Arrhythmia is an abnormal heart rhythm. This may feel like a flutter or a short pause. It can be so short that it doesn’t change your total heart rate (number of heart beats per minute). Or it can cause the heart rate to be too slow or too fast. Some arrhythmias do not cause any symptoms whereas some may cause dizziness or vertigo.

It is the disturbance of normal rhythm of the heart may be due to:

• Alterations in impulse generation
• Disturbances in impulse conduction
• A combination of both these factors

Arrhythmias are classified based on the origin and rate.

• Supraventricular arrhythmias: The term “supra” means above and “ventricular” means the lower chamber of the heart (ventricle). It begins in the atria (the heart’s upper chambers) and can cause the heart to beat very fast, slow or irregularly.

1. 1. Sinus: Electrical charges originate in the sinus node (SA)
   2. Atrial: Electrical charges begin in the atrium from foci other than the normal SA node. Junctional: Electrical charges originate from the Atrioventricular area.

• Ventricular arrhythmias: Ventricular arrhythmias begins in the hearts lower chamber (ventricles).

Classification based on rate are:

1. Bradycardia: Heart rate less than 60 beats/min is known as bradycardia.
2. Tachycardia: Heart rate more than 100 beats/min is known as tachycardia.

The causes of arrhythmias are: –

• Coronary artery disease.
• Irritable tissue in the heart (due to genetic or acquired causes).
• High blood pressure.
• Diabetes
• Overactive thyroid gland (hyperthyroidism) and less active (hypothyroidism thyroid gland)
• Changes in the heart muscle (cardiomyopathy).
• Valve disorders.
• Electrolyte imbalances in your blood, such as sodium or potassium imbalances.
• Any injury from a heart attack or scarring from previous heart attack
• The healing process after heart surgery.
• Other medical conditions.
• Coronary artery disease (Blocked arteries in the heart)
• Changes to the heart’s structure, such as from cardiomyopathy
• Infection with COVID-19
• Sleep apnea (sleep disorder in which breathing repeatedly stops and starts.
• Some medications of cold or any allergy drugs taken without a prescription
• Excessive alcohol or caffeine intake
• Genetics
• Smoking
• Taking stress or anxiety

Risk factors for practically any type of arrhythmia include narrowed heart arteries, a heart attack, damaged heart valves, prior heart surgery, heart failure, cardiomyopathy, and other heart problems.

• The rhythm of the heart may be impacted by having a cardiac problem from birth.
• The risk of irregular heartbeats might increase if your thyroid gland is hyperactive or less active.
• The electrical impulses in your heart can get damaged by excessive alcohol use.
• Your heart may beat can increase as a result of caffeine, nicotine, and other drugs, which might result in the development of more dangerous arrhythmias.
• If you suffer from congenital heart disease that can also affect your heartbeat rhythm.

Symptoms of heart arrhythmias might include:

• Discomfort in your chest
• Dizziness (feeling faint)
• High blood pressure
• Light headedness
• Rapid heart rate
• Feeling weak/tired
• Heart palpitations (feeling of skipped heartbeat)
• Difficulty in breathing
• Sluggish heartbeat
• Your heart muscle can get weak

If you feel any symptoms of arrhythmias, you should immediately go and visit a cardiologist or electrophysiologist.

They might suggest you the following tests:

• Electrocardiogram (ECG or EKG)
• Ambulatory monitors, for example, the Holter monitor.
• Stress test: A test used to document arrhythmias that develop during or get worse after physical activity.
• Echocardiogram
• Cardiac catheterization
• An electrophysiology study (EPS) is a specialized cardiac catheterization used to assess the electrical function of the heart.
• Test on a tilt table, often known as a head-up tilt test or a passive tilt test: while the table is tilted in a head-up posture at various levels, records your blood pressure and heart rate on a minute-by-minute basis.

Your arrhythmia nature and severity will determine your course of treatment. Sometimes no therapy is required. You can go for these possible forms of treatment:

• Lifestyle changes
• Medicine to prevent and control arrhythmias.
• Medicine to treat related conditions such as high blood pressure, coronary artery disease and heart failure
• Anticoagulants to reduce the risk of blood clots and stroke
• A pacemaker to help your heart beat more regularly
• Cardiac defibrillation and implanted cardioverter defibrillators (ICDs)
• Cardiac ablation
• Surgery
• Vagal maneuvers
• Cardioversion

The type of arrhythmia you have as well as any additional problems you could have influence the medicine they recommend.
Typical drug classes include:

• Calcium channel blocker: Amlodipine (Norvasc) and diltiazem (Cardizem CD), two calcium channel blockers, can help reduce your blood pressure and heart rate. They can be prescribed for a longer lifespan.
• Beta-blockers: To treat tachycardia, you take beta-blockers to lower your heart rate. Acebutolol (Sectral), metoprolol (Lopressor, Toprol XL), and other drugs can act as beta-blockers.
• Antiarrhythmic medications: Tachycardia and early heartbeats can be treated with antiarrhythmic medications. Amiodarone (Pacerone, Nexterone), propafenone (Rythmol SR), flecainide (Tambocor), and other drugs may be included. However, they could result in the unfavourable side effect of proarrhythmia, which might exacerbate your current arrhythmia or result in a brand-new arrhythmia.
• Anticoagulants: Blood clots, which can develop as a result of atrial fibrillation, are prevented by anticoagulants. Warfarin (Coumadin, Jantoven), rivaroxaban (Xarelto), and other drugs that thin the blood are included. Internal or profuse bleeding might be a negative effect.

Be sure to take your medicines exactly as instructed. Inform your doctor of any adverse effects, especially if you experience any new arrhythmias or if your current carrhythmia gets worse.

Lifestyle changes to reduce the risk of heart disease can help prevent heart arrhythmias.

You can follow these tips for a heart-healthy lifestyle:

• Make a heart-healthy diet plan. It is important for heart patients to avoid fried food items by using less oil/fat in food.
• Do Physical activities to stay active and maintain a healthy body weight.
• Quit smoking Limiting or avoiding caffeine and alcohol
• Reducing stress, as severe stress and anger can cause heart arrhythmias directly to your doctor.
• Any medications you taken without a doctor’s prescription can cause harm.