Cardiac Arrhythmia: Care Instructions

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A cardiac arrhythmia is a change in the normal rhythm of the heart. Your heart may beat too fast or too slow or beat with an irregular or skipping rhythm. A change in the heart's rhythm may feel like a really strong heartbeat or a fluttering in your chest. A severe heart rhythm problem can keep the body from getting the blood it needs. This can result in shortness of breath, lightheadedness, and fainting.

You may take medicine to treat your condition. Your doctor may recommend a pacemaker or recommend catheter ablation to destroy small parts of the heart that are causing a rhythm problem. Another possible treatment is an implantable cardioverter-defibrillator (ICD). An ICD is a device that gives the heart a shock to return the heart to a normal rhythm.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

General care

  • Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. You will get more details on the specific medicines your doctor prescribes.
  • Avoid infections such as COVID-19, colds, and the flu. Get a pneumococcal vaccine. If you have had one before, ask your doctor if you need another dose. Get a flu vaccine every year. Stay up to date on your COVID-19 vaccines.
  • Wear medical alert jewelry that says you have an abnormal heart rhythm. You can buy this at most drugstores.

Heart-healthy lifestyle

  • Eat a heart-healthy diet.
  • If they cause symptoms, limit or avoid alcohol and caffeine.
  • Do not smoke or use nicotine. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
  • Stay at a healthy weight. Lose weight if you need to.
  • Ask your doctor whether you can take over-the-counter medicines (such as decongestants). These can make your heart beat fast.
  • If you think you may have a problem with drug use, talk to your doctor. Certain drugs, such as cocaine and methamphetamine, can speed up your heart's rhythm.
  • Talk to your doctor about any limits to activities, such as driving.


  • Get regular exercise. Try for 30 minutes on most days of the week. Ask your doctor what level of exercise is safe for you. If activity is not likely to cause health problems, you probably do not have limits on the type or level of activity that you can do. You may want to walk, swim, bike, or do other activities.
  • When you exercise, watch for signs that your heart is working too hard. You are pushing too hard if you cannot talk while you exercise. If you become short of breath or dizzy or have chest pain, sit down and rest.
  • Keep a diary of your heart rate and symptoms if your doctor asks you to. Check your pulse daily. Place two fingers on the artery at the palm side of your wrist, in line with your thumb.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have symptoms of sudden heart failure. These may include:
    • Severe trouble breathing.
    • A fast or irregular heartbeat.
    • Coughing up pink, foamy mucus.
    • You passed out.
  • You have symptoms of a stroke. These may include:
    • Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
    • Sudden vision changes.
    • Sudden trouble speaking.
    • Sudden confusion or trouble understanding simple statements.
    • Sudden problems with walking or balance.
    • A sudden, severe headache that is different from past headaches.

Call your doctor now or seek immediate medical care if:

  • You have new or changed symptoms of heart failure, such as:
    • New or increased shortness of breath.
    • New or worse swelling in your legs, ankles, or feet.
    • Sudden weight gain, such as more than 2 to 3 pounds in a day or 5 pounds in a week. (Your doctor may suggest a different range of weight gain.)
    • Feeling dizzy or lightheaded or like you may faint.
    • Feeling so tired or weak that you cannot do your usual activities.
    • Not sleeping well. Shortness of breath wakes you at night. You need extra pillows to prop yourself up to breathe easier.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You have new or worse symptoms.

Where can you learn more?

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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.