Abnormal heart rate

What is an abnormal heart rate?

An abnormal heart rate (also known as arrhythmia) is when your heart is beating too fast, too slow, or your rhythm is irregular.

Your heart relies on an electrical system to help pump the heart so blood can travel around the body to deliver key nutrients and oxygen. If this system is disrupted, it can cause abnormalities in your heart’s rate. This can trigger additional symptoms.

In some cases, people won’t experience symptoms and go about their day-to-day without knowing they have an issue.

You may experience the symptoms of arrhythmia, but they are not related to a heart issue. However, it is important to speak to a medical professional about your condition and investigate further.

Abnormal heartbeats, alongside other symptoms such as shortness of breath, fainting, and chest pain, can be a sign of a more serious condition such as a heart attack. If you believe you are experiencing a medical emergency, please contact 999 for immediate medical treatment.

Risks

Several modifiable factors can put you at risk of triggering arrhythmia, including limited physical activity, alcohol and caffeine consumption, tobacco use, stress and anxiety, recreational drugs, certain medications, or dehydration.

There are ways of improving your lifestyle and habits if these factors are a cause of your condition.

Non-modifiable factors that can put you at a higher risk of developing an abnormal heart rate include family history, gender, ethnicity, and age.

You cannot change these factors, but there is a way to improve your health and lifestyle to ensure that your risk isn’t further heightened.

Types of irregular heart beats

Irregular heartbeats can present themselves in many different ways. We have listed some of the types that may present themselves depending on your condition.

Bigeminy

This causes an extra heartbeat to develop between every normal one. It can start in different parts of your heart, either in the upper or lower chambers of the heart (atria or ventricles). This condition can be the result of other issues such as anaemia or high blood pressure.

Trigeminy

This causes the bottom of the heart to beat slightly out of rhythm compared to ‘normal’. This is also known as premature ventricular contraction (PVC). When this occurs every third heartbeat, this is called a trigeminy.

Ectopic heartbeats

This causes your heart to beat too soon, before it is supposed to. It can start in different parts of your heart, either in the upper or lower chambers of the heart (atria or ventricles). This can be caused by environmental factors such as stress or too much caffeine. It can also be triggered by conditions such as atrial fibrillation.

Heart rate variability

Heart rate variability (HRV) is the measure of variation in time between each heartbeat. These variations are slight, adding or subtracting a fraction of a second between beats. It is normal to have a variation in your heart rate as the heart tackles day-to-day activities and responds to the body’s needs. These variations are influenced by the balance between the sympathetic (fight-or-flight) and parasympathetic (relaxation) nervous systems. 

Higher HRV is generally associated with better health and resilience to physical stress. Lower HRV may indicate health issues or that your body is less resilient and struggles to handle changing situations.  

Low HRV has been strongly linked with increased risks of cardiovascular issues, such as cardiac ischemia (reduced blood flow to the heart), coronary artery disease, and sudden cardiac death syndrome. Studies have found that less variation in your heart rate might mean your body has a harder time controlling blood flow and increases inflammation. Both of these factors are linked to cardiovascular disease.  

HRV can be self-monitored using smart devices and is influenced by factors such as physical activity, sleep quality, stress levels, and overall fitness. Monitoring your HRV can help you reduce your risk of a heart condition or developing further complications. This is because it can help detect cardiovascular issues early and aid in targeted prevention strategies. 

To learn more about heart rate variability, read our blog, ‘Heart Rate Variability: The Next Frontier in Fitness with Dr Ravi Assomull’. 

Causes

Abnormal heart rate can be the result of many heart conditions. These include:

• High blood pressure
• Narrowed heart arteries
• Heart disease, including valve and coronary artery disease
• Heart failure
• A heart attack

Congenital heart defects can also commonly cause arrhythmia. We have detailed some that may affect you.

Long QT syndrome (LQTS)

This condition causes a delay in your heart’s electrical system as your heart takes longer than usual to recharge between beats, resulting in arrhythmia. It is often inherited but can be caused by some medications such as anti-arrhythmic medicines or antihistamines.

Wolff-Parkinson-White Syndrome

This condition causes an extra electrical connection in the heart, resulting in the heart beating abnormally fast for brief periods of time. It is inherited, although symptoms may not develop until later in life. 

Diagnosis

During your initial appointment, we will assess your symptoms and evaluate your medical and family history. This will help us determine your risk of developing a heart concern.

If we suspect a heart issue, we will investigate further to determine what may be troubling you. Detecting a heart rhythm issue can involve a series of tests. The most common is an ECG, as it can give us a snapshot of your heart’s electrical activity. If we detect anything unusual with the heart, we may conduct further tests.

Treatment

Treatment will depend on what we discover and your individual needs. We may suggest options such as medications or surgery to help tackle your condition.

However, our first suggestion will be to implement key lifestyle changes to make sure you are as healthy as possible and reduce your risk naturally. These changes may include:

• Implementing a healthy diet and regular exercise routine
• Quitting smoking, drinking, and taking recreational drugs 
• Implementing stress management techniques such as yoga, meditation, and tai chi