Arrhythmias
An arrhythmia is a change in the rate or rhythm of your heartbeat, causing your heart to beat too fast, too slowly or irregularly. Some arrhythmias may require assessment and treatment by a heart specialist.
Heart rhythm condition
Affects the rate or rhythm of your heartbeat
Assessment & management
Treatment depends on the type of arrhythmia
Testing & diagnosis
May include ECG or Holter monitoring
Specialist care
Cardiologist or electrophysiologist
What are arrhythmias?
Heart arrhythmias occur when the electrical impulses that coordinate your heartbeat don’t work correctly, causing your heart to beat too fast, too slow, or irregularly. A normal resting heart rate is between 60–100 beats per minute in a healthy adult.
Arrhythmias can occur in an otherwise healthy heart. The most common type, ectopic beats, are often felt as a “missed beat,” thump, or flutter and are usually benign. However, some arrhythmias indicate a problem with the heart’s electrical system and require specialist evaluation.
Common types of arrhythmia include:
Tachycardia
Heart beats too quickly at rest. Includes SVT, ventricular tachycardia, and atrial flutter.
Bradycardia
Heart beats too slowly. Can cause fatigue and dizziness. May be normal in athletes.
Premature Beats
An extra beat occurring before the next regular beat. Very common and often felt as a “skipped” beat.
Fibrillation
Irregular, chaotic heartbeat. Atrial fibrillation (AFib) is the most common sustained type and increases stroke risk.
Concerned About Your Heart Rhythm?
Our specialist cardiologists assess and manage all types of arrhythmia. Medicare rebates available with a GP referral.
If you’re experiencing symptoms that may be related to your heart rhythm, speak to your GP about whether further assessment or a referral is appropriate.
What are the symptoms?
Arrhythmias don’t always cause symptoms, some are discovered incidentally during a routine examination. When symptoms do occur, they can range from mildly uncomfortable to severe.
Common Symptoms
- Heart racing or pounding (palpitations)
- Feeling the heart has skipped a beat
- Slow or pausing heartbeat
- Fluttering sensation in chest or neck
- Chest pain or tightness
Shortness of breath
Less common symptoms
- Fatigue or anxiety
- Dizziness or light-headedness
- Fainting or feeling faint (syncope)
- Difficulty breathing
- Unexplained sweating
- Weakness
These symptoms are not exhaustive. If you experience severe chest pain, sudden fainting, or breathlessness that comes on without warning,
call 000 (triple zero) immediately. For persistent or recurring symptoms, see your GP promptly. Don’t ignore them.
What causes a heart arrhythmia?
Some arrhythmias have unknown causes, some are inherited, and others are linked to underlying health conditions, medications, or lifestyle factors.
High Blood Pressure
Stiffens heart walls and disrupts electrical signals, one of the most common causes of AFib Learn more
Previous Heart Attack or Surgery
Scarring or damage to heart muscle raises the risk of abnormal electrical pathways forming.
Diabetes
People with diabetes are at increased risk of developing a heart arrhythmia, particularly AFib.
Overactive Thyroid
Thyroid disorders can accelerate heart rate and trigger or worsen an irregular heartbeat.
Electrolyte Imbalance
Low magnesium or potassium disrupts the electrical impulses that control your heart rhythm.
Sleep Apnoea
Repeated pauses in breathing during sleep can lead to irregular heartbeat and AFib over time.
Medications
Certain prescription and over-the-counter medications can trigger or worsen arrhythmias as a side effect.
Lifestyle Factors
Stress, caffeine, nicotine, excessive alcohol, and some recreational drugs can all provoke arrhythmias.
How is an arrhythmia diagnosed?
Your doctor will ask about your symptoms, medical history and any relevant family history. They may also examine you and recommend tests to better understand your heart rhythm.
An ECG is often used to assess arrhythmias, with other tests recommended depending on your symptoms and how often they occur.
Electrocardiogram (ECG or EKG)
An ECG is a quick, non-invasive test that records the electrical activity of your heart. Small electrodes are placed on your chest and limbs to measure your heart rate and rhythm.
An ECG can help identify an arrhythmia if it is occurring at the time of the test and may also show other changes in your heart’s electrical activity.
Echocardiogram
An echocardiogram, also known as an echo, uses ultrasound to create images of your heart. It allows your doctor to assess how your heart is structured and how well it is functioning.
While an echocardiogram does not primarily measure your heart’s electrical rhythm, it can provide useful information about underlying heart conditions that may be associated with an arrhythmia. Learn more.
Ambulatory ECG Monitoring
One option is a Holter monitor, a small wearable ECG device that records your heart rate and rhythm over a 24 or 48-hour period. Another option is event monitoring. This is similar to Holter monitoring, but the device is worn for up to 7 days and records only when the patient activates it after feeling symptoms.
Exercise Stress Test
An exercise stress ECG records your heart’s electrical activity while you exercise, usually on a treadmill or stationary bike. Your heart rate, rhythm and other measurements are monitored as the workload gradually increases.
Your doctor may recommend this test to assess how your heart responds to physical activity and whether exercise triggers changes in your heart rhythm.
Implantable Loop Recorder
An implantable loop recorder is a small monitoring device placed just beneath the skin of the chest. It continuously monitors your heart rhythm over an extended period and can capture changes that occur infrequently.
It may be considered when symptoms such as unexplained fainting or palpitations are difficult to capture using shorter-term heart monitoring.
Tilt Table Test
A tilt table test monitors changes in your heart rate and blood pressure as your body is moved from a lying to a more upright position.
It may be recommended when investigating unexplained fainting, dizziness or light-headedness and can help your doctor understand how your heart rate and blood pressure respond to changes in position.
Electrophysiology Study (EPS)
An electrophysiology study is a specialist procedure used to examine the electrical signals within your heart in more detail.
Thin, flexible tubes called catheters are guided through blood vessels to the heart, where they can record electrical activity. This can help identify where an abnormal heart rhythm is coming from and may help your specialist determine the most appropriate treatment.
Wearable Devices
Some smartwatches and other wearable devices can monitor your heart rate or record a single-lead ECG. They may capture information about your heart rhythm when you experience symptoms outside a medical appointment.
Information recorded by a wearable device may be useful to discuss with your doctor, but consumer wearable devices should not replace medical assessment or diagnostic testing recommended by your healthcare professional.
How are heart Arrhythmias treated?
Lifestyle Management
- Maintain a heart-healthy diet
- Limit or avoid alcohol and caffeine
- Quit smoking
- Manage blood pressure and cholesterol
- Reduce stress and anxiety
- Treat underlying conditions (e.g. sleep apnoea)
High Blood Pressure
- Antiarrhythmic or rate-control medications
- Blood thinners (anticoagulants) for AFib
- Catheter ablation to correct electrical pathways
- Electrical cardioversion to restore normal rhythm
- Pacemaker implantation (for bradycardia)
- ICD (implantable cardioverter-defibrillator)
Treatment for an arrhythmia depends on the type of heart rhythm problem, your symptoms and your overall health. Some arrhythmias may only require monitoring, while others may be managed with lifestyle changes, medication or specialist procedures. Your cardiologist will discuss the options that are appropriate for you.
Your treating specialist will discuss all relevant options with you and develop a personalised management plan shared with your GP.
Tests used to diagnose Arrhythmias
ECG Test
ECG Stress Test
