What your heart rhythm is telling you about your health
Fact checked by Shannon Sparks
Arrhythmias — abnormal heart rhythms — are commonly associated with atrial fibrillation (AFib), a condition that increases the risk of stroke. But AFib is just one of many arrhythmias that the heart can experience.
In the United States, arrhythmias affect about 1 in 18 people of all ages, and among those 40 and older, 1 in 4 people are at risk of developing one.
AFib is the “most common arrhythmia detected by Apple Watches. Sinus tachycardia (normal heart rhythm but faster rate) and supraventricular tachycardia (SVT) are also picked up by smartwatches,” says Moeen Saleem, MD, an electrophysiologist at Midwest Cardiovascular Institute.
Knowing the different heart rhythm disorders — what they are, how they’re diagnosed and treated, and which risk factors to watch for — can make all the difference.
Different beats
One way to categorize arrhythmias is by whether the heart rate is too fast (tachycardia), too slow (bradycardia), or includes extra (premature) beats.
The most common types of each include:
Tachycardia
Supraventricular tachycardia the most common arrhythmia in children. SVT is a discrete electrical short circuit that causes a fast heart rate. It can feel like a rapid, steady heartbeat that starts and stops suddenly.
Atrial fibrillation — the most common arrhythmia in older adults. AFib stems from multiple rapid impulses originating in the atria. This leads to an irregular heartbeat. AFib is associated with an increased risk of stroke, and if left untreated, it can lead to heart failure symptoms.
Bradycardia
Sinus bradycardia — a problem with the sinus node (the heart’s natural pacemaker) can lead to a heart rate below 60 bpm. This is the typical bradycardic range for adults, though it can vary based on age and health. If it occurs during sleep, Saleem says, it’s “generally benign.”
Premature beats (contractions)
Premature atrial contractions (PACs) — this may cause a fluttering sensation in the chest. The beats are usually not dangerous in people without underlying heart conditions. Saleem says PACs can be mistaken for AFib, so seeing an electrophysiology specialist helps distinguish between the two.
Premature ventricular contractions (PVCs) — premature beats from the bottom chambers (ventricles) may also cause a fluttering sensation but are typically not dangerous in otherwise healthy people.
Arrhythmia causes and risk factors
Some arrhythmias, like AFib, result from a malfunctioning electrical system in the heart. Others, such as sinus bradycardia, occur when the heart’s pacemaker (sinus node) is affected. Additional causes include hormonal or electrolyte imbalances; excessive strain, stress, or exertion; and certain heart medications.
Some people are more likely to experience arrhythmias, including those with previous heart issues or coronary artery disease, obstructive sleep apnea, excessive alcohol use, or those who consume caffeine or nicotine.
Treating heart rhythm disorders
Any symptoms of arrhythmia warrant a doctor’s visit, even those usually considered benign, like PACs and PVCs. Physicians most often use an electrocardiogram (EKG or ECG) to diagnose arrhythmias. The test records and measures the heart’s electrical activity. Other diagnostic tests may include blood work and heart imaging.
Treatment depends on the type of arrhythmia and the person’s overall condition. Some arrhythmias require no treatment. Others may need:
• Medication
• Therapies, such as:
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- Vagal maneuvers — techniques to slow the heart rate by coughing, applying ice to the face, or performing other actions
- Cardioversion — patches on the chest that send an electrical shock to reset the heart’s rhythm
- Surgery, catheter ablation, pacemaker implantation, coronary bypass graft, or other procedures
Lifestyle changes can also reduce some stroke and arrhythmia risk factors. Key steps include lowering high blood pressure, maintaining healthy cholesterol levels, achieving a healthy weight, eating a heart-healthy diet, avoiding tobacco smoke and vaping, and staying physically active.
