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What Causes an Arrhythmia?

An arrhythmia can occur if the electrical signals that control the heartbeat are delayed or blocked. This can happen if the special nerve cells that produce electrical signals don't work properly. It also can happen if the electrical signals don't travel normally through the heart.

An arrhythmia also can occur if another part of the heart starts to produce electrical signals. This adds to the signals from the special nerve cells and disrupts the normal heartbeat.

Smoking​, heavy alcohol use, use of some drugs (such as cocaine or amphetamines), use of some prescription or over-the-counter medicines, or too much caffeine or nicotine can lead to arrhythmias in some people.

Strong emotional stress or anger can make the heart work harder, raise blood pressure​, and release stress hormones. Sometimes these reactions can lead to arrhythmias.

A heart attack or other condition that damages the heart's electrical system also can cause arrhythmias. Examples of such conditions include high blood pressure, coronary heart disease, heart failure​, an overactive or underactive thyroid gland (too much or too little thyroid hormone produced), and rheumatic heart disease.

Congenital heart defects can cause some arrhythmias, such as Wolff-Parkingson-White syndrome. The term "congenital" means the defect is present at birth.

Sometimes the cause of arrhythmias is unknown.

Symptoms of an Arrhythmia

Many arrhythmia​s cause no signs or symptoms. When signs or symptoms are present, the most common ones are:

  • Palpitations​ (feelings that your heart is skipping a beat, fluttering, or beating too hard or fast)
  • A slow heartbeat
  • An irregular heartbeat
  • Feeling pauses between heartbeats

More serious signs and symptoms include:

  • Anxiety
  • Weakness, dizziness, and light-headedness
  • Fainting or nearly fainting
  • Sweating
  • Shortness of breath
  • Chest pain

Source: National Heart, Lung, and Blood Institute; National Institutes of Health; U.S. Department of Health and Human Services.

Inherited Arrhythmia Disease

Family medical history plays an important role in the accurate diagnosis of certain heart rhythm abnormalities. The Inherited Cardiovascular Disease Center - one of a very few in the nation - operates in The Heart Hospital's Center for Advanced Cardiovascular Care and provides genetic screening and counseling services and treatment (as needed) for a variety of inherited heart rhythm disorders.

The Inherited Cardiovascular Disease Center is led by specialists on the medical staff whose experience and expertise were gained in academic inherited disease centers. Importantly, the center has a dedicated cardiovascular academic cardiovascular genetics program form general medical genetics centers.

The genetics counselor spends one-on-one time with guests to understand a multigenerational family history. The counselor provides guests with a thorough explanation of the risks, benefits, and limitations of testing.

There are academic centers in Texas with interests in specific rare cardiovascular diseases that have access to medical genetics centers. However, the Inherited Cardiovascular Disease Center is one of the only dedicated inherited cardiovascular disease centers in North Texas staffed with a cardiovascular genetics counselor that offers a full range of services for rare inherited diseases.

Guests are typically referred for suspected or confirmed family dominant heart conditions, such as:

  • ​H​ypertrophic cardiomyopathy
  • Familial dilated cardiomyopathy
  • Arrhythmogenic right ventricular dysplasia (ARVD)
  • Long QT syndrome
  • Short QT syndrome
  • Brugada syndrome​

The center staff works closely with surgeons on the medical staff when evaluating guests whose conditions may require surgical intervention.​