Arrhythmia: What is a cardiac arrhythmia and how is it manifested? + Treatment

Arrhythmia: What is a cardiac arrhythmia and how is it manifested? + Treatment
Photo source: Getty images

Arrhythmia is a disorder of the heart rhythm. Arrhythmia refers to a slowed or accelerated rhythm of the heart as well as various uncoordinated movements of the heart muscle, and thus the atria or ventricles. 


The disease takes several different forms. In principle, it is a  disorder of regular and normal heart rhythm.

A heart arrhythmia is a condition in which there is a disorder in the frequency or regularity of the rhythm, that is, the work of the heart. Arrhythmias can also occur due to a disturbance in the conduction of excitation by the cardiac transmission system.

Otherwise, arrhythmias are referred to as cardiac arrhythmias or dysrhythmias.

This disease is not always observed immediately. A person suffering from an arrhythmia does not have to experience any difficulties at first. However, it is one of the common heart diseases that can seriously endanger human health and life.

Bradycardia is referred to as bradyarrhythmia and tachycardia as  tachyarrhythmia.

Heart rhythm disorders are divided into two main groups.

For bradycardia, ie a slowing of the heart rhythm. In this case, a slow pulse is present.

The second is tachycardia, ie an accelerated heart rhythm, and therefore a pulse.

Bradycardia is a heart rate below 60 pulses per minute
The normal value is 60 to 99
Tachycardia is  more than 100 beats per minute

The problem is also in the case of fibrillation, ie in the irregular to chaotic contraction of the heart muscle. Fibrillation is divided into atrial fibrillation and chambers.

In the first type, there is an irregular contraction of the walls of the atria of the heart.

The second type is an irregular tremor of the muscle fibers of the heart in the ventricles of the heart.

Heart model, heart cavities, atria and ventricle
Cardiac atria and ventricles. Photo source: Getty Images

Atrial fibrillation is a less serious heart rhythm disorder. Although it results in several serious complications.

However, ventricular fibrillation is a serious arrhythmia. Because the heart is unable to pump blood and expel it into the bloodstream.

Ventricular fibrillation is acutely hazardous to health and life.

Heart rhythm disorders have several divisions. For example, a breakdown by severity. Insignificant are benign and, conversely, the serious ones are called malignant.

Another type of division depends on where they arise. For example:

  • sinusoidal - when there is a problem with the generation of excitation in the sinusoidal node
  • supraventricular are those that arise above ventricular level
  • ventricles arise in the heart chambers

One of the main divisions divides them into heart rhythm disorders or conduction defects. And there are also combined disorders when the cause is a problem with the creation and also with the conduction of excitement, which results in muscle activity.


Heart rhythm and regularity disorders can be caused by several factors.

They are most often present in ischemic heart disease.
They are also caused by:

  • inflammation of the heart muscle 
  • cardiomyopathy
  • heart failure
  • heart muscle infarction

Outside cardiac causes are disorders of the internal environment, alkalosis and acidosisdecreased, or increased content of potassium in the blood, decreased oxygenation, thus hypoxia. But also an increased percentage of carbon dioxide or carbon monoxide in the inhaled air.

The arrhythmia is caused by thyroid disorders, poisoning by drugs and other substances. And arrhythmia also occurs due to acute alcohol poisoning or as a result of alcoholism. The risk incurred are also other diseases such as diabetes, ie diabetes.

And, for example,  atherosclerosis or poor lifestyle can lead to heart rhythm disorders.
Arrhythmia occurs during stress, during long-term mental overload.

We also know cardiac arrhythmia during physical exertion, during sports. Of course, this type of arrhythmia is not pathological and occurs under completely normal circumstances, as the heart's response to an increased need for oxygen and nutrients during exercise.

Plus, as a result of pain, such as chest pain.

Risk factors that can cause an arrhythmia:

  • age, namely older age
  • hereditary and congenital heart diseases
  • ischemic heart disease, myocardial infarction and other heart diseases
  • high blood pressure
  • endocrine diseases such as thyroid disease
  • electrolyte imbalance, decreased or increased potassium levels, decreased magnesium levels, increased blood calcium levels
  • internal disorder, alkalosis or acidosis
  • diabetes mellitus, mainly untreated or neglected
  • overweight and obesity
  • alcoholism or acute alcohol intoxication
  • intoxication with drugs or other substances
  • drugs
  • increased caffeine intake
  • sleep apnea
  • poor lifestyle
  • stress, anxiety


The symptoms of a heart arrhythmia depend on the form of the arrhythmia, as there are several different types and kinds of heart rhythm disorders. It also depends a lot on how the cardiovascular system and the respiratory system can cope with the changed activity of the heart.

And so whether he can compensate her or not.

In bradycardia, there is a reduction in heart rate.

And the manifestation of this type of arrhythmia can be, for example,  muscle, but also a general weakness, dizziness, impaired breathing. Sometimes sudden fainting can occur to a person. Collapse and impairment of consciousness can also manifest.

Takychardia is characterized by an increase in heart rate.  

And therefore the feeling of heart palpitations. Chest pain, shortness of breath and also fainting may occur. Severe tachyarrhythmia is manifested by collapse and impaired consciousness.

If there is another disease in the arrhythmia that has essentially triggered it, such as high blood pressure, there may be worsening of the disease. Of course, a change in heart rate is one of the symptoms of a heart rhythm disorder. Which we can detect by touch.

Symptoms that can be seen in arrhythmias, regardless of heart rate:

An elderly man holds his chest in the area of ​​the heart, has palpitations, ie palpitations and angina, ie chest pain
Heart palpitations along with chest pain. Photo source: Getty Images
  • heart palpitations, professionally also palpitations, they are often perceived as skipping or skipping the beating of the heart
  • difficult breathing, ie dyspnoea, in severe disorders also pulmonary edema
  • fatigue and weakness
  • nausea
  • pallor
  • sweating
  • fainting to collapse
  • dizziness
  • anxiety to fear
  • chest pain, ie angina pectoris
  • reduced blood pressure, in more severe arrhythmias
  • shock - shock state
  • cyanosis, ie the blueing of the skin on the end parts of the body, ie peripheral cyanosis, and on the lips, ie central cyanosis
  • disorder of consciousness
  • sudden death


As mentioned, heart beating is a common manifestation of arrhythmia. This is the reason for seeking professional help. The arrhythmia is most often detected on the basis of a history of the affected person.

Your doctor detects the presence of a palpitations or an irregular heartbeat. Information on the underlying cause is also important. Even what preceded the difficulties, whether it was a physical or mental burden. Other difficulties that accompany the condition of dysrhythmia are also significant. Family history and heart disease in relatives is also important.

The doctor also complements the blood test for various parameters. Such as baseline blood count, biochemistry, hormone levels, internal environment. Blood pressure, pulse, ECHO are also examined. The general practitioner, internist, cardiologist, endocrinologist and possibly other doctors cooperate in the examinations.

An ECG is used to examine the arrhythmia, which monitors cardiac activity. ECG stands for electrocardiography. What is the basic examination method in cardiology. The ECG results in an electrocardiogram.

ECG device electrodes balloons electrodes
ECG device with electrodes. Photo source: Getty images

An electrocardiogram is actually a record of the electrical activity of the heart. Recording of his transmission system, ie the spread of action potential through the heart muscle. The ECG is performed with the help of a device from which electrodes are attached to the body. They sense the mentioned electrical activity.

However, some arrhythmias may occur only occasionally and irregularlyAnd then it is not possible to capture them with a single examination. For this reason, the Holter ECG is also used. This type of examination allows continuous 24-hour recording of heart activity as well as heart rhythm disorders.

If difficulties occur, such as heart palpitations and measurement or palpation of increased or decreased heart rate, immediate professional examination is important. Early detection of a heart rhythm disorder may reveal the primary cause.

If chest pain is associated with palpitations, shortness of breath is best called for professional help, ie emergency medical services. When myocardial infarction is confirmed, coronary angiography is performed in a specialized medical facility such as a cardio center.


Heart palpitations are also present under physiological conditions. This means that the cause is not a disease or some pathological cause, ie a pathological cause. Heart palpitations occur during exercise, both physical and mental.

Young woman holding on to her chest, has chest pain, palpitations, palpitations
Heart arrhythmia can be preceded by sport. Photo source: Getty Images

Similarly, it can occur with dehydration, but also with fever. In essence, palpitations can be associated with any condition in which cardiac activity occurs. However, it is always important to know if it has a cause.

For more information on the causes of heart palpitations, see the magazine article .

Cardiac activity normally occurs unnoticed. During the change, palpitations, ie heart palpitations, are the first to occur, as they are professionally called. Other symptoms mentioned may be associated. And according to the severity.

Other problems may not be associated with minor arrhythmias. Mental reaction is also normal. One is frightened and may feel anxious. Anxiety can mimic chest tightness. This in turn raises concerns about heart problems.

Sometimes it is associated with general weakness, fatiguenausea. In addition to the deviation from the normal heart rate, it is possible if a change in heart rate is felt or an increase in high blood pressure is measured. Dizziness may also occur. However, if pallor is associated, fainting to collapse should be noted.

If the severity of the arrhythmia is higher, it is also manifested by shortness of breath. It can include cyanosis to pulmonary edema. Which means heart failure. Risky consciousness with the threat of circulatory and respiratory arrest is risky.

Unconsciousness is a manifestation of ventricular tachycardia or fibrillation. These two arrhythmias endanger a person's health and life. At this point, it is necessary to call the emergency number, number 155 and 112, respectively. The most serious manifestation of a heart rhythm disorder may be sudden death.

First aid for arrhythmias

First aid can be divided into lay and professional.

You need to keep calm at home or in public. And health monitoring. Professional help is necessary if arrhythmia attacks recur and are accompanied by other difficulties.

In first aid before retrieval or before arrival of professional help include:

  • reassuring the person concerned, controlling calm breathing and avoiding hyperventilation
  • position, should be comfortable, in case of shortness of breath position in a semi-sitting position
  • release tight clothing such as shirt, tie, belt
  • if a person is being treated for heart problems for a long time, he should take his medication or medication that is intended for the condition of an arrhythmia attack
  • after administration of the drugs it is possible to wait for their effect, approximately 30-60 minutes, but only in less serious cases
  • in case of persistent difficulties, in case of recurrence of arrhythmias, but also in case of more serious arrhythmias, professional examination
  • in serious cases, call an ambulance

Professional help follows on from primary lay help. Examinations such as blood pressure and ECG measurements are added. Access to a vein will be provided where drugs for intravenous administration will be administered. In some cases, oxygen inhalation is also required.

What to do when the heart stops working and there is no breathing?

Immediate CPR is necessary when blood circulation and respiration are stopped.

CPR is an abbreviation of cardio - pulmonary - resuscitation.
Cardio indicates heart,
pulmonary lungs,
resuscitation resuscitation.

The term KPCR can also be found  , with the letter C meaning cerebral, i.e. cerebral.

CPR involves external compression, that is, chest compressions.

It is also popularly called a heart massage. Mouth-to-mouth resuscitation is also important. However, he must take care of his own safety.

Automatic external defibrillators are available in public areas such as shopping malls, municipal offices or airports, their abbreviated designation is AED.
The place with their availability is marked with a green sticker with the abbreviation AED, heart and the sign of electricity, ie an arrow (lightning).

AED, ie automatic external defibrillator, two variants, also with green marking, heart with electric arrow, lightning
Two variants of AED. Photo source: Getty Images

The importance of AEDs is high because their use can reverse the cause of unconsciousness and respiratory arrest. Especially ventricular tachycardia and fibrillation. Which significantly affects the prognosis. Of course, along with the launch of CPR.

With CPR, there is no need to worry about getting hurt. On the contrary, we can save our lives. Of course, it is important to consider safety when providing lay first aid and CPR.

How it is treated: Arrhythmia

Treatment for arrhythmia? Both medication and lifestyle changes are necessary

Show more

Different types of heart arrhythmia

fshare on Facebook

Interesting resources

  • "What Is Arrhythmia?". National Heart, Lung, and Blood Institute. 
  • "Types of Arrhythmia". National Heart, Lung, and Blood Institute. 
  • "Who Is at Risk for an Arrhythmia?". National Heart, Lung, and Blood Institute.
  • "How Are Arrhythmias Diagnosed?". National Heart, Lung, and Blood Institute. 
  • "How Are Arrhythmias Treated?". National Heart, Lung, and Blood Institute. 
  • Martin CA, Matthews GD, Huang CL (April 2012). "Sudden cardiac death and inherited channelopathy: the basic electrophysiology of the myocyte and myocardium in ion channel disease". Heart98 (7): 536–543
  • Vogler J, Breithardt G, Eckardt L (July 2012). "Bradyarrhythmias and conduction blocks". Revista Espanola de Cardiologia65 (7): 656–667.
  • Zoni-Berisso M, Lercari F, Carazza T, Domenicucci S (2014). "Epidemiology of atrial fibrillation: European perspective". Clinical Epidemiology6: 213–220. 
  • GBD 2013 Mortality Causes of Death Collaborators (January 2015). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet385 (9963): 117–171.
  • Kuck KH (June 2020). "Arrhythmias and sudden cardiac death in the COVID-19 pandemic". Herz45 (4): 325–326. 
  • Mehra R (2007). "Global public health problem of sudden cardiac death". Journal of Electrocardiology40 (6 Suppl): S118–S122.
  • "Trigeminy PVC: Definition, Causes, Treatment". 
  • Wagner GS (2001). Marriott's Practical Electrocardiography (10th ed.). Philadelphia, PA: Williams & Wilkins. ISBN 0683307460.
  • Zipes DP, Wellens HJ (November 1998). "Sudden cardiac death". Circulation98 (21)