Frequently Asked Questions
Please find answers below to questions that are frequently asked by people who have, or think that they might have, an arrhythmia.
What is an arrhythmia?
To enable your heart to beat, electrical impulses travel through the heart via what is sometimes referred to as a conduction pathway. Arrhythmias are disorders of your heart’s electrical system, which means there is a change in the regular beat of your heart. This can be as a result of the conduction pathway being damaged or blocked, or because an extra pathway is present. The heart may beat too quickly (tachycardia), or too slowly (bradycardia) or irregularly, all of which may affect the heart’s ability to pump blood around the body. These abnormal heart beats are known as arrhythmia. Arrhythmias can occur in the upper chambers of the heart (atria) or in the lower chambers of the heart (ventricles). An arrhythmia may occur at any age, and are most often a nuisance rather than a serious problem.
What happens in the heart to cause arrhythmia?
Any interruptions in the heart’s electrical system can cause arrhythmias. For example, an irregular heartbeat may begin with an abnormal impulse in the part of the heart other than the normal pacemaker (the sinus node), or the sinus node may develop an abnormal rate or rhythm.
What can trigger an arrhythmia?
Common causes of an arrhythmia can include stress, caffeine, tobacco, alcohol, diet pills and cough and cold medicines. If your heart tissue is damaged as a result of acquired heart disease, such as myocardial infarction (heart attack) or congenital heart disease, you may be at risk of developing an arrhythmia. However for some patients doctors cannot identify a cause of their arrhythmia.
How do I know what kind of arrhythmia I have?
You will need to visit your doctor and have an ECG. If the ECG does not detect any abnormality it may be necessary to arrange for further monitoring of your heart. This may involve having a continuous ECG for a period of time, usually 24-72 hours. This is done via a small recording device which can easily be carried around with you. You do not have to stay in hospital for this test. Once the recording device is fitted, which involves attaching some small stickers to your chest and connecting the leads of the device, you can go home and return the recorder at the end of the specified period.
There are also other ways of monitoring your heart over a period of time; your nurse, physiologist or doctor will discuss this with you if required.
My heart starts to race and then skips a beat or two, I feel very light-headed can you help?
Yes, first you should visit your doctor for advice, there may be a simple explanation as to what is happening or he or she may decide to send you for further tests. In many cases palpitation, or awareness of the heartbeat, may feel very frightening but actually be quite safe. Many palpitations are due to extra beats that cause the heart to pause for a second or two. This can feel as if the heart is about to stop and be very frightening, but in fact there is no threat of this. In many cases an electrical disturbance causing awareness of the heart beat occurs in the absence of any other heart problem. Palpitations can occur when there is no risk whatsoever of a heart condition/problem. The Arrhythmia Alliance has information leaflets explaining the various tests and eventual diagnosis. We are happy to answer your questions and signpost you to relevant organisations once you have a diagnosis.
Will I die from arrhythmia?
Arrhythmia should not be dismissed, and it is always advisable to seek advice from an appropriate health care professional if you think you may have an arrhythmia. Many patients with palpitations are at no risk whatsoever, but their symptoms need investigating.
If an arrhythmia occurs in a patient who has other heart disease, such as a previous heart attack, heart valve disease or abnormal heart muscle, this can be a sign that there is a more serious problem.
The arrhythmia should then be investigated further. In some cases patients should then be referred to a heart rhythm specialist (Electrophysiologist).
What should I expect my GP to do?
You should expect your GP to establish whether you have any underlying heart disease and to refer you to an appropriate health care professional for investigations to establish the cause of the arrhythmia. If there is no underlying heart disease, and the arrhythmia is easily explained, for example by extra beats, reassurance may be all that is needed.
If a more complicated arrhythmia is suspected, then you should expect to be referred to a cardiologist or and electrophysiologist.
Will I see a cardiologist?
All patients with a diagnosis of heart disease should see, or have seen, a cardiologist. All patients with an arrhythmia which is not due to simple extra beats should see a cardiologist or a heart rhythm specialist, even if this is the only problem and the heart is otherwise quite normal.
Who/What is an electrophysiologist?
An electrophysiologist is a cardiologist who has had special training in managing arrhythmias.
How can I find a specialist locally?
If my local hospital does not have an electrophysiologist where is the nearest one to me and how do I get to see him?
What is an ECG?
An electrocardiogram (ECG) is a tracing of the electrical activity that triggers each heartbeat. This should be recorded wherever possible with four leads attached to the arms and legs, and 6 leads attached across the chest. Patterns seen on the ECG can tell if a heart attack is happening or has happened and also roughly where in the heart the damage has occurred. The ECG is quite critical in assessing a heart rhythm disorder, the presence of any underlying heart problems, whether an arrhythmia is present, and whether it is an arrhythmia that requires treatment.
Your own doctor or other medical attendant MUST organise an ECG immediately if you are having on-going symptoms of arrhythmia that are not transient.
Can my GP carry out an ECG or will I have to go to hospital?
Your GP practice may have an ECG machine, and we believe that every practice should acquire one. If there is not ECG available, all practices should have easy access to an ECG nearby. An ECG should be arranged immediately if symptoms of palpitation are continuing.
What is a Tilt Test?
A Tilt Test is used to find the cause of blackouts. For more information on Tilt Tests please visit our sister charity website, STARS (Syncope Trust And Reflex anoxic Seizures) www.stars.org.uk or email firstname.lastname@example.org
What is a pacemaker and how will it help my arrhythmia?
A pacemaker is a small self-contained metal box containing a battery, circuits and connections for wires. These are passed down through veins under the collar-bone under local anaesthetic, guided by X-rays. The implantation of a pacemaker leaves a scar about two inches long, takes about 1 hour, and sedation is often given to increase comfort.
Often patients can go home the same day, and after a week or two, when the wound has settled a completely normal life can resume. There are sensible restrictions on activity which might damage the pacemaker box, such as the recoil from a shotgun and competitive swimming which strains the wires. Airport security should be alerted as you approach the routine checks. Otherwise pacemakers hardly affect normal life. The batteries last about 10 years, and then they are changed with another simple procedure under local anaesthetic.
Our Pacemaker factsheet explains what a pacemaker is and what to expect after your pacemaker has been fitted.
What is an ICD and how will it help my arrhythmia?
An Implantable Cardioverter Defibrillator (ICD) is a small self-contained metal box containing a battery, circuits and connections for leads, which are passed down through veins under the collarbone under local anaesthetic, guided by X-rays. The implantation of an ICD leaves a scar about three inches long and takes about 2 hours. In most cases sedation is given to increase comfort, and may allow patients to have no memory of the implant, but general anaesthetic is not needed.
Often patients can go home the same day, and after a week or two, when the wound has settled a near-normal life can resume. There are sensible restrictions on activity which might damage the ICD box, such as the recoil from a shotgun and competitive swimming which strains the wires. Airport security should be alerted as you approach the routine checks. There are restrictions on driving which are available to read at www.direct.gov.uk/en/motoring/driverlicensing/medicalrulesfordrivers Our ICD factsheet explains what an ICD is and what to expect after your ICD has been fitted.
Will I have to have open heart surgery?
Patients with an arrhythmia who need a procedure to cauterise a short circuit, (catheter ablation procedure) or have a pacemaker or other device fitted do not need heart surgery. These procedures are done under local anaesthetic to freeze the skin, often with some sedation to ease anxiety, but with the patient breathing on their own. Catheter ablation is done through tiny needle punctures in the skin; pacemaker or other devices need small incisions and stitches. It is very unusual nowadays for any arrhythmia patient to need heart surgery.
How long will I be in hospital?
Most arrhythmia treatments can be done as a day case or with one night in hospital.
Should I still be driving?
There are restrictions on driving which are available to here. You can also consult the DVLA website.
Are there any drugs I could take rather than have an arrhythmia procedure?
Drugs are effective for many arrhythmias, but are not a cure. They may give side effects and may have risks associated with their use, such as causing a new arrhythmia in some circumstances. Many doctors will try simple drugs first for conditions that are not life threatening. However, any patient who has a life-threatening arrhythmia should see a heart rhythm specialist and be offered a rhythm control procedure such as catheter ablation or an implantable pacemaker or ICD.
I have Atrial Fibrillation - can you tell me what it is and is there any treatment?
Ectopic beats - are there any treatments for them?
Most ectopic beats are harmless and do not require treatment. If a patient is very symptomatic, medication such as beta blockers may help. Some arrhythmias have an ectopic focus which can be ablated.
I have tested positively for the Long QT gene but am currently showing no symptoms. Should I declare this when applying for travel insurance?
If a clinically unaffected individual takes a predictive genetic test, then this need not be declared to an insurer. In these circumstances, it is encouraged that a genotype positive, phenotype negative individual (not clinically affected) should disclose their family history and phenotypic status, but not the genetic test result.
The school has demanded a carer for my child - how do I obtain someone to help?
Contact your local Education Authority who will help you to obtain an assessment for Special Educational Needs (SEN) - this can lead to the school being provided with extra help to care for your child.
Am I entitled to Disability Living Allowance?
Contact the Welfare Benefits Office in your area and they will help advise and complete the forms if appropriate.
Can I obtain any financial help as I am unable to leave my partner, who needs a carer?
You may be able to claim Carer’s Allowance - contact your local Welfare Benefits Office for advice.