Arrhythmia 101

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identifying and preventing arrHythmia

Not every change in your heart’s rhythm is cause for concern. “If you notice it once, it does not last long, and you have no history of heart problems, there may be nothing to worry about,’’ Natale says.

An overactive thyroid, caffeine, chocolate, exercise, alcohol, cigarettes, or stress can send your heart into orbit. So can changes in estrogen levels, premenstruation or menopause, or drugs.

Not all offbeat beats are harmless. “Palpitations can be due to coronary heart disease, an electrical problem in the heart, or an abnormality in heart valves, all of which may require medical intervention,’’ says Lori Mosca, M.D., author of Heart to Heart (Health Communications, 2005) and preventive cardiology director at New York-Presbyterian Hospital.

There’s a risk you’ll suffer ventricular fibrillation, when the lower chamber walls can’t contract and you’re deprived of blood. It’s the number one cause of sudden cardiac death. You also may suffer atrial fibrillation, where the heart’s electricity malfunctions and the muscle in the heart’s upper chambers contracts chaotically. This carries its own risk: blood pools in chamber walls, making stroke-causing clots more likely.

The danger of having a stroke is four to five times higher in people with atrial fibrillation. One of five strokes in patients over 65 results from this condition, says Richard Stein, M.D., American Heart Association spokesperson and chief of preventive cardiology at New York’s Beth Israel Medical Center.

The risk of atrial fibrillation is six times higher in those taking 7.5 milligrams or more of corticosteroids, which are found in many asthma, arthritis, and allergy remedies. The drugs appear to affect the balance of potassium in heart muscle cells, which leads to irregular contractions, according to a 10-year study of 8,000 people reported in the May 2006 Archives of Internal Medicine. Blood pressure medicines also can affect the heartbeat.

Surprisingly, omega-3 fatty acids—found in supplements and oily fish, such as salmon, mackerel, and herring—might raise your risk of atrial fibrillation. A recently released survey of 17,700 doctors found those who ate fish five or more times weekly were 61 percent more likely to develop the condition than those who ate fish once a month.

Omega-3 fatty acids may encourage atrial fibrillation in younger people but prevent it in older people with other medical problems, says study author Anthony Aizer, M.D., a New York University electrophysiologist. But younger people are less likely to have high blood pressure or congestive heart disease. “As a result, the danger to them can be significantly lower,” he says.