Arrhythmia: What Causes an Irregular Heartbeat and What You Can Do

An arrhythmia is any change from the normal rhythm of your heart. Sometimes it's a harmless extra beat you notice as a skip or flutter. Other times it signals a more serious problem that needs treatment. You can learn to spot common signs, know when to get checked, and understand main treatment options.

What to feel and watch for

Palpitations—fast, fluttering or pounding heartbeats—are the most common symptom. You might also feel dizzy, short of breath, weak, or experience chest discomfort. If you faint or have severe chest pain, call emergency services right away.

Common causes explained Many things can trigger an arrhythmia. Heart disease, previous heart attack, high blood pressure, valve problems, and scarring of heart tissue are common medical causes. Non-heart causes include thyroid issues, low or high potassium and magnesium, fever, heavy alcohol use, caffeine, nicotine, and some medicines. Stress and lack of sleep can make symptoms worse.

How doctors diagnose it First-line tests are an electrocardiogram (ECG) and a review of symptoms. If your ECG looks normal, your doctor may send you home with a Holter monitor (24–48 hours) or an event recorder to catch intermittent episodes. An echocardiogram checks heart structure, and blood tests look for thyroid or electrolyte problems. More advanced testing includes an electrophysiology study when doctors need to map where the abnormal beats start.

Treatment options that work Treatment depends on the type and cause. For occasional, harmless palpitations, simple fixes like cutting back on caffeine, alcohol, and stopping stimulants often help. For persistent or risky arrhythmias, medications such as beta-blockers, calcium-channel blockers, or antiarrhythmic drugs can slow or control the rhythm. If atrial fibrillation raises stroke risk, anticoagulants are usually recommended.

Procedures and devices When medicines aren't enough, procedures can fix the problem. Electrical cardioversion can reset the rhythm. Catheter ablation targets and destroys the tiny area causing the abnormal signals. People with very slow rhythms might need a pacemaker. In life-threatening cases, an implantable cardioverter-defibrillator (ICD) prevents sudden cardiac arrest.

Everyday tips to manage risk Keep blood pressure and diabetes under control, avoid excessive alcohol, cut back on caffeine if it triggers palpitations, and get regular sleep. Track symptoms in a simple log—note when palpitations happen and what you were doing. Bring that log to your appointments; it helps your doctor connect triggers to episodes.

When to get urgent help

Call emergency services if you have severe chest pain, fainting, sudden shortness of breath, or a fast heartbeat that lasts more than a few minutes and makes you feel unwell.

Arrhythmias can be frightening, but many are manageable. Talk openly with your doctor, ask about tests that match your symptoms, and don’t ignore warning signs.

If you live with an arrhythmia, carry an up-to-date list of medications and allergies, wear a medical ID if advised, learn CPR, and schedule regular follow-ups. Ask your clinician about drug interactions, activity limits, and when it's safe to drive or fly after episodes.