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We sat down with Dr. Nicholas Kerr, MD, a senior electrophysiology fellow within the Libin Cardiovascular Institute, to discuss arrhythmias. Read on for an in-depth look at these heart disturbances, including their diagnosis and treatment, and get expert advice on managing a diagnosis.

Recognizing Symptoms

Arrhythmias manifest through various symptoms, ranging from palpitations and light-headedness to chest discomfort and reduced exercise capacity. Interestingly, some individuals may experience no symptoms despite having an arrhythmia.

What is an arrhythmia? 

The heart beats about 2.5 billion times in the average lifetime. An arrhythmia is a disturbance of the normal rhythm of heartbeats, causing the heart to beat too quickly, too slowly or irregularly. 

An electrical impulse begins in the heart’s natural pacemaker, the sinus node, then spreads first through the upper heart chambers, the atria, then through the lower main pumping chambers, the ventricles. Any glitch in the generation or spread of this electrical impulse can cause an arrhythmia.

What are the common signs and symptoms? 

Arrhythmia may produce a wide range of symptoms including the sensation of irregular or rapid heartbeats (palpitations), light-headedness, fainting, chest discomfort, shortness of breath, reduced exercise capacity and fatigue. In some people arrhythmia may produce no symptoms. 

How common are arrhythmias? 

It is estimated that one in 20 people in Canada have an arrhythmia.

How do arrhythmias impact someone’s life? 

The impact of arrhythmias on an individual's life varies depending on the type and severity. Some arrhythmias are harmless but cause symptoms that impact quality of life. Other arrhythmias may be life-threatening or result in serious consequences such as a stroke.

What causes an arrhythmia? 

A multitude of factors can disrupt the heart's electrical system, including age-related changes, lifestyle choices like excessive alcohol consumption and smoking, underlying heart conditions, and genetic predispositions.

How is an arrhythmia diagnosed?

Arrhythmias are most commonly diagnosed with an echocardiogram. For intermittent arrhythmias, continuous or prolonged monitoring devices such as Holter monitors or insertable cardiac monitors may be used. Invasive procedures like electrophysiology studies (EPS), which involves directly recording electrical activity in different regions of the heart via a catheter, provide further insights into specific arrhythmias.

How are arrhythmias treated? 

Treatment strategies vary based on the type and severity of the arrhythmia. Pacemakers and implantable defibrillators are common interventions, alongside lifestyle modifications, medications, cardioversion, and catheter ablation.

Are there lifestyle factors that can help prevent or manage an arrhythmia?

Leading a heart-healthy lifestyle significantly contributes to arrhythmia prevention and management. Weight management, moderation in alcohol consumption, regular exercise, smoking cessation, and a heart-healthy diet play pivotal roles in maintaining heart health. Treating high blood pressure and obstructive sleep apnoea also play a role in preventing and managing arrhythmias in some patients.

What advice do you have for patients? 

For individuals experiencing symptoms suggestive of arrhythmia, seeking medical attention is crucial. Prompt medical intervention, especially in cases of fainting, can be life saving. Moreover, maintaining a positive outlook is essential, given the array of effective treatment options available.

What resources can you recommend? 

Some reputable online resources for patient with arrhythmia include: