Article Revisions
References:
Barsky, AJ, Cleary, PD, Coeytaux, RR, Ruskin, JN. The clinical course of palpitations in medical outpatients. Arch Intern Med.1995;155:1782. Barsky, AJ, Cleary, PD, Coeytaux, RR, Ruskin, JN. The clinical course of palpitations in medical outpatients. Arch Intern Med.1995;155:1782.
Harrison's Principles of Internal Medicine. 14th ed. McGraw-Hill; 1998.
Lok NS, Lau CP. Prevalence of palpitations, cardiac arrhythmias and their associated risk factors in ambulant elderly. Int J Cardiol.1996;54:231. Lok NS, Lau CP. Prevalence of palpitations, cardiac arrhythmias and their associated risk factors in ambulant elderly. Int J Cardiol.1996;54:231.
Mayo Clinic and Foundation for Medical Education and Research website. Available at: http://www.mayo.edu/ .
National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/ .
Sarter BH, Finkle JK, Gerszten RE, et al. What is the risk of sudden cardiac death in patients presenting with hemodynamically stable sustained ventricular tachycardia after myocardial infarction? J Am Coll Cardiol.1996;28:122.
Sarter BH, Finkle JK, Gerszten RE, et al. What is the risk of sudden cardiac death in patients presenting with hemodynamically stable sustained ventricular tachycardia after myocardial infarction? J Am Coll Cardiol.1996;28:122
References:
Barsky, AJ, Cleary, PD, Coeytaux, RR, Ruskin, JN. The clinical course of palpitations in medical outpatients. Arch Intern Med.1995;155:1782.
Harrison's Principles of Internal Medicine. 14th editioned. McGraw-Hill; 1998.
Lok NS, Lau CP. Prevalence of palpitations, cardiac arrhythmias and their associated risk factors in ambulant elderly. Int J Cardiol.1996;54:231.
Mayo Clinic and Foundation for Medical Education and Research website. Available at: http://www.mayo.edu/ .
National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/ . National Institutes of Health website. Available at: http://www.nih.gov/ .
Snow, V, Weiss, KB, LeFevre, M, et al. Management of newly detected atrial fibrillation: a clinical practice guideline from the American Academy of Family Physicians and the American College of Physicians. Ann Intern Med.2003;139:1009 Weber, BE, Kapoor, WN. Evaluation and outcomes of patients with palpitations. Am J Med.1996;100:138Sarter BH, Finkle JK, Gerszten RE, et al. What is the risk of sudden cardiac death in patients presenting with hemodynamically stable sustained ventricular tachycardia after myocardial infarction? J Am Coll Cardiol.1996;28:122.
Arrhythmias are abnormal beats of the heart, such as:
- Heartbeats that are too slow ( bradycardia )
- Heartbeats that are too fast (tachycardia)
- Extra beats
- Skipped beats
- Beats coming from abnormal areas of the heart
The Heart |
Arrythmias can also be classified by the point of origination within the heart muscle:
- Arrhythmias originating within the atria
- Arrhythmias originating within the ventricles
The heart is a muscular pump with its own power supply and internal controls. It generates its own electrical signals to prompt each heartbeat and can therefore beat independently of the rest of the body. The electrical signal begins in a "pacemaker" called the sinoatrial, or sinus, node, which is in the back of the right atrium (upper right heart chamber). Arrhythmias can arise from any part of the heart's circuitry. Those that come from the atria are called atrial and are usually benign. Most of the dangerous arrhythmias start in the ventricles (lower chambers) or are due to failure of conduction through the atrioventricular (AV) node or due to abnormal electrical activity within the ventricles. The AV node is the electrical connection point between the atria and ventricles.
For descriptions of the many types of arrhythmias, click here.
What are the risk factors for arrhythmias?
What are the symptoms of arrhythmias?
How are arrhythmias diagnosed?
What are the treatments for arrhythmias?
Are there screening tests for arrhythmias?
How can I reduce my risk of developing an arrhythmia?
Arrhythmias may be identified either during routine health check-ups or when you first report having symptoms. In either case, the doctor will ask about your symptoms and medical history, and perform a physical exam, which includes listening to your heart. For older patients and those with symptoms or risk factors for heart disease, the healthcare provider will focus extra attention on cardiovascular health.
Tests may include:
Blood Tests—These tests evaluate your overall health, the function of your kidneys, the levels of various electrolytes, and may provide clues about your heart's health.
Urine Tests—These tests assess your general health and look for certain markers in the urine that may determine what is happening with your heart.
Electrocardiogram (EKG)—The EKG records the heart's activity by measuring electrical currents that travel through the heart muscle. This test can detect damaged areas of heart muscle and abnormal beats.
Exercise Stress Test—An EKG is used to record the heart's electrical activity during increased physical activity, such as exercising on a treadmill or stationary bicycle. For patients who are not able to exercise on a treadmill, a medication may be given intravenously that causes the heart to work harder, simulating a condition of physical exercise.
Echocardiogram—High-frequency sound waves (ultrasound) are directed at your heart to examine the size, shape, and motion of the heart. A more specialized version uses the Doppler effect to visualize blood flow.
24-hour Holter Monitor—If your rhythm disturbance does not happen in the doctor's office, you may be given a portable EKG machine to take home with you. The machine will be belted around your waist and will record your heart rhythm over 24 hours or more.
Transtelephonic Monitoring—Instead of a 24-hour monitor, you may take home a device that allows you to send your EKG recording over the telephone at the moment you feel symptoms of an arrhythmia.
Implantable Loop Recorder—Sometimes, a longer period of recording is necessary. A small, about 2" x 1" rectangular recording device may be surgically implanted underneath the skin of the chest. This device can record EKG-like information over a longer period of time. If the information recorded falls within certain normal limits, the device erases the data. Any episodes of abnormal heart rhythms are retained in the device until retrieval by the physician.
Nuclear Scanning—A radioactive material is injected into a vein and observed as it is absorbed by the heart muscle. This test is not specific for rhythm disturbances. It is used to visualize the blood supply to the heart. Areas with poor blood supply can potentially generate abnormal rhythms.
Cardiac Catheterization and Coronary Angiography—A more precise view of blood flow to and through the heart is obtained by threading catheters into the heart and injecting x-ray dye. This test is not used specifically for detection of heart rhythm disturbances, but rather to evaluate for presence of coronary artery disease (a common cause of heart arrythmias).
CT and MRI Angiography—This test combines the use of traditional CT and MRI with angiography. Certain dyes injected into your circulation can produce better pictures of blood vessels and other structures of the heart than CT or MRI alone.
Electrophysiologic Testing—For complex rhythm disturbances, and as a prelude to invasive treatment of arrhythmias, it may be necessary to map the spread of electrical impulses within the heart muscle. In order to accomplish this, the electrode is threaded through the blood vessels to various spots within the heart.
Tilt Table Testing—This test is usually ordered for patients with fainting episodes. Your heart rate and blood pressure are closely monitored while you are first lying flat on a table and then when the table is tilted.
The most common cause of dangerous arrhythmias is a heart attack, which results from heart disease. Prevention of arrhythmias is mostly a matter of reducing your risk of heart disease and then preventing subsequent rhythm disturbances if you survive the first one. However, there are a few measures that specifically influence your risk of arrhythmias.
General Guidelines for Reducing Your Risk of Arrhythmias
Manage Stress
Stress may raise your risk of arrhythmias if you have predisposing factors. If you need support or assistance in reducing stress, you may want to try some of the following techniques:
- Counseling
- Stress management classes
- Relaxation techniques
- Yoga
Beware of Medications That May Cause Arrhythmias
Ask your doctor or pharmacist what effect your medications will have on heart rhythm. If you are predisposed to arrhythmias, ask about substitutes for the drugs that can precipitate an abnormal rhythm. Be particularly wary of:
- Diet pills
- Certain heart medicines
- Asthma medicines
- Psychoactive medicines (eg, antidepressants)
- Thyroid replacement
- Cough and cold medicines
Avoid Illegal Drugs
Avoid illegal drugs, especially cocaine, methedrine, and other amphetamines.
General Guidelines for Reducing Your Risk of Heart Disease
- If you smoke, quit.
- Eat a heart-healthy diet.
- Low in saturated fat and cholesterol
- Rich in whole grains, fruits, and vegetables
- Exercise regularly.
- Take your medications as directed.
- Lose weight if you are overweight or obese.
- Drink alcohol only in moderation.
- One or fewer alcoholic beverages per day for women
- Two or fewer alcoholic beverages per day for men
If You Smoke, Quit
Smoking can increase the amount of fatty material that collects in your arteries. Also remember that secondhand smoking is detrimental to your health. Make sure you're not exposed to cigarette smoke. When you quit smoking, your risk of heart disease drops significantly within the first year.
Eat a Heart-healthy Diet
A diet low in saturated fat, trans fat, and cholesterol, and rich in whole grains, fruits, and vegetables will help lower cholesterol levels, blood pressure, and body weight—three heart attack risk factors. Follow the meal plan recommended by your doctor. Also, there is evidence to suggest that supplementation with omega3 fatty acids may reduce the risk of arrhythmias. Talk to your doctor about this.
Exercise Regularly
Follow your doctor’s recommendations for physical activity. After a heart attack, he or she will likely refer you to a cardiac rehabilitation program, which will help you establish a life-long exercise plan and monitor your initial program. Choose exercises you enjoy and will make a regular part of your day. Strive to maintain an exercise program that keeps you fit and at a healthy weight. For most people, this could include walking briskly or participating in another aerobic activity for at least 30 minutes per day.
Maintain a Healthful Weight
Follow the dietary and exercise plan recommended by your doctor or dietitian. Being overweight or obese is associated with higher risk of heart attack, and losing weight lowers that risk. To lose weight, consume fewer calories than you expend. To maintain a healthy weight , eat an amount of calories equal to the calories you expend. One indicator of a healthy weight is body mass index (BMI). BMI of 25 and above is associated with high blood cholesterol, high blood pressure and increased risk of heart disease.
Drink Alcohol Only in Moderation
Heavy drinking is associated with increased risk of heart attack. Moderate drinking may lower the risk of heart attack. Moderate drinking is one drink per day for women and two drinks per day for men. One drink equals 12 ounces of beer or four ounces of wine or one ounce of 100-proof spirits. In addition, be aware that alcohol may interfere with your medications, and chronic intake of alcohol may have deleterious effects on your health.
Take Your Medications as Directed
Your doctor may prescribe medications to reduce your risk of heart disease. These may include medications to lower your blood pressure, manage your cholesterol levels, or manage diabetes (if you have diabetes). If your doctor has prescribed medications, take them exactly as directed and report side effects to your healthcare provider immediately. Do not skip pills or stop taking them without consulting your healthcare provider.
References:
Barsky, AJ, Cleary, PD, Coeytaux, RR, Ruskin, JN. The clinical course of palpitations in medical outpatients. Arch Intern Med.1995;155:1782.
Harrison's Principles of Internal Medicine. 14th editioned. McGraw-Hill; 1998.
Lok NS, Lau CP. Prevalence of palpitations, cardiac arrhythmias and their associated risk factors in ambulant elderly. Int J Cardiol.1996;54:231.
Mayo Clinic and Foundation for Medical Education and Research website. Available at: http://www.mayo.edu/ .
National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/ . National Institutes of Health website. Available at: http://www.nih.gov/ .
Snow, V, Weiss, KB, LeFevre, M, et al. Management of newly detected atrial fibrillation: a clinical practice guideline from the American Academy of Family Physicians and the American College of Physicians. Ann Intern Med.2003;139:1009 Weber, BE, Kapoor, WN. Evaluation and outcomes of patients with palpitations. Am J Med.1996;100:138Sarter BH, Finkle JK, Gerszten RE, et al. What is the risk of sudden cardiac death in patients presenting with hemodynamically stable sustained ventricular tachycardia after myocardial infarction? J Am Coll Cardiol.1996;28:122.
References:
Harrison's Principles of Internal Medicine.14th ed. McGraw-Hill; 1998.
Kroenke K, Arrington ME, Mangelsdorff AD. The prevalence of symptoms in medical outpatients and the adequacy of therapy. Arch Intern Med.1990;150:1685.
Mayou R, Sprigings D, Birkhead J, Price J. Characteristics of patients presenting to a cardiac clinic with palpitation. QJM.2003;96:115.
National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/ .
Zimetbaum P, Josephson ME. Evaluation of patients with palpitations. N Engl J Med.1998;338:1369.
Some arrhythmias may occur without any symptoms. Others may cause noticeable symptoms, such as:
- Fainting
- Dizziness, sensation of lightheadedness
- Weakness
- Fatigue
- Shortness of breath
- Chest pain
- Sensation of your heart fluttering (palpitations)
- Sensation of a missed or extra heart beat
Fainting, dizziness, lightheadedness, weakness, fatigue, and shortness of breath all mean that your brain or your muscles are not getting enough blood because your heart isn't pumping effectively.
Chest pain means that the heart itself is not getting enough blood. This is called angina.
Some people report an unusual feeling of their “heart beating,” especially if it is beating abnormally. With none of the other symptoms, this may be harmless or it may be a warning of a potential problem.
A risk factor is something that increases your likelihood of getting a disease or condition.
It is possible to develop arrhythmias with or without the risk factors listed below. However, the more risk factors you have, the greater your likelihood of developing arrhythmias. If you have a number of risk factors, ask your doctor what you can do to reduce your risk.
Risk factors for arrhythmias include:
Medical Conditions
The following medical conditions increase your chances of developing an arrhythmia:
- Heart muscle damage after heart attack
- Coronary artery disease
- Problems with heart valves
- Rheumatic heart disease
- Endocrine disorders, such as thyroid or adrenal gland problems
- Anemia
- High blood pressure
- Cardiomyopathy
- Diabetes
- Obstructive sleep apnea
- Liver disease
- Typhoid fever
- Hypothermia
- Complication after near-drowning
- Electric shock or lightning strike
- Certain birth defects
Medications
Taking the following medication may increase your chances of developing an arrhythmia:
- Diet pills or decongestants
- Antidepressant medications
- Digitalis
- Thyroid medications
- Prescription stimulants (eg, Ritalin)
Lifestyle Habits
The following habits may increase your chances of developing an arrhythmia:
- Smoking
- Alcohol
- Stress
- Excessive caffeine intake
Illegal Drugs
Use of illegal drugs, especially stimulants such as cocaine, methedrine, and other amphetamines, increases your risk of developing an arrhythmia.
Age
As with the risk of heart disease, your risk of developing an arrhythmia increases as you age.
References:
Bruce GK, Friedman PA. Device-based therapies for atrial fibrillation. Curr Treat Options Cardiovasc Med.2005;7(5):359-370.
Crawford MH, Bernstein SJ, Deedwania PC, et al, for the American College of Cardiology/American Heart Association task force on practice guidelines. ACC/AHA guidelines for ambulatory electrocardiography: Executive summary and recommendations. Circulation.1999;100:886.
Harrison's Principles of Internal Medicine.16th ed. McGraw-Hill; 2004.
Heart Rhythm Society website. Available at: http://www.hrsonline.org .
Krahn AD, Klein GJ, Skanes AC, Yee R. Insertable loop recorder use for detection of intermittent arrhythmias (review). Pacing Clin Electrophysiol.2004;27(5):657-664.
National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/ .
Rosano GM, Rillo M, Leonardo , et al. Palpitations: What is the mechanism, and when should we treat them? Int J Fertil Womens Med.1997;42:94.
Weber BE, Kapoor WN. Evaluation and outcomes of patients with palpitations. Am J Med.1996;100:138.
References:
American Dietetic Association website. Available at: http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/index.html .
American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=1200000 .
Harrison's Principles of Internal Medicine.14th ed. McGraw-Hill; 1998.
National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/ .
Leaf A. Omega-3 fatty acids and prevention of arrhythmias. Curr Opin Lipidol.2007;18(1):31-34.
American Heart Association
Address:
7272 Greenville Avenue
Dallas, TX 75231
Phone:
1-800-AHA-USA-1
1-800-242-8721
Internet Address:
http://www.americanheart.org
Description of Services Provided:
AHA offers patient and physician information, advocacy, research support, publications, and health news related to cardiovascular diseases. It has local offices in every state that provide instructional materials and classes in CPR and emergency cardiovascular care.
Heart Rhythm Society
Address:
1400 K Street, NW
Suite 500
Washington, DC 20005
Phone:
(202) 464-3400
Internet Address:
http://www.hrsonline.org/
Description of Services Provided:
Library of consumer and professional information on diseases related to the heart.
National Heart, Lung, and Blood Institute
Address:
NHLBI Health Information Center
Attn: Website
PO Box 30105
Bethesda, MD 20824-0105
Phone:
1-301-592-8573
Internet Address:
http://www.nhlbi.nih.gov
Description of Services Provided:
NHLBI offers an extensive library of consumer and professional information on diseases related to the heart, lungs, and blood.
References:
Ferri F, ed. Ferri’s Clinical Advisor 2010. 1st ed. Philadelphia: Mosby Elsevier, 2009.
Goldman L, Ausiello D, eds. Cecil Textbook of Internal Medicine. 23rd ed. Philadelphia: Saunders, 2008.
Harrison's Principles of Internal Medicine.14th ed. McGraw-Hill; 1998.
Kroenke, K, Arrington, ME, Mangelsdorff, AD. The prevalence of symptoms in medical outpatients and the adequacy of therapy. Arch Intern Med.1990;150:1685.
Libby P, et al. Braunwald’s Heart Disease.8th ed. Philadelphia: Saunders, 2007.
Mayou R, Sprigings D, Birkhead J, Price J. Characteristics of patients presenting to a cardiac clinic with palpitation. QJM.2003;96:115.
National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/ .
Noble J. Textbook of Primary Care Medicine. 3rd ed.
Rakel R. Textbook of Family Medicine 2007. 7th ed. Philadelphia: Saunders Elsevier, 2009.
Rakel RE, Bope ET. Conn's Current Therapy. 60th ed. Philadelphia: Saunders Elsevier, 2009.
The purpose of screening is early diagnosis and treatment. Screening tests are usually administered to people without current symptoms, but who may be at high risk for certain diseases or conditions.
Screening Tests
Screening is not done specifically for arrhythmias, since they are just one manifestation of heart disease. Instead, your annual physical should provide a screening for heart disease. The screening involves measuring your blood pressure and cholesterol levels, listening to your heart and lungs, and asking questions about your lifestyle habits, such as eating, smoking, exercise, and drinking alcohol.
Depending on the outcome of this screening, your doctor may decide to do an electrocardiogram (EKG) . The EKG records the heart’s activity by measuring electrical currents through the heart muscle. It can detect damaged areas of heart muscle or an arrhythmia that is occurring at the time of the test.
Screening Guidelines
There are no screening guidelines specifically for arrhythmias. However, if you are over the age of 50 and have a history of heart disease, it is recommended that you have an annual check-up, which should include an evaluation of your heart health.
References:
Harrison's Principles of Internal Medicine.14th ed. McGraw-Hill; 1998.
Mayo Clinic and Foundation for Medical Education and Research website. Available at: http://www.mayo.edu/ .
Mayo Clinic Heart Center website. Available at: http://www.mayoclinic.com/health/heart-arrhythmias/HB00060 . Accessed on February 2, 2007
National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/ .
You have a unique medical history. Therefore, it is essential to talk with your doctor about your personal risk factors and/or experience with arrhythmias. By talking openly and regularly with your doctor, you can take an active role in your care.
General Tips for Gathering Information
Here are some tips that will make it easier for you to talk to your doctor:
- Bring someone else with you. It helps to have another person hear what is said and think of questions to ask.
- Write out your questions ahead of time, so you don't forget them.
- Write down the answers you get, and make sure you understand what you are hearing. Ask for clarification, if necessary.
- Don't be afraid to ask your questions or ask where you can find more information about what you are discussing. You have a right to know.
Specific Questions to Ask Your Doctor
About Your Arrhythmia
- Is this arrhythmia benign, or is it a warning that a life-threatening event is pending?
- Can you tell why I developed this arrhythmia?
- How many people who have this type of arrhythmia die of sudden cardiac death?
- Is there anything I can do to stop the arrhythmias?
About Your Risk of Sudden Death Due to Arrhythmia
- How likely is it that this arrhythmia will lead to sudden death?
- How rapidly do we need to act to prevent sudden death?
About Treatment Options
- What are my treatment options?
- Are there any alterative options?
- What are the possible side effects of each treatment?
- How long will treatment last?
- Will I have to take medication for the rest of my life?
About Lifestyle Changes
- What activities are hazardous for me until this is under control?
- Are there any activities that I will never be able to do again?
- Are there any lifestyle changes I can make to help prevent the arrhythmia from recurring?
- Should I carry something with me so people know I have an arrhythmia?
About Your Outlook
- What chance is there that I can return to my former lifestyle after treatment?
- Do I need to prepare my estate and family for the possibility of my sudden death?
References:
American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=1200000 .
Harrison's Principles of Internal Medicine. 14th ed. McGraw-Hill; 1998.
Heart Rhythm Society website. Available at: http://www.hrsonline.org .
Mayo Clinic and Foundation for Medical Education and Research website. Available at: http://www.mayo.edu/ .
National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/ .
Rosano GM, Rillo M, Leonardo F, et al. Palpitations: What is the mechanism, and when should we treat them? Int J Fertil Womens Med.1997;42:94.
Arrhythmias are abnormal beats of the heart, such as:
- Heartbeats that are too slow ( bradycardia )
- Heartbeats that are too fast (tachycardia)
- Extra beats
- Skipped beats
- Beats coming from abnormal areas of the heart
The Heart |
Arrythmias can also be classified by the point of origination within the heart muscle:
- Arrhythmias originating within the atria
- Arrhythmias originating within the ventricles
The heart is a muscular pump with its own power supply and internal controls. It generates its own electrical signals to prompt each heartbeat and can therefore beat independently of the rest of the body. The electrical signal begins in a "pacemaker" called the sinoatrial, or sinus, node, which is in the back of the right atrium (upper right heart chamber). Arrhythmias can arise from any part of the heart's circuitry. Those that come from the atria are called atrial and are usually benign. Most of the dangerous arrhythmias start in the ventricles (lower chambers) or are due to failure of conduction through the atrioventricular (AV) node or due to abnormal electrical activity within the ventricles. The AV node is the electrical connection point between the atria and ventricles.
For descriptions of the many types of arrhythmias, click here.
What are the risk factors for arrhythmias?
What are the symptoms of arrhythmias?
How are arrhythmias diagnosed?
What are the treatments for arrhythmias?
Are there screening tests for arrhythmias?
How can I reduce my risk of developing an arrhythmia?
References:
Barsky, AJ, Cleary, PD, Coeytaux, RR, Ruskin, JN. The clinical course of palpitations in medical outpatients. Arch Intern Med.1995;155:1782.
Harrison's Principles of Internal Medicine. 14th ed. McGraw-Hill; 1998.
Lok NS, Lau CP. Prevalence of palpitations, cardiac arrhythmias and their associated risk factors in ambulant elderly. Int J Cardiol.1996;54:231.
Mayo Clinic and Foundation for Medical Education and Research website. Available at: http://www.mayo.edu/ .
National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/ .
Sarter BH, Finkle JK, Gerszten RE, et al. What is the risk of sudden cardiac death in patients presenting with hemodynamically stable sustained ventricular tachycardia after myocardial infarction? J Am Coll Cardiol.1996;28:122.
Arrhythmias are very common, both the harmless type and the dangerous type. An arrhythmia can be caused by:
- The heart's natural pacemaker developing an abnormal rate or rhythm
- The normal electrical conduction pathway being interrupted
- Another part of the heart (other than the sinus node) taking over as pacemaker
The most common cause of dangerous arrhythmias is a heart attack. When the heart is deprived of adequate blood supply during a heart attack, its electrical activity can become erratic. Diseased heart valves and diseased heart muscle, direct injury to the heart, diseases that alter the body's chemical balance, and several kinds of medication can also upset the heart's circuitry.
The most common causes of arrhythmia include:
- Coronary artery disease (eg, heart attacks)
- Diseased myocardium (heart muscle)
- Abnormal heart valves
- Birth defects
- Stress
- Caffeine
- Tobacco
- Alcohol
- Illegal stimulants, such as cocaine and methedrine
- Diet pills
- Some over-the-counter medications, such as cough and cold medicines
Various prescription medications such as the following can also cause arrhythmias:
- Heart medicines
- Asthma medicines
- Psychoactive medicines, such as antidepressants
- Thyroid hormone replacement medicines
