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Understanding the Types of Arrhythmia: In Plain English

“My heart skipped a beat when I saw you” is more than just a cute saying.

Our hearts physically respond to excitement, fear, and even love. They also react to other stimuli, such as food, drink, and illness. An occasional skipped beat is usually nothing to worry about. However, if it happens regularly, you might have an arrhythmia. Read on to learn about the different types of arrhythmia — in words you can actually understand.

What is an arrhythmia?

The heart is a fist-sized muscle responsible for pumping oxygen-rich blood throughout the body. It is equipped with its very own electrical conduction system, and the four chambers of the heart beat according to the electrical stimuli. The heart’s electricity typically follows the same route, as if it were driving down a familiar road. 

In a healthy heart, the electrical system causes the heart to contract at a regular rate and rhythm. Normally, the adult heart beats anywhere from 60-100 times per minute when the body is at rest. While there is slight variability, the rhythm is generally regular, meaning that it beats at a pace with similar intervals of rest between each contraction. A heart beating with a steady rate and rhythm is said to be in “normal sinus rhythm (NSR).” 

Sometimes, the heart’s electrical system misfires, causing the heart to beat fast, slow, or in an erratic pattern. A palpitation is the “feeling” or symptom experienced from the skipped or abnormal beat. However, you could even experience a palpitation feeling when your heart is in normal sinus rhythm (NSR).  An arrhythmia is when the electrical impulses in the heart don’t work properly, also known as an irregular heartbeat.

While some arrhythmias are harmless, others have the potential to be dangerous. The heart works best when it beats according to a regular rate and rhythm. When this pattern is interrupted, the heart pump works less effectively.

What causes arrhythmia?

Many different factors can cause an irregular heartbeat. Oftentimes, these abnormal beats are nothing more than a quick and harmless misfiring of the heart. Simple actions such as a cough or a sudden change in position can trigger an occasional abnormal beat or two. Other reversible causes of an irregular heartbeat include: 

  • Stress or anxiety
  • Caffeine
  • Alcohol
  • Nicotine
  • Electrolyte imbalances
  • Dehydration
  • Exercise 
  • Medication use
  • Diet imbalances

Other times, heart palpitations are red flags for an impending arrhythmia. Arrhythmias can be caused by an underlying disease, such as diabetes, thyroid disorder, high blood pressure, heart disease, sleep apnea, or recent infection.

Some arrhythmias result from scar tissue on the heart or problems with the heart valves. Finally, arrhythmias are occasionally caused by problems with the heart’s electrical circuitry. 

If you wonder why your heart is beating irregularly, consider it your body’s attempt to get your attention. The human body is made for health. When something is out of balance, your body will almost always find a way to let you know before it becomes a bigger problem. 

What are the types of arrhythmias?

Arrhythmias are often classified according to their rate. An adult’s resting heart rate is typically between 60 and 100 beats per minute (BPM). A heart rate faster than 100 BPM is called tachycardia. As long as the rhythm is normal, the person is in sinus tachycardia. Common causes of sinus tachycardia are exercise, stress, and caffeine. 

When a heart rate falls below 60 BPM, the individual has bradycardia. Again, if the rhythm is normal, the individual is in sinus bradycardia. 

Keep in mind that there are reasons why a heart rate might be low in a healthy individual. For example, athletes tend to have lower resting heart rates. A heart rate might fall below 60 BPM during sleep and may elevate with exercise or stress. While many reasons for a low heart rate are not concerning, sinus bradycardia can also be the first sign of an unhealthy heart. 

The origin of the irregular beat further classifies arrhythmias. The heart has four chambers. The top two are the atria, and the bottom two are the ventricles. Sometimes the problem begins at the top of the heart, while the issue is lower at other times. 

Supraventricular arrhythmias

These abnormal rhythms begin above the ventricles, in the atria or AV node of the heart. They typically produce a very rapid heart rate. A fast heart rate that starts above the ventricles is also called supraventricular tachycardia (SVT). Some examples of supraventricular arrhythmias include: 

  • Atrial fibrillation (AFib) – The most common type of heart arrhythmia, AFib, occurs when the heart’s upper chambers beat in a fast and irregular rhythm due to chaotic electrical activity. 
  • Atrial flutter– Similar to AFib, this abnormal heart rhythm originates in the heart’s upper chambers. However, atrial flutter makes the heart beat fast in an organized, regular pattern instead of an irregular rhythm. 
  • Atrioventricular reentrant tachycardia – This abnormal rhythm occurs due to an extra pathway in the AV node of the heart. Instead of a normal electrical path from the upper part of the heart to the lower, electricity travels in circles.

Ventricular arrhythmias

These more dangerous arrhythmias begin in the ventricles of the heart. 

  • Premature ventricular contractions (PVCs) – These abnormal beats are the most common cause of an irregular heartbeat. PVCs are unpredictable, early beats that originate in the ventricles instead of the atria. They are typically not a reason for significant concern unless they happen repeatedly.
  • Ventricular tachycardia (VTach) – This condition occurs when the heart’s normal pacemaker, the SA node, fails to control the heart rate. Instead, the electrical impulses start in the ventricles and cause the heart to beat very fast.  
  • Ventricular fibrillation (VFib) – This life-threatening condition occurs when multiple electrical signals are firing at once, creating irregular, chaotic, and ineffective contractions of the ventricles. 

When the electrical signal from the upper part of the heart to the lower part becomes blocked or impaired, heart block can occur. There are several different kinds of heart blocks, and they are named according to how severe or what degree the heart block is. 

How are arrhythmias diagnosed?

Diagnosing arrhythmias can be challenging for several reasons. First, they are often unpredictable. If they happen sporadically and at unexpected times, capturing them at the doctor’s office can be challenging. Additionally, the symptoms of the many different types of arrhythmias often overlap. Fatigue, weakness, shortness of breath, dizziness, and pounding in the chest can occur with all of the abnormal rhythms. 

If you wonder why your heart is beating irregularly, you should seek help from your medical provider. A thorough cardiac exam may include multiple diagnostic tests, including:

  • Electrocardiogram (EKG or ECG) – An EKG measures the electrical signals of the heart. It’s the most important diagnostic tool in evaluating the heart. However, because it’s just one snapshot in time, it can miss critical cardiac events.
  • Echocardiogram (Echo) – An echocardiogram uses sound waves to take photos of the heart. An echo can detect any structural abnormalities or changes to the heart. 
  • Holter monitor or other wearable monitors – These portable EKGs measure the heart’s electrical signals for a more extended period. Wearable monitors can be worn anywhere from 24-hours up to two weeks at a time. 
  • Cardiac mapping – More severe cardiac arrhythmias may require an electrophysiology (EP) study. This invasive surgery maps the heart’s electrical activity to determine the cause of the abnormal heart rhythm. 

How do I stop my arrhythmia?

As with all diseases, it’s essential to identify the root cause of your abnormal heart rhythm. After all, treating the arrhythmia without understanding the “why” behind it will only be a temporary fix. 

There are some simple things that you can immediately try at home that may help to reduce or eliminate your irregular heartbeat.  

  • Eat a clean, 100 Year Heart Diet
  • Eliminate alcohol use
  • Increase quality water consumption
  • Get good sleep
  • Reduce your exposure to toxins
  • Check your caffeine intake 
  • Manage stress 
  • Work with your doctor to determine any vitamin or mineral deficiencies

Some types of heart arrhythmias will require medical intervention, so always seek assistance from your healthcare provider. However, even if you require medical treatment, getting your body to its best state of health will optimize your chances of a successful recovery. 

Next steps 

Our hearts are very good at giving love to others, but are you giving your heart enough love in return? Sometimes irregular heartbeats are just our heart’s way of sending a signal that something is out of balance. If you take the time to listen to your body and treat it kindly, you might be able to avert a more significant health disaster. Fill out an application today to work with NHD’s expert practitioners and start working towards your 100 Year Heart.

Eat well, Live well, Think well

Medical Review: Dr. Lauren Lattanza 2022

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About Dr. Keith Smigiel NP, DC

Dr. Keith Smigiel

Dr. Keith Smigiel is a regenerative medicine physician and pain management specialist. He takes an integrative approach to medicine, focusing on customized solutions tailored to individual needs. Using advanced, non-surgical treatments, Dr. Smigiel stimulates your body’s ability to naturally heal itself.

Dr. Smigiel helps people suffering from conditions such as chronic pain and erectile dysfunction, to hair loss and weight gain. Combining treatments such as PRP Therapy, Ozone, Neural Prolotherapy, and IV Infusions with functional rehabilitation, he helps you look and feel better.

He heals the body, instead of just treating the symptoms!

With his professional qualifications as a certified family nurse practitioner, a doctor of chiropractic, and a fellow of the International Academy of Medical Acupuncture, Dr. Smigiel offers patients comprehensive care from a broad perspective of conventional and alternative medicine. He also has extensive experience in functional rehabilitation and chronic pain management.

Dr. Smigiel is married to Angela and has two children, Sophia and Larz. When he’s not busy helping patients, he enjoys hiking, mountain biking, motocross, and boating.

About Dr. James Kneller, M.D., Ph.D., FHRS

Dr. James Kneller, M.D., Ph.D., FHRS

Dr. James Kneller is one of the nation’s leading heart rhythm specialists. Dr. Kneller is certified by the American Board of Internal Medicine (ABIM) in Clinical Cardiac Electrophysiology, Cardiovascular Disease, and Internal Medicine.

As a Fellow of the Heart Rhythm Society (FHRS) and Certified Cardiac Device Specialist (CCDS), Kneller provides comprehensive patient care, combining best medical practice with invasive procedures using state-of-the-art technologies to treat heart rhythm disorders.

Beyond guideline-directed therapies, Kneller is passionate about optimized personal health. With a deep interest in complimentary alternative medicine (CAM), he strives to reduce the need for pharmaceuticals, invasive procedures, and exposure to harmful radiation. With Natural Heart Doctor, he strives to help each and every client to Live Well, Eat Well, and Think Well to attain their 100-year heart!

About Dr. Lauren Lattanza NMD, FACC

Dr. Lattanza Office Visit with Patient

As a Naturopathic Physician, I am trained to treat the whole person and get to the root cause of disease.

I went to Arizona State University where I graduated with a bachelor’s degree in psychology with a depth in physiology and minor in Spanish. After my undergraduate degree I was working on prerequisite classes towards medical school, which is when I came to learn that my values identified best with the principles of naturopathic medicine. I knew that I wanted to help patients identify the causes of disease and be able to offer treatments which would improve their health rather than simply treating symptoms.

I dedicated the next 4 years to the Southwest College of Naturopathic Medicine in Tempe, Arizona where I attained my Doctorate of Naturopathic Medicine. I served as Class President all 4 years, Board of Trustees – Student Trustee, spoke as the Club President for our branch of Toastmasters, and was voted by my peers and attending physicians to earn the Outstanding Leadership Award for the Class of 2020. Throughout medical school I took it upon myself to work alongside MDs, DOs, chiropractors, and functional medicine practitioners in addition to naturopathic physicians.

As a Spanish speaking student, I was able to volunteer with community clinics around Phoenix and provide free healthcare to low-income families. Due to this combined exposure, I came to find my passion in treating cardiometabolic and digestive disorders that are all too common, yet largely preventable. I took the opportunity to learn the broad spectrum of healthcare so I can ensure that I am able to provide my patients with the best options.

About Dr. Jack Wolfson DO, FACC

Dr. Wolfson Office Visit with Patient

Dr. Jack Wolfson is a board-certified cardiologist, Amazon best-selling author, husband, father, and the nation’s #1 Natural Heart Doctor.

For more than two decades, more than one million people have enjoyed the warmth, compassion, and transformational power of his natural heart health courses and events.

Dr. Wolfson is the founder of Natural Heart Doctor Scottsdale, his heart health practice in Arizona, and Natural Heart Doctor, an online resource center with natural health information. Doctors from across the globe reach out to Dr. Wolfson for training and education in holistic health practices.

He has been named one of America’s Top Functional Medicine Doctors and is a five-time winner of the Natural Choice Awards as a holistic M.D. Dr. Wolfson’s work has been covered by more than 100 media outlets, including NBC, CNN, and the Washington Post. His book “The Paleo Cardiologist: The Natural Way to Heart Health” was an Amazon #1 best-seller.

Dr. Wolfson and his wife Heather have four children and are committed to making the world a better place to live. They provide for those in need (including animals) and support natural health causes through their philanthropic efforts.

Chiropractic

Our chiropractor is an expert at adjustments and holistic chiropractic care and works closely in conjunction with the other health care experts at Natural Heart Doctor.

Call (480) 535-6844 for details and scheduling.

IV Therapy

We use specially formulated natural vitamins and minerals that are injected into a vein to prevent or treat dehydration. Ideal for people in Arizona.

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Acupuncture

Stimulate your body’s natural healing abilities and promote physical and emotional well-being with acupuncture at Natural Heart Doctor.

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Health Coaching

Our health coaches use evidence based skillful conversation, clinical interventions, and strategies to engage you actively and safely in health behavior changes.

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Cardio Tests

We use the most advanced testing in the world to assess heart health and to identify the root cause of your health issues.

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Office Visits

Schedule an office visit with one of our cardiologists, holistic physicians, chiropractor, or health coaches.

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Frequently Asked Questions

I’d like to receive an online second opinion from Natural Heart Doctor. What do I do next?

You can initiate a second opinion online through our website at any time. To begin, select the team member you’d like to speak with and open an account.

Click here for cardiologist Dr. Jack Wolfson.

Naturopathic Medical Doctor Dr. Lauren Lattanza. Get details.

Naturopathic Medical Doctor Dr. Tonia Rainier. Get details.

Click here for  Natural Heart Doctor Health Coach.

Alternatively, you can email health@naturalheartdoctor.com. A member of our care team will help guide you through the process of starting a second opinion.

What is the cost of a Natural Heart Doctor Online Second Opinion?

The cost for most second opinions varies by team member. This fee includes information collection, a phone or video consultation, a second opinion from a Natural Heart Doctor specialist and guidance throughout the process from your personal Care Team at Natural Heart Doctor.

Cardiologist Dr. Jack Wolfson’s Second Opinion Fee is $1500.

Holistic Physician’s Dr. Lauren Lattanza’s Second Opinion Fee is $250.

Naturopathic Physician Dr. Tonia Rainier’s Second Opinion Fee is $250.

Note: We apply the Online Second Opinion Call fee as a credit to any future consultations with Natural Heart Doctor, should you choose them.

Will my insurance cover the cost of a Natural Heart Doctor Online Second Opinion?

Most likely, no. Most health plans do not cover online second opinions or consultations. You are responsible for the cost of our second opinion. Natural Heart Doctor cannot file a claim with your insurance carrier, nor can we provide a procedure (CPT) code for this service.

What is the timeline to receive an online second opinion?

We do our best to schedule your second opinion as quickly as possible. Typically, it takes 5 to 7 business days after your information has been collected to receive your phone or video online second opinion.

What information do you need in advance of our call?

Our office will send you a short questionnaire to complete and return. We DO NOT need your complete medical records.

How many questions can I ask the expert during our call?

You may ask a maximum of five questions. This is to ensure that the expert has sufficient time to devote to each question. All questions must be finalized before your online meeting.

What should I expect to receive once my second opinion is complete?

You will receive a summary of our discussion along with our second opinion. The second opinion will be in written form. After you have reviewed the second opinion, a Natural Heart Doctor clinician will follow up with you by phone to address general medical questions about the information provided in the second opinion.

What if I have follow-up questions for the expert after I have reviewed my second opinion?

If you have a clarifying question about an expert’s response to one of the questions in your second opinion, and the Natural Heart Doctor clinician is unable to address it, then you may request a follow up session for an additional fee. 

Is my medical and payment information secure?

Natural Heart Doctor is strongly committed to protecting the privacy and security of all our patients. Our website meets all federal requirements for protecting personal health information under the Health Insurance Portability and Accountability Act (HIPAA). All financial transactions are processed by Natural Heart Doctor securely using industry standard payment processing tools.

I would rather visit Natural Heart Doctor for an in-person appointment. What should I do next?

If you would prefer an in-person appointment at Natural Heart Doctor instead of an online second opinion, please call (480) 535-6844 for details and scheduling.

Can I schedule a follow up appointment with the specialist who provided my online second opinion?

Yes, we’re happy to help you on an extended basis. Our clinician can discuss options with you when presenting our second opinion summary.