Shamard Charles, MD, is a physician-journalist and public health doctor who advances health policy through health communication and health promotion.
Yasmine S. Ali, MD, MSCI, is a board-certified preventive cardiologist and lipidologist. Dr. Ali is also an award-winning writer.
An abnormal heartbeat, also known as an arrhythmia, is often characterized as the heart feeling like it's skipping a beat. Arrythmia has several causes, such as when the electrical signals do not travel normally throughout the heart, causing it to beat out of normal rhythm (known as sinus rhythm).
If you have a medical history that includes a previous heart attack, smoking, a congenital heart defect, or chronic stress you are at higher risk of having an arrhythmia.
There are many different types of arrhythmias, from occasional fluttering and palpitations to atrial fibrillation to lethal arrhythmias like ventricular tachycardia and ventricular fibrillation that can stop the heart and lead to death.
This article discusses the symptoms and potential causes of abnormal heartbeat. It also covers risk factors and when to seek tests or treatment for your symptoms.
The Good Brigade /Getty Images
Arrhythmias present in a wide array of ways, including silently (no symptoms). The feeling of an abnormal heartbeat can be scary. Some of the most common symptoms associated with a cardiac arrhythmia include:
In more severe cases, an arrhythmia may also cause:
Below are the different types of abnormal heartbeat.
Colloquially called A-fib, atrial fibrillation is the most common type of arrhythmia, and it is often characterized by a faster than normal, chaotic rhythm.
Your healthcare provider may describe this rhythm as “irregularly irregular.” A-fib occurs when a trigger, such as a structural defect in the heart or medication, disrupts the smooth passing of an electrical signal through the sinoatrial (SA) node of the atrium. As a result, a chaotic rhythm with no discernible pattern occurs.
Your heart usually beats between 60 and 100 times per minute. If you have episodes of abnormally fast heart rate at rest—that is over 100 beats per minute—you might have supraventricular tachycardia.
In SVT, the upper chamber of the heart (the atria) and the bottom chamber (the ventricles) are not in sync. These extra electrical impulses in the atria cause the heart to beat rapidly, not allowing the ventricles enough time to adequately fill with blood. SVT, which is usually first experienced in childhood, may be associated with:
Normally the heart beats between 60 and 100 times per minute. If your heart beats more slowly than that—below 60 times—you may have bradycardia.
It is normal for your heart to be at or around 60 beats per minute (BPM) when you are sleeping or if you exercise routinely, but sometimes a slow heart rate can be a sign of an underlying issue such as:
Sometimes bradycardia is also associated with symptoms of:
Heart block usually represents a delay or disturbance in the transmission of an impulse from the atria to the ventricles. In these cases, the heart may beat more slowly than normal.
There are three types of heart block:
This rare arrhythmia is a rapid and disorganized rhythm of heartbeats that occurs in the main pumping chamber of the heart. V-fib is a medical emergency. If left untreated, it can lead to rapid loss of consciousness and sudden death.
Any condition that compromises your heart tissue or changes the conduction pathways that control the normal rhythmic pattern of your heartbeat can cause an arrhythmia.
The most common causes of an abnormal heartbeat are:
A host of medications can trigger arrhythmias, including antiarrhythmic drugs (medications that prevent and/or treat an abnormal heartbeat) themselves. Much research has been done about the adverse effects of proarrhythmic drugs, because in rare cases they have been shown to induce life-threatening ventricular tachycardias and conduction disorders.
Some drugs trigger atrial fibrillation, which is rarely deadly in and of itself, but it can cause substantial discomfort and death, as well as increase your risk of stroke.
Drug-induced arrhythmias and sudden death are uncommon events that occur in unpredictable ways but it is important to know your risk and the medications associated with these events—especially for those with structural abnormalities or at high risk of heart disease.
Most drugs that cause arrhythmias do so in one of several ways, as follows:
The following medications have been associated with heart arrhythmias, particularly atrial fibrillation, QT prolongation, and/or Torsades de Pointes:
Most people don’t experience an abnormal heart rhythm during a medical visit, but taking a detailed medical history (asking you about your medications, lifestyle habits, and past medical history) and performing a focused physical exam (listening to your heart with a stethoscope and measuring your blood pressure and pulse) can help your healthcare provider diagnose a potential arrhythmia.
To determine what might be causing your abnormal heartbeat, your healthcare provider may recommend/perform one of these tests:
Consult your healthcare provider if your test results are unclear or if you have any questions. After taking these exams check in with your healthcare provider so they can explain the results and discuss your treatment options.
There is no one-size-fits-all approach to treating arrhythmia, and a treatment that works for one person may not work for another person. The most effective way to manage your condition is to diagnose the type of arrhythmia and resolve the underlying cause of your abnormal heartbeat.
The goals of arrhythmia treatment are to:
Less serious types of arrhythmia may be well managed with antiarrhythmic medication and regular checkups. For more serious or recurrent cases, you may need to undergo a procedure to treat your arrhythmia. Procedures may include:
If your abnormal heartbeat is accompanied by severe chest pain, shortness of breath, light-headedness, feeling faint, or does not go away with your typical treatment, then seek immediate medical attention as untreated arrhythmia can lead to heart failure and sudden cardiac arrest.
In rare cases, an arrhythmia may be severe enough to disrupt the heart's ability to pump blood, causing oxygenated blood to be restricted throughout the body. This may cause you to lose consciousness.
If this occurs to someone else, call 911 immediately and start performing cardiopulmonary resuscitation (CPR), especially if the person is not breathing or you suspect that their heart has stopped beating. An EMT (emergency medical technician) may take over CPR when they arrive and use an automated external defibrillator (AED) to jump-start the heart.
An abnormal heartbeat (arrhythmia) occurs when the electrical signals cannot travel smoothly throughout the heart, causing your heart to quiver and beat out of rhythm.
An abnormal heartbeat should be a cause for concern. If your abnormal heartbeat is accompanied by severe chest pain, shortness of breath, light-headedness or feeling faint, or if it does not go away with your typical treatment, it is important to seek immediate medical attention.
A healthcare provider can help determine the cause and subsequent treatment for your abnormal heartbeat.
An abnormal heartbeat is caused by a disruption in the heart, such as damaged heart muscle tissue or a structural anomaly that distorts electrical signals throughout the heart.
When electrical impulses cannot travel smoothly throughout the heart, it can cause your heart to quiver and beat out of rhythm, which compromises its ability to pump blood effectively throughout the body.
An abnormal heartbeat doesn’t necessarily mean you have a heart issue like heart disease or heart failure, but it may be a sign of a larger heart problem if it is associated with symptoms like chest pain, shortness of breath, dizziness, and fatigue.
Antiarrhythmic medications and procedures such as placing a pacemaker, electrical cardioversion, and ablation therapy can resolve your abnormal heartbeat.
Keidar N, Elul Yn, Schuster A, Yaniv Y. Visualizing and quantifying irregular heart rate irregularities to identify atrial fibrillation events. Frontiers in Physiology. VOLUME 12. 2021. doi:10.3389/fphys.2021.637680
Children's Hospital of Philadelphia. Supraventricular tachycardia.
Tisdale JE, Chung MK, Campbell KB, et al. Drug-induced arrhythmias: a scientific statement from the American Heart Association. Circulation. 2020;142(15). doi:10.1161/CIR.0000000000000905
Thank you, {{form.email}}, for signing up.
There was an error. Please try again.