Arrhythmia

Key facts

• Arrhythmia means the heart beats too fast, too slow, or with an irregular pattern because of a fault in its electrical timing system.
• Common causes include coronary artery disease, high blood pressure, thyroid disorders, electrolyte imbalances, stimulant use, and aging.
• Atrial fibrillation is the most common sustained form; treatment uses rate-control drugs like metoprolol and atenolol, or amiodarone for persistent cases.
• Seek urgent care for palpitations combined with chest pain, breathlessness, fainting, or fluttering that doesn't settle within a few minutes.

Why it happens

The heart's electrical pathway can be disturbed by coronary artery disease, high blood pressure, thyroid disorders, electrolyte imbalances, stimulant use, or simply aging. Atrial fibrillation (AF) is the most common sustained form of arrhythmia and becomes more likely as people age and rates of hypertension climb.

How it is managed

Treatment depends on the type and severity. Rate-control medicines slow a racing heart, while rhythm-control agents aim to restore a regular beat. Beta-blockers such as metoprolol and atenolol are a common first step for rate control in AF and certain other fast rhythms. Calcium channel blockers such as verapamil are used when beta-blockers aren't suitable. For persistent or complex arrhythmias, amiodarone is a potent antiarrhythmic that can restore and maintain a normal rhythm, though it needs careful monitoring over time. All of these sit within the broader heart and blood pressure group of treatments.

Warning signs to take seriously

Occasional mild palpitations are common and often harmless. Seek urgent care for palpitations combined with chest pain, breathlessness, fainting, or a sense that the heart is fluttering uncontrollably for more than a few minutes. These could signal a rhythm problem that needs prompt assessment.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.