Arrhythmia

Overview

What is arrhythmia?

Arrhythmia is an abnormal heart rhythm your heart can beat too quickly, too slowly, or irregularly because the electrical signals that coordinate each beat misfire. Some irregular rhythms are harmless and fleeting. Others can trigger symptoms or raise your risk of serious problems like stroke or heart failure. Understanding which type you have and why is the first step to getting the right care. 

How serious is a heart arrhythmia?

Severity depends on type, cause, and context. Many people live for years with benign rhythm quirks and no treatment. But some arrhythmias demand urgent attention because they can lead to loss of consciousness, cardiac arrest, or stroke. Atrial fibrillation, for example, can increase stroke risk; certain fast rhythms from the ventricles can be life-threatening and require immediate care. Your personal risk hinges on factors like symptoms, underlying heart disease, and test results.

What are the types of arrhythmia?

Clinically, we group them by where they start and how they behave: supraventricular tachycardias (including atrial fibrillation and flutter), ventricular arrhythmias (like ventricular tachycardia), bradyarrhythmias (slow rhythms often tied to conduction problems), and extrasystoles (premature beats). Each has distinct triggers, risks, and treatment options. 

How common is arrhythmia?

Arrhythmias are common worldwide and rise with age. In sub-Saharan Africa, atrial fibrillation appears less prevalent than in high-income regions, yet absolute numbers are climbing as populations age and cardiovascular risk factors increase. A systematic review estimated <1% prevalence of AF/AFL in the general population—still translating to roughly 1.3 million people across the region. And the broader picture is sobering: in 2019, cardiovascular disease accounted for more than a million deaths in sub-Saharan Africa. 

Symptoms and Causes

What are the warning signs of arrhythmia?

Red flags range from subtle to dramatic: palpitations (a flutter, thud, or racing in the chest), shortness of breath, chest discomfort, dizziness, light-headedness, fatigue, and, in severe cases, fainting. Some arrhythmias are silent and only show up on testing one reason routine evaluation matters if you’re at risk.

What causes arrhythmia?

Anything that upsets the heart’s electrical system can spark rhythm problems: coronary disease, high blood pressure, heart failure, valve disease, thyroid disorders, sleep apnea, certain medications or stimulants, and scarring from prior heart surgery. Infections and electrolyte imbalances play a role too. Sometimes, no clear cause is found. 

What is the main cause of arrhythmia?

There isn’t a single “main” cause for everyone, but structural heart disease and high blood pressure are frequent culprits. Disrupted electrical pathways whether from ischemia, fibrosis, or congenital conduction issues set the stage for misfiring signals.

What are the risk factors for arrhythmia?

Ageing, hypertension, diabetes, obesity, sleep apnea, thyroid disease, heavy alcohol use, and stimulant use all raise risk. Prior heart attack, heart failure, and valve disease are strong predictors. In some communities, rheumatic heart disease meaningfully contributes, and the regional mix of risk factors is shifting as lifestyles change.

What are the complications of arrhythmia?

Complications depend on the rhythm. Atrial fibrillation increases stroke risk and can weaken the heart over time. Fast ventricular arrhythmias can cause syncope or cardiac arrest. Persistent tachycardia may lead to cardiomyopathy, while bradyarrhythmias can cause falls and fatigue. The good news: targeted treatment sharply reduces these risks.

Diagnosis and Tests

How is an arrhythmia diagnosed?

Diagnosis starts with a clinical conversation and exam, then documentation of the rhythm during symptoms or continuously if episodes are intermittent. Because arrhythmias come and go, ambulatory monitors are workhorses in real-world practice. 

What tests will be done to diagnose arrhythmia?

Expect an ECG to read your heart’s electrical activity. If the ECG misses episodic symptoms, your clinician may order a Holter monitor (24–48 hours), an event monitor, or an implantable loop recorder for longer surveillance. An echocardiogram checks heart structure and function. Blood tests look for triggers such as thyroid problems or electrolyte issues. Some patients undergo stress testing or electrophysiology studies to map the heart’s circuits in detail. 

Management and Treatment

How is an arrhythmia treated?

Treatment is tailored: some people need only observation; others benefit from medication, targeted procedures, devices, or surgery. The aims are to relieve symptoms, prevent complications like stroke or heart failure, and, when appropriate, restore or control rhythm. Shared decision-making matters—I like to walk patients through options, trade-offs, and what day-to-day life will look like. 

Medications

Antiarrhythmics can suppress abnormal rhythms or maintain normal rhythm. Rate-control drugs slow a fast heartbeat to reduce symptoms and protect the heart. For atrial fibrillation and flutter, stroke prevention with anticoagulants is often crucial. Medication choices depend on rhythm type, kidney and liver function, and other conditions.

Lifestyle changes

Simple moves help: manage blood pressure, treat sleep apnea, moderate alcohol, stop tobacco, aim for a healthy weight, and build steady aerobic activity. Even caffeine timing can matter if you’re sensitive. These aren’t “soft” interventions combined with medical therapy, they improve outcomes.

Therapies

Vagal maneuvers (like bearing down) can terminate certain fast supraventricular rhythms in the moment. Catheter ablation using heat or cold to silence misfiring tissue offers a durable solution for many symptomatic arrhythmias, including AF in selected patients and a range of SVTs and ventricular tachycardias. 

Devices

Pacemakers treat slow rhythms by providing reliable electrical signals. Implantable cardioverter-defibrillators (ICDs) monitor for dangerous fast rhythms and deliver life-saving shocks or pacing when needed. Some patients benefit from cardiac resynchronization therapy if heart failure and conduction delay coexist.

Surgery

When arrhythmias ride along with other surgical indications say, valve repair surgeons may add procedures like the Maze (creating controlled scar lines to block errant signals). Surgical options are also considered when catheter strategies fail or aren’t feasible.

Complications/side effects of the treatment

Every option carries trade-offs. Antiarrhythmics can provoke other rhythms or affect organs; anticoagulants increase bleeding risk; ablation can cause vascular injury or, rarely, more serious complications; devices can become infected or need lead revision. The art is balancing benefits against these risks in your specific context. 

How soon after treatment will I feel better?

Timelines vary. Some people feel relief immediately after cardioversion or a successful ablation; others notice gradual improvement over weeks as inflammation settles and medications are fine-tuned. It’s common to have transient flutters in the first few months after ablation the “blanking” period while the heart heals. 

Outlook / Prognosis

What can I expect if I have an arrhythmia?

With modern care, most people live full, active lives. The keys are accurate diagnosis, attention to underlying conditions, and a plan that fits your goals. For many, rhythm control or rate control plus stroke prevention (when indicated) dramatically lowers long-term risk.

How long arrhythmia lasts

Some arrhythmias are brief and self-limited; others are persistent or chronic. Atrial fibrillation, for example, can be paroxysmal (comes and goes), persistent (lasting more than seven days), or permanent. Duration influences treatment choices and success rates.

Prevention

How can I lower my risk of arrhythmia?

Keep blood pressure, diabetes, and thyroid issues under control. Treat sleep apnea. Limit alcohol, especially binge drinking. Maintain a healthy weight and keep moving regular aerobic activity is protective. Review your medication list with a clinician to identify drugs that may trigger arrhythmias. And stay current with routine checkups so small problems don’t snowball.

Living With

How do I take care of myself?

Know your rhythm and your plan. Take medications as prescribed, track symptoms, and bring a list of triggers you notice to each visit. If you use a wearable or home BP/ECG device, share those readings they can be incredibly helpful when symptoms are sporadic. Build a heart-healthy routine you enjoy; consistency beats perfection. 

What can’t I eat/drink with this condition?

There’s no one “arrhythmia diet,” but moderation matters. Excess alcohol can provoke episodes, caffeine can trigger palpitations in some people, and very high-sodium diets can worsen blood pressure and fluid retention. If you’re on anticoagulants, discuss consistent vitamin K intake; if you’re on antiarrhythmics, review grapefruit and other interactions. Your clinician or pharmacist can tailor advice to your prescriptions.

When should I see my healthcare provider?

Schedule a visit if you notice new palpitations, worsening exercise tolerance, breathlessness, or dizzy spells. Even “quiet” arrhythmias deserve attention if you have risk factors or underlying heart disease. Early confirmation and tailored therapy pay dividends.

When should I go to the ER?

Call emergency services if you have chest pain, fainting, severe shortness of breath, or a rapid heartbeat that won’t settle especially if you have known heart disease. Sudden, severe symptoms can signal dangerous rhythms that require immediate care. 

What questions should I ask my doctor?

Ask which rhythm you have, what’s driving it, and how it changes your stroke or heart-failure risk. Clarify the goal of each treatment symptom relief, rhythm control, rate control, or risk reduction and what success looks like in your case. Finally, discuss monitoring: how you’ll track progress and when to escalate care. 

A quick, grounded perspective why this matters now

Cardiovascular disease is rising fast across the region, with more than one million deaths in sub-Saharan Africa in 2019 alone. That reality gives urgency to practical, scalable arrhythmia care: accurate diagnosis, judicious use of anticoagulation, and timely referral for ablation or devices when indicated. Investing in these basics saves lives full stop. 

FAQ

Can arrhythmias be cured ? Some can be effectively “cured” in practice certain supraventricular tachycardias and many atrial flutter circuits respond extremely well to catheter ablation, with high long-term success. Others, like atrial fibrillation, are often manageable rather than curable; ablation and medications can reduce burden, improve quality of life, and cut complications, but ongoing care is typical. For slow rhythms due to conduction disease, pacemakers don’t cure the problem but reliably control it. The goal is durable control and risk reduction tailored to you. 

Published 2nd September 2025

References

1. Mayo Clinic — Heart arrhythmia: Diagnosis and treatment. Available at: https://www.mayoclinic.org/diseases-conditions/heart-arrhythmia/diagnosis-treatment/drc-20350674.

2. Cleveland Clinic — Arrhythmia: Symptoms & Treatment. Available at: https://my.clevelandclinic.org/health/diseases/16749-arrhythmia.

3. American Heart Association (JAHA) — Fifty Years of Global Cardiovascular Research in Africa. Available at: https://www.ahajournals.org/doi/10.1161/JAHA.122.027670.

4. Global Heart (via PubMed Central) — A Systematic Review of the Spectrum of Cardiac Arrhythmias in Sub-Saharan Africa. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC7413135/.