AFib and Arrhythmias: What You Need to Know

Feeling your heart fluttering, racing or skipping a beat might sound romantic, but heart arrhythmias — or irregular or abnormal heartbeats — can be dangerous and lead to serious health complications. Atrial fibrillation, or AFib, is the most common type of arrhythmia and, left untreated, increases your risk of stroke.

During AFib Awareness Month, Kenneth Yamamura, MD, a board-certified cardiac electrophysiologist at AdventHealth Pepin Heart Institute, shares more about heart arrhythmias, their symptoms and the treatment options available to get your heartbeat back to normal.

Types of Heart Arrhythmias

Your heart normally pumps between 50 and 80 times per minute. During each heartbeat, the top chambers of your heart (atria) squeeze, forcing blood into the bottom chambers (ventricles), which then pump blood out of the heart.

This process is complicated but controlled by electrical impulses that keep the four chambers of your heart in sync at every step. However, if you have an arrhythmia, these impulses don’t fire like they’re supposed to, leading to an irregular heartbeat.

“Arrhythmias are typically either atrial, from the top chambers of the heart, or ventricular, from the bottom chambers,” says Dr. Yamamura. “Arrhythmias can also be either fast — ‘tachy’—arrhythmias, or slow — ‘brady’ — arrhythmias. And the treatments for these two different conditions will be very different.”

Tachycardia

Rapid heartbeat, or tachycardia, is caused by an abnormal electrical impulse somewhere in the heart that causes your heart to beat at over 100 beats per minute. Types of tachycardia include:

• AFib
• Atrial flutter
• Ventricular tachycardia
• Supraventricular tachycardia

Atrial fibrillation or Afib is the most common heart arrhythmia. During AFib, instead of the heart squeezing normally, the top chamber of the heart quivers at a rate of up to 400 beats per minute, leading to a higher risk of stroke and over time weakness of the heart muscle called cardiomyopathy. Given these potentially life-threatening consequences, it is important to diagnose Afib.

Bradycardia

A lower-than-normal heart rate under 60 beats per minute can signal bradycardia, although for young, healthy people, a heart rate under 60 beats per minute does not necessarily mean there’s a problem.

Older patients are more likely to get bradycardia because scar tissue can form in the electrical system of the heart. Bradycardia can also be caused by:

• Medications
• Obesity
• Sleep apnea
• Thyroid problems

Heart Arrhythmia Symptoms

While some people living with heart rhythm disorders don’t have any symptoms, arrhythmias can cause different symptoms depending on if they are caused by tachycardia or bradycardia.

Symptoms of tachycardia include:

• Heart palpitations
• Lightheadedness or fainting
• Rapid heartbeat
• Shortness of breath
• Rarely, sudden cardiac death

Bradycardia can cause similar symptoms, like lightheadedness, fainting and shortness of breath, but it can also lead to fatigue, confusion and chest pain. “It’s important to recognize and get a diagnosis because AFib and other arrhythmias can lead to dangerous conditions like stroke if left untreated,” says Dr. Yamamura.

“We’ve seen that wearable devices have been able to capture abnormal heart rhythms, alerting people who might not have otherwise realized they had an arrhythmia. It’s a new era of diagnostics for arrhythmias.”

Treatments for Heart Arrhythmias

Fortunately, most arrhythmias are very treatable. Depending on your diagnosis, your care team may recommend different treatment options for your condition.

Medications

Your cardiologist may suggest medications to manage your arrhythmia and lower your risk of dangerous symptoms. These include:

• Beta blockers: To slow your heart rate in the case of tachycardia
• Blood thinners: To lower your risk of stroke
• Channel blockers: To control your heart’s rhythm

If you have bradycardia, your doctor could also suggest limiting other medications that interfere with your heart rate. They may also prescribe medicine to treat underlying conditions, like thyroid problems, that are causing your bradycardia.

Ablation

During this minimally invasive procedure, your care team uses a thin, flexible tube called a catheter to deliver heat energy, cryo energy, or pulsed electrical field to scar the part of your heart sending abnormal electrical signals, restoring a normal heartbeat.

Pacemakers

If medications are not helping to manage your arrhythmia, your cardiologist may suggest implanting a pacemaker, a small, battery-powered device that sends electrical signals that control your heartbeat. Your provider implants this device under your collarbone during a minimally invasive procedure. Pacemakers can be programmed to address your specific arrhythmia and return your heart to its normal rhythm.

WATCHMAN™ devices

These devices can be implanted directly into the left atrial appendage in the left upper chamber of your heart and are used to reduce the stroke risk from AFib (though they don’t stop AFib itself). This device sits in your heart and blocks clots from forming there or leaving the appendage to go to other parts of the body and leading to stroke. WATCHMAN™ devices are safe for patients who have a bleeding risk and can’t take blood thinners long term.

Get Your Heart Back in Sync

Whether your heart is beating too fast or too slow, AdventHealth Pepin Heart Institute’s team of cardiovascular disease experts is here to help it beat just right with the most advanced diagnostics and minimally invasive treatment options tailored to you. Learn more.

About Dr. Yamamura

Kenneth Yamamura, MD is a board-certified cardiologist specializing in cardiology and clinical cardiac electrophysiology. He is the Director of Electrophysiology at AdventHealth Pepin Heart Institute and a Fellow of the American College of Cardiology and Heart Rhythm Society.

Dr. Yamamura has over 20 years of clinical experience and practices all areas of cardiac electrophysiology, including device implantation and ablation of cardiac arrhythmias (atrial fibrillation, atrial flutter, SVT, PVCs and ventricular tachycardia).