When Should I Worry About an Irregular Heartbeat?

Your heart begins beating while you are in the womb, and pumps steadily your whole life through. At least, that’s the way it’s supposed to work. But we sometimes experience an irregular heartbeat, and it can be alarming.

Every heartbeat starts with an electrical signal from your heart’s natural pacemaker. The signal begins a cycle in which heart muscle contracts in a rhythmic fashion to pump blood through your body. A healthy heart rate, which is how many times your heart beats per minute, ranges from 60 to 100 beats per minute for most adults.

To understand an irregular heartbeat, let’s review the heart’s structure and the normal rhythm when the heart beats. The heart is divided by a wall and each side has two chambers. The upper chambers are called atria, and the lower chambers are called ventricles. The two atria pump blood down into their ventricles, causing the first sound in a heartbeat. Then the ventricles pump blood out of the heart, causing the second sound. Physicians often described the sound as “lub-DUB.” The right side pumps blood to the lungs and the left side pumps blood that’s full of oxygen from the lungs into the rest of the body.

It’s normal for your heart rate to fluctuate depending on whether you’re relaxed or exerting yourself, but a heart rate that’s consistently too high or too low, or that fluctuates dramatically, can be a sign of health problems. It can even lead to cardiac arrest, which means the heart stops beating because its electrical system malfunctions.

Here’s what you need to know about the causes and signs of an irregular heartbeat and when to seek medical treatment.

When should you worry about an irregular heartbeat?

Some types of irregular heartbeat, or arrhythmia, are harmless and usually don’t require medical intervention or treatment. One example is when it feels like your heart skipped a beat.

Some of the most common signs and symptoms of heart arrhythmias include:

  • Heart palpitations (Your heart feels like it’s racing, fluttering, or pounding without explanation.)
  • Dizziness or lightheadedness
  • Shortness of breath
  • Chest pain/discomfort
  • Fainting
  • Unexplained weakness/fatigue

If you have a history of cardiovascular problems or heart disease, you may also be at risk for more severe forms of arrhythmia.

Common types of irregular heartbeats

There are several types of heart arrhythmias, based on what part of the heart they occur in and what problem they cause. Some of the most common types include:

Atrial fibrillation

Atrial fibrillation is the most common type of arrhythmia and affects more than two million Americans, according to the National Heart, Blood, and Lung Institute. Atrial fibrillation can make the heart race at up to 400 beats per minute, well over the normal range of 100. This irregular heartbeat occurs in the upper chamber of the heart (the atria), so the lower chambers don’t get enough blood flow to pump efficiently.

Atrial fibrillation occurs when the heart’s electrical signals misfire and the upper chambers beat irregularly. Atrial fibrillation, or AFib, can resolve itself within a few hours or a few days. If it lasts less than a week, it’s called paroxysmal atrial fibrillation. This type is more common in younger people, and typically doesn’t require treatment or medical intervention.

You should seek medical attention if you have symptoms of atrial fibrillation that lasts longer than several days, or goes away and then returns. Persistent and long-lasting AFib can increase the risk of stroke and other serious cardiovascular problems.

Some of the most common treatments for atrial fibrillation include medication to regulate your heart rate, blood thinners to manage the risk of stroke, and medical procedures like cardioversion and ablation.

Atrial flutter

Atrial flutter, like atrial fibrillation, also is caused by a short-circuit in the heart’s electrical system. It’s not usually as severe a problem as AFib. With a flutter, the atria pump rapidly, far beyond 100 beats a minute. The ventricles beat faster too, but not as fast as the atria, and the heart beat is not as erratic as it is with fibrillation. The symptoms of the two conditions are similar. Atrial flutters are rare in people younger than 50. Atrial flutters can damage the heart and possibly lead to atrial fibrillation.


Bradycardia causes your heart rate to drop below normal heart rhythms, generally under 60 beats per minute. Some of the most common symptoms of bradycardia include:

  • Feeling dizzy and lightheaded
  • Fatigue
  • Fainting
  • Shortness of breath

Some of the possible causes of bradycardia include:

  • Getting older
  • Taking medications like beta blockers and calcium channel blockers
  • Hypothyroidism
  • Obstructive sleep apnea
  • Infection or damage to the heart

In some cases, bradycardia may not require treatment, especially if you don’t have symptoms or underlying health problems. Some of the typical treatment options for bradycardia include medication and/or a pacemaker to help regulate the heartbeat.


Tachycardia is an accelerated resting heart rate of more than 100 beats per minute. Atrial fibrillation is a common cause of this. When it results from problems in the heart’s two lower chambers, the ventricles, it’s called ventricular tachycardia. Some people with tachycardia don’t experience symptoms, but common symptoms include:

  • Chest pain
  • Heart palpitations
  • Shortness of breath
  • Lightheadedness
  • Fainting

Some of the common causes of tachycardia include:

  • Stress
  • Medications or supplements like stimulants and decongestants
  • Using alcohol or drugs
  • Other heart problems
  • Hyperthyroidism
  • Anemia

The treatment options for tachycardia vary depending on the underlying cause and severity. It may be treated with medication to slow down the heart rate, a pacemaker, an implantable cardioverter-defibrillator (ICD), or a medical procedure like cardioversion or catheter ablation.

Some types of irregular heartbeats are benign and don’t require medical treatment, while others can be more serious and potentially life threatening. If you experience any signs or symptoms of an irregular heartbeat, schedule an appointment for an exam to rule out more serious health and cardiovascular problems.

Causes of irregular heartbeats

Several risk factors can contribute to the development of an abnormal heart rhythm, including:

Age. The risk of developing an irregular heartbeat increases as you get older.

Heart disease. This includes a previous heart attack, heart failure, valve problems, congenital heart disease, coronary artery disease, and other conditions.

High blood pressure. Uncontrolled high blood pressure can trigger atrial fibrillation, and increase your risk of stroke, according to the American Heart Association.

Thyroid problems. An underactive or overactive thyroid may increase the risk of irregular heartbeat.

Smoking. Smoking can cause heart arrhythmia and heart damage, as well as increase your risk of other serious illnesses like cancer.

Alcohol and drug use. Using alcohol and drugs like narcotics, stimulants, and amphetamines can also increase the risk of irregular heartbeat.

Sleep apnea. Sleep apnea causes pauses and interrupted breathing throughout the night, and can also increase the risk of arrhythmia.

Genetics. A family history of arrhythmia and heart disease can increase your risk as well.

When to seek medical attention for an arrhythmia

While some types of irregular heartbeat are harmless and don’t require treatment, it’s important to monitor your health and any new symptoms as they develop, especially if you have a history of heart disease, high blood pressure, or other underlying medical problems.

Seek medical treatment if you experience the following symptoms:

  • Sudden onset of a very rapid or irregular heartbeat
  • Chest pain or pressure
  • Fainting or loss of consciousness
  • Trouble breathing
  • Severe weakness or fatigue

Regular blood pressure screenings are a good way to keep track of your heart health. If you have questions or concerns about your heart health or develop new symptoms, don’t hesitate to contact a healthcare provider to be on the safe side.

Diagnosis and treatment of irregular heartbeat

Diagnosing an irregular heartbeat usually includes a physical exam, a medical history, and diagnostic testing with an EKG or echocardiogram. Some of the methods used to treat arrhythmias include:

  • Medication to control heart rhythm.
  • Use of electrical impulse to restore normal heart rhythm.
  • Catheter ablation. Delivering high-frequency electrical energy to the heart tissue to create scar tissue that blocks abnormal electrical signals.
  • Implantable devices like a pacemaker.
  • In some cases, surgery is recommended to correct structural abnormalities causing the cardiac arrhythmia.

Find Interventional Cardiology Services in the Tampa Bay Area

Your best defense against complications from arrhythmia is prevention and knowing your risk factors and the symptoms to watch for. Our cardiology team offers prevention, diagnostics, and treatment plans for life-threatening heart rhythms, stroke, and other forms of heart disease.

If you’re experiencing symptoms or have been diagnosed with heart disease, contact us today at 1-813-780-8440 to schedule an appointment. You can also schedule an appointment online.

Meet Jesal V. Popat, MD, FACC

Dr. Popat is a board certified interventional cardiologist serving Central and North Tampa at Florida Medical Clinic Orlando Health. He emphasizes prevention through proper nutrition and active, healthy lifestyle and fitness.

He works with local non-profit agencies like the Tampa Bay chapters of the American Heart Association, the University of South Florida STEM academy and Best Buddies organizations. Dr. Popat graduated with honors from the University of South Florida with degrees in biology and chemistry before attending the Morsani College of Medicine in Tampa.



About this author.


Jesal V. Popat, MD, FACC

Interventional Cardiology

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