The heart beats continuously at a steady, regular rate. During exercise, the heart rate is faster, while at rest it is slower. In cardiac arrhythmias, however, the heart rhythm changes from normal; it speeds up or slows down inappropriately or becomes irregular.

How do I know if I have arrhythmias?

Most of us have experienced symptoms that can be called cardiac arrhythmias at some point in our lives. When the heart feels “pounding,” it is usually a fast heartbeat, tachycardia. On the other hand extra beats (extrasystoles) or slow beats (bradycardia) can be felt as if the heart is pounding or skipping beats. We all have extra beats at some point in our lives, but we feel them in different ways. Although heart palpitations can be worrisome, they’re usually harmless. Harmless extra beats that occur at rest occur in many healthy people. If arrhythmias occur in episodes, they usually always cause symptoms, but arrhythmias that continue all the time, especially in the elderly, are often symptomless. The most common chronic arrhythmia is atrial fibrillation, which can cause a stroke if left untreated, but with early recognition and good treatment, the risk of a stroke can be significantly reduced. It is therefore important to palpate your own heart rate regularly, making it easier to recognize changes in the rhythm.

When should you seek medical attention?

If new symptoms appear, you should see a cardiologist to determine the nature of the arrhythmia. Especially if you’re also feeling unwell, dizziness or lightheadedness, loss of consciousness, weakness or chest pain, it is a good idea to seek medical attention immediately. Especially if the loss of consciousness has occurred while sitting or lying down or if a seizure has occurred in those situations as well, you should seek treatment immediately. If there has been a family history of serious, life-threatening arrhythmias, especially at a young age, it is worth seeking medical attention with particular urgency.

How are arrhythmias diagnosed?

The most important test for diagnosing an arrhythmia is an electrocardiogram, or ECG, which measures the electrical activity of the heart for a few seconds. If the arrhythmia is paroxysmal and does not occur during the electrocardiogram, the nature of the arrhythmia may remain as unknown. However, we use Holter devices for long-term registration. Holter devices record the electrocardiogram continuously for 1-7 days. If the symptom occurs infrequently, a more appropriate device for determining the nature of the arrhythmia is an event ECG device. With event ECG device you can easily register electrocardiogram yourself when the symptom occurs. We also use the user-friendly PulseOn device, which detects an arrhythmia and asks the user to take an ECG, which helps, for example, in detecting atrial fibrillation. If it is known that the arrhythmia occurs during exercise, it can also be examined with an exercise ECG. For example, repeated but unclear episodes of loss of consciousness can also be examined with a small device that registers the heart rhythm for much longer time. This kind of rhythm monitor is placed under the skin and can record the rhythm for two to three years.

Treatment of arrhythmias

Arrhythmias can be treated in many ways, depending on the arrhythmia and the symptoms it causes. Extra beats that are considered harmless are rarely treated if the heart is otherwise healthy. If your arrhythmias has been diagnozed as harmless it is a good idea to focus on your lifestyle to see if there are any factors that predispose you to extra beats, such as stress, being awake, or drinking too much coffee or alcohol. It is usual that harmless arrhythmias go away and come back in response to what triggers them. Often, reducing these factors will calm down the extra beats.

Treatment of arrhythmias can be symptomatic, for example, benign extra beats can be treated with beta-blockers. Some arrhythmias, such as atrial fibrillation, may require electrical cardioversion. If a cardiologist determines that an arrhythmia is dangerous or troublesome, it can be treated with catheter ablation. In catheter ablation a cardiologist treats the part of the heart’s electrical structure that is causing the arrhythmia. A pacemaker may be needed if the heart rate is so slow that it is causing symptoms. There are also arrhythmia pacemakers that detect life-threatening arrhythmias and stop them with a strong electrical impulse to the heart.