Every year in the UK around two million people experience an arrhythmia. Although arrhythmias are common, they are not all serious, often needing no treatment. So how can you tell if you have an arrhythmia and when should you be concerned?
Your heart is similar to a metronome, it beats in a regular fashion. This is controlled by your heart’s electrical activity. An arrhythmia occurs when there is a disturbance in this electrical activity, which causes your heart to beat too fast, too slow or erratically.
Although a healthy heart beats regularly, everyone occasionally experiences extra heartbeats, sometimes felt as a brief fluttering in your chest or a more forceful heartbeat. This is normal and not something to worry about. For most people, it is simply a nuisance that passes after a few seconds.
More sustained arrhythmias occur when an erratic heartbeat persists for more than 30 seconds, sometimes lasting hours or even days. This is more than a brief fluttering, with the most common symptoms being sustained palpitations, breathlessness and lightheadedness. In rare cases, a sustained arrhythmia can cause you to pass out.
If you’re concerned that you may have an arrhythmia, whether your symptoms are mild, moderate or severe, then it’s time to see your GP.
Arrhythmia symptoms you should pay particular attention to include extreme lightheadedness, chest pain, breathlessness or passing out. If you experience any of these symptoms, see your GP as soon as possible.
Arrhythmia can affect anyone of any age, gender or health status — you do not need to have a heart condition to develop an arrhythmia.
However, there are certain factors that put you at greater risk. For example, the most common type of arrhythmia, atrial fibrillation, becomes more common with advancing age.
By far the biggest risk factors for arrhythmias are heart disease, a history of heart attacks and high blood pressure. Your risk also increases if you have an inactive lifestyle as this reduces the fitness of your heart.
Looking after your heart health and blood pressure can significantly reduce your risk of developing an arrhythmia. The two biggest factors to consider are your diet and exercise.
The government recommends at least 30 minutes of exercise four to five times a week. You don’t need to go to the gym or take up a sport. Regular brisk walks that get your heart rate up can be just as effective. If you notice that exercise is triggering palpitations, see your GP to have this investigated and resolved, so you can continue to exercise.
Maintaining a healthy weight and following a healthy balanced diet are also important. Make sure you have a good mix of fruits, vegetables, lean protein and whole grains in your diet. Avoid highly processed, high-salt, high-fat and high-sugar foods.
When it comes to high blood pressure, if lifestyle changes alone aren’t enough to keep your pressure down, your GP can prescribe medication.
Reducing your risk factors is important to keep your chances of developing an arrhythmia low. However, if you already have an arrhythmia, there are treatments available to reduce or in some cases, eliminate your symptoms.
It’s important to remember that if your arrhythmia doesn’t affect your quality of life, it may not need treatment. If you do need treatment, your doctor may prescribe anti-arrhythmic tablets to control your heartbeat. These tablets are highly effective and include several that don’t need to be taken every day but can be taken when symptoms occur.
If tablets are not suitable or effective in reducing your symptoms and the specific area of heart tissue causing your arrhythmia can be identified, your doctor may recommend a type of surgery called catheter ablation.
This procedure can be performed under local or general anaesthetic. It involves passing thin tubes (catheters) into a large vein in your groin. The catheters are then guided through your veins into your heart, where they are used to test the electrical activity of your heart.
Once the area of heart tissue causing your arrhythmia has been identified, the catheters are used to deliver targeted heat energy to scar this tissue and prevent its abnormal electrical activity.
Catheter ablation usually takes one to two hours and is performed as a day case so you can return home on the same day as your procedure. However, in more complex cases, it can take longer and may require general anaesthetic. In these cases, you may need to stay overnight in hospital.
After your procedure, you can usually get back to your normal activities in around a week. Catheter ablation is an effective treatment for arrhythmia and in certain cases, can completely cure the condition.
Treatment for arrhythmias continues to advance, most notably in catheter ablation. Even compared to just five years ago, the technology used to identify the specific area of heart tissue causing arrhythmia and then neutralise it has become more accurate and robust. This means that today arrhythmia is a highly treatable condition.
Dr Manav Sohal is a Consultant Cardiologist and Electrophysiologist at Spire St Anthony's Hospital and St George's NHS Hospital, specialising in arrhythmias. He has a special interest in the cardiac procedures of complex ablation and pacemaker/defibrillator implantation, and is one of only a few UK cardiologists who holds European Heart Rhythm Society Advanced Electrophysiology Certification. He is also an Honorary Senior Lecturer at St George's University, London.