What are the symptoms of arrhythmia? How it is treated, what to watch for when taking medicine, and which specialty to see

What are the symptoms of arrhythmia?

Arrhythmia may cause no symptoms, and a doctor may find it during a routine physical examination; noticeable symptoms can include palpitations, dizziness, fainting, fatigue, shortness of breath, chest pain and reduced exercise tolerance, and in severe cases there can be symptoms of a possible stroke, such as slurred speech, disturbed vision and weakness of the limbs (Department of Health Drug Office, October 2014).

Arrhythmia is a problem related to the rate or rhythm of the heartbeat and is a common heart disease: when the heart's electrical impulses are not coordinated with the heartbeat, the heart beats too fast, too slowly or irregularly; most arrhythmias are harmless, but some can be very serious or even life-threatening (Department of Health Drug Office, October 2014).

Arrhythmia increases the chance of stroke fivefold, of heart failure threefold and of death twofold (Department of Health Drug Office, October 2014); for stroke symptoms, see What are the warning signs of stroke?. The diagnosis for an individual patient is made by the doctor.

How is arrhythmia treated? Is surgery needed?

Treatment depends on the type and severity of the arrhythmia: some mild arrhythmias need no treatment, while others can be treated with medical procedures (such as a pacemaker), surgery (such as coronary artery bypass surgery when the arrhythmia is caused by coronary heart disease) or anti-arrhythmic drugs; the doctor will find the underlying cause before deciding which method to use (Department of Health Drug Office, October 2014).

Anti-arrhythmic drugs are used to slow down a heart that is beating too fast, or to bring an abnormal rhythm back to normal and keep it stable; a heartbeat that is too slow cannot be sped up with medicine, and a pacemaker may be needed (Department of Health Drug Office, October 2014). All anti-arrhythmic drugs are prescription medicines and should only be taken under close supervision by healthcare professionals (Department of Health Drug Office, October 2014).

Atrial fibrillation is a type of arrhythmia, and people with it may need to take blood thinners; anticoagulants are mainly recommended for patients at high risk of stroke and patients with atrial fibrillation (Department of Health Drug Office, September 2014).

Which treatment an individual patient receives is decided by the treating doctor.

What should I watch for when taking arrhythmia medicine?

People taking these medicines who feel dizzy or faint, have pain in the chest, neck, jaw, arm, back or shoulder, or feel short of breath should lie down and rest, should not try to walk or drive, and should call an ambulance immediately (999 in Hong Kong) (Department of Health Drug Office, October 2014); other reminders are in the table below.

Which specialty should I see for arrhythmia? What tests are needed?

Cardiology is a specialty of adult internal medicine responsible for the prevention, investigation, diagnosis and treatment of diseases of the heart and blood vessels (Hong Kong Academy of Medicine, Specialty Descriptions, April 2025); arrhythmia is a common heart disease (Department of Health Drug Office, October 2014).

Which specialty follows up, and which test is done, is decided by the treating doctor according to the condition; for choosing a cardiologist, see How to choose a cardiologist, and for private fees for tests such as an ECG, see Heart test fees compared.

For general arrangements for seeking care, see Not sure which specialty to see?; in an emergency, go to Accident and Emergency.

Frequently asked questions