Arrhythmia

Overview

Because underlying heart disease so often causes or aggravates arrhythmias, the guidelines that apply to managing heart disease also apply to managing arrhythmias. These guidelines are largely the same as the guidelines for preventing arrhythmia and heart disease (see Preventing for details), but it's important to note that it is not too late to make lifestyle changes when you have an arrhythmia.

These include:

• Diet: As recommended by the American Heart Association, a healthy diet can help to control heart disease.
• Obesity: It's also important to balance calories taken in through food sources with calories burned through daily activity and exercise.
• Exercise: In addition to helping control weight, daily exercise that works the aerobic system is good for your heart.
• Smoking and alcohol: The American Heart Association recommends you quit smoking and restrict alcohol use to one drink per day (for women) and two per day (for men).
• Stress: Daily stress has also been linked to heart disease, so removing as much stress as you can from your daily life is advised.

This section discusses other special considerations for people with existing arrhythmias:

• Medications
• Sports participation
• Fish oil

Medications

Certain medications can aggravate some forms of arrhythmia. For this reason, always tell your doctor, dentist, and other healthcare providers about your arrhythmia and, if medicines are prescribed, ask if they might set off an abnormal heart rhythm.

People with the inherited form of long QT syndrome are especially vulnerable to medication triggers, and should be particularly careful to avoid the drugs that may prolong the QT interval (see our section on Ventricular tachycardia), which include antibiotics and antihistamines (see our section on Prevention). In addition to those drugs, some kinds of medications, including appetite suppressants, bronchodilators, catecholamines (adrenal hormones), decongestants, uterine relaxants, and vasoconstrictors may also trigger fast heart rhythms in people who have inherited LQTS. Again, check with your physician.

Sports

While exercise is usually good for the heart, that's not always true for patients with arrhythmia. Some types of arrhythmia may result in sudden cardiac death, making participation in competitive sports inadvisable. For children and adults with long QT syndrome (LQTS), for example, sports participation is one of the biggest issues they must face. Each person with long QT syndrome is different, and should discuss participation in sports with his or her physician. In general, if you have LQTS, however, doctors advise that you do not play competitive sports, especially in junior high, high school, or university settings. The heightened competition of school sports combines all the elements of the "fight-ort-flight" response and increases the possibility that the heart may spin electrically out of control.

Recommendations about recreational sports and exercise should be developed for each person. Factors that should be considered include your medical history, your symptoms, and your treatment.

Fish oil

There is some debate over whether fish oil containing omega-3 fatty acids is beneficial for people with arrhythmias. Studies have shown that fish oil prevents sudden cardiac death among heart attack survivors, but more recent research found that it increased the chance of arrhythmia in people with implantable cardioverter defibrillators (ICDs-see Treatment). You should ask your doctor if it's advisable to eat a lot of fish or take fish oil supplements, especially if you have an ICD or a history of ventricular fibrillation or ventricular tachycardia.