What is Atrial Arrhythmia?

Atrial arrhythmia is a disorder that affects an individual’s heart rhythm. A variety of behavioral and physiological factors may contribute to the development of an atrial arrhythmia, or irregular heart rhythm. Immediate treatment for this condition involves restoring normal rhythm to the heart muscle and may require the administration of long-term treatment to ensure normal rhythm stability.

Arrhythmias of the heart occur when there is a disruption in the electrical conductivity of the heart muscle. When the heart is functioning normally, all the chambers contract in an organized fashion. The sinoatrial node (SA node) is essentially the pacemaker that establishes and maintains heart rhythm while sending out electrical impulses to the four chambers of the heart. An arrhythmia may present as either a fibrillation or flutter, depending on whether it is the upper or lower chambers of the heart that receive impaired electrical impulses.

If the electrical signals traveling from the SA node to the heart's upper chambers are somehow scrambled into an irregular pattern, the impaired electrical impulses induce premature contractions of the muscle, thus promoting an irregular, accelerated heartbeat. Individuals who develop this form of elevated, irregular rhythm are said to have an atrial fibrillation. An atrial flutter occurs when the lower chambers of a person's heart receive the impaired impulses. Those who are diagnosed with this condition often exhibit an elevated heart rate that still possesses a regular rhythm.

There are several situations that may contribute to the development of an atrial arrhythmia. Behaviors such as binge drinking and recreational drug use can be taxing on the heart muscle, leading to the development of an arrhythmia. Medical conditions, including coronary heart disease, hyperthyroidism, and pericarditis, may also contribute to an irregular heart rhythm. Additionally, the regular use of certain medications and heart surgery may lead to a diagnosis of an atrial arrhythmia.

Individuals with an atrial arrhythmia may remain asymptomatic, meaning they exhibit no symptoms at all. Others may develop sporadic or chronic signs that their heart rhythm has become irregular. Common symptoms indicative of an atrial arrhythmia may include fatigue, dizziness, and light-headedness. Some individuals may develop episodic bouts of confusion or fainting. Additional signs may include heart palpitations, shortness of breath, and an abnormal pulse.

Considering most individuals with an atrial arrhythmia remain asymptomatic, an irregular heart rhythm is usually discovered during routine examinations or during the course of treatment for a secondary condition. Upon discovery, an individual may be referred for additional testing that may include a treadmill test, echocardiogram, and coronary angiography, which are used to evaluate the overall condition of the heart muscle. Additional diagnostic tests may include an electrocardiogram (ECG) and Holter monitor to assess the electrical conductivity of the heart.

Treatment for an atrial arrhythmia may be initially centered on restoring normal rhythm to the heart. In some cases, emergency treatment may involve the intravenous administration of drugs or application of electrical cardioversion, or electrical shock, to restore proper heart rhythm. Blood thinners may be recommended as a precautionary measure to prevent the risk for blood clots and stroke. Some individuals may require the administration of long-term drug therapy to ensure that their heart rhythm remains stabilized.

Depending on the cause for the arrhythmia, drug therapies may be used to either speed up or slow down an individual’s heart rate. Medications used to slow rhythm may include calcium channel blockers and beta-blockers. Other anti-arrhythmic medications may be employed to regulate rhythm, but may carry significant risks for side effects in some individuals. Before starting any prescription medication regimen, both benefits and risks should be discussed with a qualified health care provider.

Most atrial arrhythmias are considered to be manageable conditions with timely and appropriate treatment. Though an irregular heart rhythm has the potential to be either a recurrent or chronic condition, those who follow the direction of their health care provider usually do well. Complications associated with this condition include stroke and heart failure.