Heart arrhythmia: symptoms, types, causes and treatment

The British Heart Foundation (BHF) explains that an arrhythmia is an abnormal heart rhythm. The heart has an electrical system that sends out impulses to help it beat regularly and in time. If these impulses do not work properly, the heart can beat too slowly, too quickly or not regularly.

The NHS says heart rhythm problems happen when there is a fault with the electrical system that makes your heart beat, either from a heart rhythm condition such as atrial fibrillation or supraventricular tachycardia (SVT), or because of another condition. It adds that you may have a fast heartbeat (tachycardia), a slow heartbeat (bradycardia) or an irregular heartbeat in which the rhythm changes.

The NHS says there are different types of heart rhythm problem and they can make you feel the following. It notes that having these symptoms does not necessarily mean you have a heart rhythm problem.

• Like your heart is pounding, racing, fluttering or missing a beat (heart palpitations), which may last a few seconds up to a few minutes.

• Short of breath.

• Lightheaded, dizzy or like you might faint.

• Tired.

• Chest pain or discomfort.

The NHS says to call 999 or go to A&E if you currently have heart palpitations with any of these symptoms: chest pain, shortness of breath, feeling dizzy or lightheaded, or fainting or feeling like you might faint. Do not drive to A&E. If you have had these symptoms but they have now stopped, ask your GP surgery for an urgent appointment, call 111 or get help from 111 online.

The NHS says to see a GP if you think you may have heart rhythm problems or if you have heart palpitations that keep happening or are getting worse. The BHF similarly advises speaking to your GP if palpitations last a long time, do not improve or get worse, you have a history of heart problems or you are concerned.

The BHF describes several common types. Sinus tachycardia and sinus bradycardia, where the heart beats regularly but faster than 100 or slower than 60 beats per minute, do not necessarily mean there is anything wrong with the heart.

The NHS says other conditions can sometimes cause heart rhythm problems, including high blood pressure, coronary heart disease, heart valve disease, heart attack and Wolff-Parkinson-White syndrome. An abnormal heartbeat can also come from medicines, viruses, caffeine, alcohol, smoking or drugs.

The BHF adds that some arrhythmias can develop after some types of heart surgery or be caused by inherited conditions such as Long QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia (CPVT) or progressive cardiac conduction defect (PCCD). If that is the case, your doctor will talk to you about having family members tested. It also lists heart failure and cardiomyopathy among conditions that can cause an arrhythmia.

The BHF says your GP might refer you for tests including an ECG (which may include a 24-hour ECG, an exercise ECG or an implantable loop recorder), an echocardiogram or an electrophysiological (EP) study. It says your doctor might want tests to find out more if you have a regular but fast or slow heart rate.

The NHS says how a heart rhythm problem is treated depends on the type you have and what is causing it. Many people may not need any treatment at all or will only need regular check-ups. You may also need treatment for any condition that is causing the rhythm problem.

The BHF says most arrhythmias are manageable, which means that with the right treatment you can carry on living as you were before diagnosis. Living with an abnormal rhythm can be emotionally challenging for you and your family, and it is important to manage anxiety and stress and get support from your GP or loved ones.

There may be practical matters such as driving, holidays and returning to work. The BHF says that if your ability to drive is affected you must let your insurance company and the DVLA know, and your GP can tell you whether you need to. Talk to your manager or occupational health department if your work may be affected.

On the NHS, a GP can arrange an ECG and refer you to a cardiology or heart rhythm (electrophysiology) service for monitoring, medicines or procedures such as ablation. If symptoms are severe or come with chest pain, breathlessness or fainting, go to A&E or call 999.

Some people choose private cardiology consultations or heart rhythm monitoring for quicker access, usually with a referral letter. Whichever route you take, new or worsening symptoms with warning signs should be assessed urgently.