What is an irregular heartbeat?

An irregular heartbeat is what many doctors refer to as arrhythmia. Arrhythmia is inconsistent beating or fluttering of the heart muscle. So either the heart may beat rapidly, a condition known as tachycardia or very slowly, which is what we refer to as bradycardia. However, sometimes, you may not notice anything.

What are the signs?

Some forms of arrhythmia are so silent that you may be unaware you have it. However, common signs include the following:

• Heart palpitations
• Pounding of the chest
• Fatigue
• Chest tightness (angina)
• Perspiration
• Trouble with vision

What causes the condition?

An arrhythmia occurs due to narrowed coronary arteries, hypertension when blood pressure rises and diseased heart valves, previous heart surgery, heart failure and cardiomyopathy.

Another possible cause is sleep apnoea, leading to pauses between breaths. As a result, sleep apnoea can cause a slow heartbeat (bradycardia), inconsistent heartbeats and atrial fibrillation.

How do we diagnose it?

Heart arrhythmia can be diagnosed through the following means:

• An electrocardiogram is a test designed to measure the timing of a heartbeat.
• A Holter monitor can be worn throughout the day to trace the heart's electrical activity.
• An echocardiogram utilises high-powered sound waves to create detailed images of the heart.
• A stress test measures the heart’s electrical activity when the body is placed under stress-induced exercise.

What does treatment involve?

Heart arrhythmia can be treated through the use of medication, such as blood thinners, to reduce the risk of blood clot formation. Medication can prevent an abnormal heart rhythm by controlling the heart rate.

The vagal manoeuvre is assisted heart therapy that controls the vagus nerves (heartbeats) that cause the heart to slow down. Cardioversion is another form of treatment to reset the heart rhythm. Shocks are delivered directly to the heart through patches attached to the chest; this treatment is usually recommended to treat atrial fibrillation.

Surgical procedures to treat arrhythmia include pacemaker insertion, catheter ablation, implantation of a cardioverter-defibrillator and surgery referred to as a maze procedure. For example, catheter ablation is a procedure whereby catheters are threaded through the blood vessels meticulously. Electrodes attached to either side of the catheter release energy (hot or cold) to create scar tissue. Small scars help control the heart’s abnormal electrical signals.