My first experience with a heart arrhythmia was as a young athlete. Pulling up to a belay after a hard rock-climbing pitch, my heart began to beat abnormally fast. I became slightly dizzy and felt shortness of breath – an awkward and frightening experience, especially as I was cliffside, perched hundreds of feet above the ground. After a few moments of focus and deep breathing, my heart bounced back to a regular beat, and my life continued without issue for several years.
A heart arrhythmia is an irregular heartbeat and occurs when the electrical signals that tell the heart to beat are missent or disrupted. The heart may beat too fast or too slow, the pattern sporadic or inconsistent. A heart arrhythmia may feel like a fluttering, pounding or racing heartbeat. Some heart arrhythmias are harmless, while others may cause life-threatening symptoms.
Many years after my first symptoms, I began to experience rapid heartbeats more frequently, especially during sessions of skiing, cycling and climbing — activities making up the bulk of my lifestyle. After testing, my cardiologist diagnosed me with Atrial Fibrillation. Atrial fibrillation is a quivering or irregular heartbeat, commonly referred to as AFib or AF, which, when left unchecked, can lead to blood clots, stroke or heart failure. According to the American Heart Association, over 12 million people are projected to have AFib by 2030.
In general, heart arrhythmias are grouped by the speed of the heart rate. Tachycardia is a fast heartbeat, where the heart rate is greater than 100 beats a minute, and bradycardia the slower heartbeat cousin, where the rate is less than 60 beats a minute. But a low resting heart rate doesn’t always mean there’s a problem. If you’re physically fit, your heart may be able to pump enough blood to the body with fewer than 60 beats a minute. According to the American College of Cardiology, several case studies over the last 20 years have shown a complex relationship between endurance exercise and the increased risk of developing AFib. The studies have shown that at low to moderate levels of exercise, the risk of AFib is lower, but surprisingly, as exercise intervals and intensities are increased, the risk benefits actually decrease, meaning there is a higher rate of contracting AFib.
Normally, your heart contracts and relaxes to a regular beat, but in AFib, the upper chambers of the heart, or the atria, beat like a 4-year-old on the drums; chaotic and irregular. Because not enough blood is being pumped out of the atria, blood pools in the area. The pooled blood can clot – which can be extremely dangerous. If a blood clot forms, it can be pumped out of the heart to the brain, blocking the blood supply to the brain and causing a stroke. The clot risk is why patients with this condition (like me) are prescribed blood thinners. Untreated AFib doubles the risk of heart-related deaths and is associated with a fivefold increased risk for stroke. Yet many people are unaware that AFib is a serious condition. I was one of those people.
My AFib developed into Persistent Afib, where I was consistently out of sinus rhythm — the balanced and natural beat of the heart. My treatment started with cardioversion, where an electric impulse shocks the heart back to normal. After multiple attempts, it was recommended to receive an ablation, a minimally invasive surgery where the extra heartbeat impulse areas are cauterized. I am now one year post surgery, have been in sinus rhythm, and am enjoying the return to a more normal exercise life.
Terms to know:
Atrial flutter is similar to AFib, but the heartbeats are more organized. Atrial flutter also is linked to stroke.
Supraventricular tachycardia: A broad term which includes irregular heartbeats that start above the lower heart chambers, called the ventricles. Supraventricular tachycardia causes episodes of a pounding heartbeat that start and stop suddenly.
Ventricular fibrillation: Rapid and chaotic electrical signals cause the lower heart chambers to quiver instead of squeezing in a coordinated way. This serious problem can lead to death if a regular heart rhythm isn’t restored within minutes. Most people with ventricular fibrillation have an underlying heart disease or had a serious injury. Ventricular fibrillation is an emergency that needs immediate medical help. It’s the most frequent cause of sudden cardiac death.
Ventricular tachycardia: A rapid, irregular heart rate that starts with faulty electrical signals in the lower heart chambers, called the ventricles. The rapid heart rate doesn’t let the ventricles properly fill with blood, so the heart may not be able to pump enough blood to the body. Ventricular tachycardia may not cause serious problems in people with otherwise healthy hearts. In those with heart disease, ventricular tachycardia can be an emergency that needs immediate medical care.
Premature heartbeats: Extra beats that occur one at a time, sometimes in patterns that alternate with a regular heartbeat. If the extra beats come from the top chamber of the heart, they are called premature atrial contractions (PACs). If they come from the bottom chamber, they are called premature ventricular contractions (PVCs). A premature heartbeat may feel like your heart skipped a beat. These extra beats are generally not a concern. They rarely mean you have a more serious condition. Still, a premature beat can trigger a longer lasting arrhythmia, especially in people with heart disease. Occasionally, having very frequent premature ventricular beats may lead to a weak heart. Premature heartbeats may occur when resting. Stress, heavy exercise and the use of stimulants, such as caffeine or nicotine, also may cause premature heartbeats.
This article appears in Source Weekly July 18, 2024.
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