,” Dr. Singh says.

Solution: Medication, ablation or an implantable cardioverter defibrillator, which monitors your heartbeat and delivers tiny shocks if it becomes dangerously irregular, can treat ventricular tachycardia, Dr. Singh says.

Reduce your heart rate risk

You can’t always prevent irregular heartbeats, but you can take steps to make them less likely. Here’s what Dr. Singh recommends:

  • Don’t smoke.
  • Exercise regularly.
  • Control your cholesterol levels and blood pressure.
  • Limit caffeine, alcohol and salt.
  • Control diabetes and obesity.
  • Reduce stress.
  • Monitor your pulse.
  • Ask your doctor if medications you are taking increase your risk of an irregular heartbeat.

Providers with heart

A heart expert like Dr. Singh can help if you’re experiencing symptoms of an irregular heartbeat. Often, the best place to start is with an appointment with your primary healthcare provider. He or she can help you rule out conditions, understand next steps and set up follow-up tests to find the right diagnosis and treatment. Reach out to your provider’s office or find a provider near you using our easy find-a-doctor search.