Arrhythmia: Are You At Risk?If your heart beats too quickly, too slowly or irregularly, the abnormal heart rhythm is called a cardiac arrhythmia.
If your heart beats too quickly, too slowly or irregularly, the abnormal heart rhythm is called a cardiac arrhythmia. These are caused by an abnormality in the electrical conduction system that keeps your heart pumping blood around your body, or by problems with the heart's natural pacemaker (the sinus node). Arrhythmias are also fairly common, affecting more than two million people each year in the UK, claims the NHS.
A normal healthy heart beats between 60 and 100 times a minute when you're resting. It can often fall below this rate when you're asleep, for instance, or it can naturally beat faster when you exercise or if you're excited, stressed or anxious.
Certain health conditions can also affect the speed of your heart beat, such as thyroid conditions (an underactive thyroid can make it beat more slowly while an overactive thyroid can quicken your heart rate).
Other normal heart beats include palpitations and ectopic beats. Palpitations – that is, when you can feel your heart pounding or if you get a fluttering sensation in your chest – can feel worrying, but they are very common and they aren't usually a sign of a serious heart condition.
Ectopic beats – which often feels like your heart is skipping or missing a beat – are normal too, and despite feeling unpleasant they are usually nothing to worry about.
But while palpitations are usually nothing serious, they can also be a symptom of an arrhythmia. Other symptoms of arrhythmia include dizziness, breathlessness, chest pain and feeling faint.
There are several types of arrhythmia, some of which are more serious than others. Some happen in the upper chambers of the heart (atria), and some in the lower chambers (ventricles). Some require no treatment, while others are treated with medication, surgery or a heart monitoring device such as a pacemaker or ICD.
Many cases of arrhythmia develop in people who have one of the following heart conditions:
Coronary heart disease
As well as causing angina and heart attacks, coronary heart disease can damage parts of the heart muscle, including those that are part of the heart's conduction system.
High blood pressure
People with high blood pressure may experience arrhythmias because of the way the condition puts a strain on the heart.
Heart valve disease
This can make the heart muscle larger, which can lead to abnormal electrical activity in the heart.
Those born with some types of heart conditions may also experience arrhythmia.
If you're concerned about palpitations, ask your GP for a check-up.
Fast arrhythmias (tachycardia)
If you have an abnormal heart beat where your heart beats too quickly and/or irregularly, it's called tachycardia. There are several different types, the main ones being the following:
According to the NHS, atrial fibrillation (AF) is the most common type of arrhythmia (around a million people are thought to be affected in the UK). It causes an irregular and often abnormally fast heart rate, often with noticeable heart palpitations as well as problems such as dizziness, tiredness and breathlessness.
AF happens when your heart's atria (upper chambers) contract randomly and sometimes so quickly that the heart can't relax between contractions, and is a result of abnormal electrical impulses coming from the atria. You may have episodes that come and go, or more persistent symptoms that last for days or even permanent symptoms.
It isn't usually life-threatening, but AF significantly increases your risk of having a stroke, so you may need to take medicines to prevent that happening. Other medicines can help control your heart rate, or you may need to have a pacemaker fitted.
This too is quite common but rarely life-threatening. SVT is when your heart starts beating very quickly, accompanied by other symptoms such as light headedness, breathlessness, dizziness and chest pain. These symptoms tend to come and go – you may experience them a few times a day or as seldom as once or twice a year. And they can last anything from a few seconds to a few days in some rare cases.
Some people who have SVT have had a heart condition since birth, called Wolff-Parkinson-White syndrome. This is caused by an extra electrical connection in the heart that makes their heart beat abnormally quickly on occasion. Others find things like alcohol, caffeine, smoking and stress can trigger the symptoms of a SVT.
Most people with who experience this type of tachycardia don't need treatment. But others who have ongoing SVT episodes may need medication, a type of electric shock therapy called cardioversion or a surgical procedure called catheter ablation.
According to the British Heart Foundation, the most common cause of this type of tachycardia is a heart attack (most people who get it have it either during or just after a heart attack). It can also be caused by an underlying heart condition, such as a cardiomyopathy, and can be life-threatening.
Another type of ventricular arrhythmia is ventricular tachycardia, which is usually found in those with a type of heart disease such as cardiomyopathy. It can start and stop suddenly, and can make you feel dizzy, breathless and give you palpitations, as well as make you feel sweaty and nauseated. If it doesn't stop on its own, it can make your blood pressure fall too low, which can lead to cardiac arrest.
Slow arrhythmias (bradycardia)
If your heart beats too slowly, it can lower your blood pressure as well as make you feel tired, dizzy, lightheaded and even lead to a blackout.
When you have an abnormally slow heart rate, the medical term is bradycardia. Usually, this is caused by a condition called heart block. In very simple terms, this is the result of an electrical signal from one part of your heart failing to reach its destination (as in, it gets blocked) or becoming delayed.
Heart block doesn't stop the heart beating altogether, however. But it can make your heart beat abnormally slowly (bradycardia). But in many cases of heart block there may be no symptoms whatsoever.
Several things can cause heart block, including congenital heart defects and blood pressure medications called beta-blockers. You may also be more likely to develop a heart block if you have a history of heart disease, heart attacks or heart failure.
Heart block degrees
There are three main types of heart block – first-degree heart block, second-degree heart block and third-degree heart block.
First-degree heart block rarely causes any noticeable symptoms, while second-degree heart block can cause symptoms including dizziness, fainting and light headedness.
Third-degree heart block can be more serious, and can be potentially life threatening. Any of the three degrees can increase your risk of developing other types of arrhythmia, including atrial fibrillation.
How is it treated?
If you have first-degree heart block you may not need any treatment. But most people with a type of second-degree heart block called Mobitz type 2 and all of those with third degree heart block usually need to have a pacemaker fitted. This is an electrical device that's implanted in your chest to keep your heart beating at a normal pace.
Arrhythmia: are you at risk?
If two million people in the UK are affected by arrhythmia, what makes them more susceptible to the condition than others?
Age is an important factor, as the most common type of arrhythmia – atrial fibrillation – is more common in older people. However, it's also true that arrhythmia can affect you at any age.
If you drink an excessive amount of alcohol, it can increase your risk of developing atrial fibrillation.
Being overweight or obese can also mean your risk of developing atrial fibrillation is higher than average.
Having a severe heart condition can cause arrhythmia and even cause sudden cardiac death. According to the NHS, this kills 100,000 people in the UK each year.
As well as alcohol, other lifestyle factors can trigger an episode of arrhythmia, including drinking too much caffeine, exercising, smoking and taking certain medicines (including over-the-counter, prescription and illegal recreational drugs). In some people, a viral illness may also lead to arrhythmia.
What can you do?
According to the NHS, it isn't always possible to prevent arrhythmia. However, the best advice for reducing your risk of this and any other heart condition is to follow a healthy lifestyle.
This means eating a healthy balanced diet with at least five portions of fruit and vegetables a day, being physically active for a minimum of 150 minutes a week where you feel warm and slightly out of breath, not smoking and keeping your alcohol intake within the recommended guidelines (currently, this is a maximum of 14 units of alcohol each week for men and women, spread over at least three days).
If you have any of the symptoms of arrhythmia, chances are it could be nothing to worry about. But you should always see your GP if you have symptoms, if only to put your mind at rest. If, however, you are diagnosed with an arrhythmia, your doctor can advise you about treatments that can help prevent any more episodes.
You can help your doctor to determine whether or not you have a heart rhythm problem by going to your appointment with the appropriate information. This includes how often you experience symptoms, what sort of things trigger your symptoms and whether or not you have a family history of heart rhythm problems.
The Arrhythmia Alliance has a handy checklist you can print out and take with you – visit www.arrhythmiaalliance.org.uk and look for the Your Heart in Your Hands Checklist in the section for patients.
Natural support for arrhythmia
If you have an arrhythmia, your GP or heart specialist may recommend medication, a therapy called cardioversion, catheter ablation or a pacemaker, depending on the type of arrhythmia that's affecting you.
Some natural treatments, however, may be used alongside conventional treatments to support the heart (always speak to your health professional before using natural remedies for arrhythmia). These include the following:
Needed for normal nerve transmission, including that in the heart muscle, magnesium is often used to keep the heart stable. Some natural health practitioners believe many people with atrial fibrillation are deficient in magnesium. You can get magnesium from foods such as dark leafy green vegetables, nuts, seeds, beans, seafood, whole grains and avocados. You may, however, like to try a magnesium supplement too.
A compound found in high concentrations in the mitochondria – the energy-driven cells of the heart – CoQ10 (or ubiquinone) is best known for treating congestive heart failure. There is also evidence it may be beneficial for people with atrial fibrillation, with one study showing that just three percent of volunteers taking CoQ10 had atrial fibrillation episodes after 12 months' treatment compared with 22 percent of volunteers who didn't receive any C0Q10 supplements (i). For natural angina support, take a daily dose of 200mg CoQ10.
Omega-3 fatty acids
The omega-3 fatty acids found in fish oil are thought to be important for the heart's electrical system. Some experts believe that fish oil supplementation should be recommended for coronary heart disease and arrhythmias, especially among those who cannot or don't want to eat fish (ii). One study also suggests increased levels of omega-3 fatty acids may reduce the risk of atrial fibrillation in older people by about 30 per cent (iii).
An amino acid used by the body to turn fat into energy, carnitine is found in high concentrations in the heart muscle and is often used for heart-related conditions. One report suggests it may help heart attack sufferers by reducing abnormal heart rhythms by up to 65 per cent (iv).
The richest food source of carnitine is beef, followed by milk, fish, chicken and cheese. Vegetarians can source some carnitine from wholewheat bread and asparagus. Carnitine is also available as a nutritional supplement.
Rich in nutrients including polyphenols, pomegranate juice has three times the antioxidant activity of green tea or red wine. These polyphenols include compounds called tannins, including punicalagin, ellagic acid and gallagic acid. These compounds are thought to help protect cells from free radical damage, which may help support your heart.
Zhao. Q, Kebbati. AH, et al. Effect of coenzyme Q10 on the incidence of atrial fibrillation in patients with heart failure. J Investig Med. 2015 Jun;63(5):735-9.
Anand. RG, Alkadr. M, Lavie. CJ, Milani. RV, et al. The role of fish oil in arrhythmia prevention. J Cardiopulm Rehabil Prev. 2008 Mar-Apr;28(2):92-8.
Wu. JHY, Lemaitre. RN, et al. Association of plasma phospholipid long-chain omega-3 fatty acids with incident atrial fibrillation in older adults: the cardiovascular health study. Circulation. 2012; 125: 1084-1093.
Di Nicolantonio. JJ, Lavie. CJ, et al. L-Carnitine in the secondary prevention of cardiovascular disease: systematic review and meta-analysis. May Clin Proc. 2013 Jun;88(6):541-51.
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