The first week in June marks World Heart Rhythm Week, so we’ll be discussing a few aspects of heart rhythm in this article.

It is said that one of the reasons music is so powerful is because the pulses in our favourite songs remind us of our heartbeats. This is life itself. We have written extensively on how the Bee Gees song ‘Staying Alive’ gives the correct timing for getting the blood to move through the body when applying cardio-pulmonary resuscitation (CPR).

But what happens if our heartbeats become irregular? How much of a concern is this, and what can we do about it?

What is heart arrhythmia?

When the rhythm of the heart is either too fast, too slow or irregular, you have heart arrhythmia. It happens when the electrical impulses that manage your heartbeat do not work properly. The old English saying, “Be still my beating heart” comes to mind, though this is often linked to the heart flutter you might get when you see someone that you’re instantly drawn to. When the heart flutters or races this may mean nothing, but it could also be linked to some form of irregular heartbeat, or at the other extreme, some sort of heart damage.

The heart is made up of four chambers, with two at the top (atria) and two at the bottom (ventricles). The heart’s rhythm is maintained by a natural pacemaker (a sinus node) contained in the right upper chamber, which produces electrical pulses that start the heartbeat and cause the atria to contract and push blood into the ventricles. Here, a second delayed pulse (caused by the atrioventricular node) causes the ventricles to contract and push blood out of the heart, where it then flows to the lungs and the rest of the body, giving the body its lifeblood.

Your doctor will be able to tell you if the irregularity is emanating from the top of your heart (atria) or bottom (ventricles), and whether the irregular rhythm is fast (known as tachycardia), where the resting heartbeat is more than 100 beats per minute, or slow (known as bradycardia), where the resting heartbeat is less than 60 beats per minute.

One of the most common types of irregular heartbeat is known as atrial fibrillation, or AF, which is caused by uncoordinated electrical impulses in the atria, and which may require treatment if it cannot be brought under control – it can be associated with stroke.

AF, also known as AFib, affects as many as 33 million people around the world. Some 2% of people younger than 65 may have it, while it occurs in around 9% of people over 65.

What does it feel like?

People affected by arrhythmia tend to feel a fluttering in the chest, a slow or racing heartbeat, chest pain, shortness of breath, anxiety, fatigue, dizziness or feeling lightheaded, sweating, and fainting. Remember that exercise will drive up your heartbeat, so if you’ve just walked a flight of stairs and your heart feels like it’s popping out of your chest, this might not be arrhythmia. Likewise, your heart rate will slow down when you sleep, so this may also not be cause for concern.

Who is most at risk?

Like many lifestyle diseases, irregular heartbeat can be aggravated by a lifestyle of excess from too much alcohol or caffeine, smoking, high blood pressure, drug abuse, excessive use of over-the-counter medicines, obesity, diabetes, coronary artery disease, and stress or anxiety. Genetics can also play a factor.

Scarring of heart tissue from a heart attack, having an over- or underactive thyroid, electrolyte imbalance, sleep apnoea and infection with COVID-19 can also cause arrhythmia, and it can lead to a stroke.

What can I do to deal with the problem?

The first thing you need to do is determine if you have a problem, which will require a trip to your doctor, and then, if need be, a specialist. Tests will be done, such as an ECG, a stress test, or other types of tests.

The usual lifestyle changes apply here as with any disease – avoid smoking, cut back on salt and sugar, drink lots of water, watch those fatty meats, get enough water-soluble fibre into your diet, eat fruit and vegetables daily, and exercise.

In some cases, you will need medication, for example, to control thyroid problems or blood pressure. Depending on the extent of the irregular heartbeat, you may also need medication to control this, which may include anticoagulants to thin your blood. Invasive therapies such as having a pacemaker installed or heart surgery may be required, but don’t let this unnerve you. Your heart may be fine. Have a chat with a doctor in the know – someone you can trust. If your heart has a problem, at least you’ll know. If it doesn’t, your heart will feel much lighter anyway.

The lenmed Group is a world-class chain of Private Hospitals that brings quality healthcare to communities across Southern Africa.

For more information please contact:

Dr James Fortein, Cardiologist
MB ChB Free State, FCP (SA), Mmed (Int), Cert Cardiology (Phys), 2020 CMSA
Royal Hospital and Heart Centre
Tel: +27 (0) 53 045 0560
Email: jfortein@gmail.com or info@lenmed.co.za

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis.