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Care During Chemotherapy and Beyond

Heart Rhythm Changes (Arrhythmias)



What are heart rhythm changes (Arrhythmias)?

Your heart pumps blood through the body continuously, in a systematic manner. Blood flows from the top, right side of the heart (the right atrium of the heart), and moves down the heart tissue into the lower chambers of the heart, called the ventricles. Heart rhythm changes, or arrhythmias, occur when there is a disruption in the heart's normal electrical system, causing it to beat irregularly.

Your heart rhythm changes can be diagnosed easily, if your healthcare provider performs an ECG. You may or may also be ordered an echocardiogram, which is another tool in diagnosing the arrhythmia.

Your treatment will depend upon the type of irregular heart rate, your symptoms, and your overall health status.

A common type of arrhythmia is called atrial fibrillation, when the heart beats irregularly irregular, and fast. This means that the heart is unable to pump blood through the body very well. Arrhythmias occur for many reasons. They can be due to: 

  • Heart disease
  • High blood pressure for a long time
  • Damage to the heart muscle
  • Chronic lung disease, or pneumonia
  • Alcohol intake
  • Medications
  • Arrhythmias may be a complication of heart failure

What are some symptoms to look for?

  • Chest pain
  • Light headedness and excessive tiredness
  • You may experience shortness of breath, either at rest or while performing any type of activity. This may include walking to the door, or climbing stairs.
  • You may be very weak, and it might be difficult to perform your usual daily activities
  • You may feel your heart beat, or an irregular heart beat.
  • You may experience palpitations.

Things you can do:

  • Make sure you tell your doctor, as well as all healthcare providers, about any other medications you are taking (including over-the-counter, vitamins, or herbal remedies). 
  • Remind your doctor or healthcare provider if you have a history of diabetes, liver, kidney, or heart disease.
  • If you have a family history of heart disease, stroke, high blood cholesterol, or high blood pressure, in a first or second-degree relative, you may be at risk for certain problems. Notify your healthcare provider if you have any of these diseases in your family.
  • Smoking can cause you to feel palpitations, or an irregular heart rate. If you smoke, be sure to quit. Smoking can also increase the chance of developing heart vessel damage.
  • Caffeine and alcohol can cause palpitations. Eliminate caffeine and alcohol from your diet, and your palpitations may resolve.
  • Keep a diary of your irregular heart rate or palpitations, if they are occurring regularly. Write down the foods that you have eaten, the exercise or activity you were undergoing when the rapid or irregular heartbeats occurred, and how you felt before they occurred. This diary may be valuable in determining the cause of your palpitations.
  • Questions to ask yourself, may include:
    • Did the irregular heart rate or palpitations occur gradually, or did this episode come on all of a sudden? Was I feeling anxious? Did I perform any kind of activity, or was I resting?
  • Make sure to exercise, under the supervision of your healthcare provider. Walking, swimming, or light aerobic activity may help you to lose weight, and promote the flow of oxygen in your lungs and blood.
  • Use relaxation techniques to decrease the amount of anxiety you have. If you feel anxious, place yourself in a quiet environment, and close your eyes. Take slow, steady, deep breaths, and try to concentrate on things that have relaxed you in the past (such as a vacation, an area of your home, etc.). 
  • If you are ordered a medication to treat this disorder, do not stop taking any medication unless your healthcare provider tells you to. Take the medication exactly as directed. Do not share your pills with anyone.
  • If you miss a dose of your medication, discuss with your healthcare provider what you should do.
  • If you experience symptoms or side effects, especially if severe, be sure to discuss them with your health care team.  They can prescribe medications and/or offer other suggestions that are effective in managing such problems.
  • Keep all your appointments for your treatments.

Drugs that may be prescribed by your doctor:
There are many types of medications that may be used to treat arrhythmias. These may include:

  • ACE inhibitors - These drugs work by opening, or dilating, your arteries. They will lower your blood pressure, and improve blood flow to your kidneys, and through out your body. Your healthcare provider may also prescribe these medications if you have diabetes or protein in your urine, to protect your kidneys. Some examples of this medication may include: enalapril maleate (Vasotec®), lisinopril (Zestril®), and fosinopril sodium (Monopril®)
  • Anticoagulants - These medications prevent your blood from clotting. Each of them works in a variety of ways. Depending on your overall health status, the kind of chemotherapy you are receiving, and the location of the blood clot, your healthcare provider may suggest warfarin sodium (Coumadin®), or enaxoparin (Lovenox®).
  • Antianxiety medications - If your symptoms are due to anxiety, your healthcare provider may prescribe an Anti-anxiety medication, called an anxiolytic.  These medications will help you to relax. These medications will help you to relax. These may include lorazepam (Ativan®), or alprazolam (Xanax®).  It is important to take these medications only when you are feeling anxious. Do not operate heavy machinery, or drive an automobile while taking these. If these medications do not control your symptoms, discuss this with your doctor.
  • Aspirin - Depending on your overall health status, and the type and severity of your arrhythmia, your healthcare provider may prescribe aspirin as a "blood thinner." Aspirin works by preventing platelets in your blood from forming blood clots (anti-platelet).
  • Beta-blockers - Can be used to slow down your heart rate, and improve blood flow through your body. You may take this drug if you have been diagnosed with irregular heartbeats, or high blood pressure. Some examples of this medication may include: metoprolol (Lopressor®), propranolol (Inderal® ), and atenolol (Tenormin® ).
  • Calcium Channel Blockers - These medications may be given to treat chest pain, high blood pressure, or irregular heart beats. A few common drugs include verapamil HCL (Calan®), and diltiazem (Dilacor XR®).
  • Digoxin - Also called digitalis, this medication works by slowing down the heart rate, and making it beat more effectively. This will pump blood through out the body better. It is also called Lanoxin® .
  • Diuretics - may be known as "water pills" as they work to prevent heart failure by making you urinate out extra fluid. You will receive this if your arrhythmias are due to fluid accumulation in your heart or lungs. Some examples of this medication may include furosemide (Lasix®), and Hydrochlorthiazide. You may receive this medication alone or in combination with other medications.
  • Do not stop any of these medications abruptly, as serious side effects may occur.

When to call your doctor or health care provider:

  • Fever of 100.5° F (38° C), chills, sore throat (possible signs of infection).
  • Shortness of breath, chest pain or discomfort; swelling of your lips or throat should be evaluated immediately
  • Feeling your heart beat rapidly (palpitations)
  • Any new rashes on your skin, especially if you have recently changed medications
  • Any unusual swelling in your feet and legs
  • Weight gain of greater than 3 to 5 pounds in 1 week.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.