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ConditionsGeneral information

Arrhythmias

A heart rhythm disorder — a change in the rate, sequence or regularity of the heartbeat.

Detailed articles: 3

Reviewed by a doctorSherzod Nasirovich SabirovCardiologist-arrhythmologist

Short answer

Arrhythmia means a change in the rate, sequence or regularity of the heartbeat. Some rhythm disorders are safe, while others require monitoring or treatment.

To assess the situation, a doctor’s examination, an ECG and, if needed, Holter monitoring are usually used.

This is general information and does not replace diagnosis or treatment. If you have symptoms, see a doctor.

  1. Sinus node
  2. AV node
  3. Bundle of His
  4. Bundle branches
The heart's conduction system. Schematic image, not a patient recording.

Reviewed by a doctor

In detail: articles on this topic

Seeing a doctor6 min read

Who is an arrhythmologist and when should you see one?

An arrhythmologist is a cardiologist with additional training in heart rhythm disorders. If your heartbeat is irregular, if it comes with dizziness, chest pain or shortness of breath, or if your watch shows an unusual rhythm, see a doctor. Whether you need a cardiologist or an arrhythmologist is decided by the doctor at the appointment. Bring your previous ECG results, a list of your medicines and a symptom diary to the appointment.

In the article:

  1. Who is an arrhythmologist and how do they differ from a cardiologist?
  2. When should you see a doctor?
  3. What should you bring to the appointment?
  4. Which family history should you tell the doctor about?
  5. What usually happens at the first appointment, and who makes the decision?
  6. Frequently asked questions
Read the paper

Tests7 min read

ECG, Holter or long-term monitoring: which test answers which question?

An ECG gives a recording of the heart rhythm at that moment, while Holter monitoring usually keeps recording for 24–48 hours. The choice depends on how often the symptoms occur: if almost every day, a Holter; if less often, an external recorder worn for up to about one month; if less than once a month, an implantable monitor. The doctor decides which one you need. For severe chest pain, shortness of breath or fainting, call 103.

In the article:

  1. What does a standard ECG show, and why is it sometimes not enough?
  2. What is Holter monitoring, and who is it suitable for?
  3. Which monitoring is chosen if symptoms are infrequent?
  4. What other tests may be needed?
  5. How should you prepare for the test, and what should you tell the technician?
  6. Frequently asked questions
Read the paper

Lifestyle6 min read

What speeds up the heartbeat and what can you do to reduce arrhythmia?

The state after exercise, excitement, an infection, anxiety, caffeine and alcohol may speed up the heartbeat or make you feel it. The 2024 ESC/EACTS guidelines on atrial fibrillation, in turn, recommend keeping high blood pressure, diabetes, weight, breathing during sleep, physical activity and alcohol under control. These recommendations are specifically for fibrillation and are not a rule for everyone: the plan is made with your doctor.

In the article:

  1. What may speed up the heartbeat or make you feel it?
  2. What can be said about caffeine, alcohol and anxiety?
  3. Which conditions raise the risk of atrial fibrillation?
  4. What do the guidelines say about weight and physical activity?
  5. What should you do if you suspect sleep apnea?
  6. When should you see a doctor?
  7. Frequently asked questions
Read the paper

Frequently asked questions

Is an arrhythmologist different from a cardiologist?

An arrhythmologist is a cardiologist with additional training in heart rhythm disorders. According to the EHRA practical guide, unusual rhythm findings are assessed by a team that includes an arrhythmologist or a cardiologist. The doctor determines at the appointment which specialist you need.

Answer from the article: Who is an arrhythmologist and when should you see one?

What is the main difference between an ECG and a Holter?

An ECG records the rhythm over a short time, while a Holter usually keeps recording for 24–48 hours during everyday life. If a symptom comes and goes, a recording made exactly during the symptom is the most important, so a method that records for longer may be needed.

Answer from the article: ECG, Holter or long-term monitoring: which test answers which question?

Do I need to give up caffeine completely?

The ESC sources in this article give no limit for caffeine. AFib Matters only names caffeine as a possible trigger. Watch whether you feel your heartbeat after caffeine, write it down in a diary and discuss it with your doctor.

Answer from the article: What speeds up the heartbeat and what can you do to reduce arrhythmia?

What procedures does an arrhythmologist perform?

The work mentioned in the ESC guidelines: catheter ablation, the electrophysiology study, implantation of a pacemaker or an ICD, and long-term monitoring. Not every patient needs them; whether you need them is decided by the doctor together with you.

Answer from the article: Who is an arrhythmologist and when should you see one?

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