Other Rhythm Variants
Other Heart Rhythm Disorders
Beyond the major arrhythmias, several other rhythm variations are met in clinical practice. Some are normal, some depend on another condition, and a few deserve specialist assessment.
On this page
Overview
A Wider Range of Rhythm Findings
This page describes rhythm findings that are less commonly discussed than atrial fibrillation or SVT. Many are not diseases in themselves; their meaning depends on the person, the symptoms and the clinical context.
The major conditions have their own pages, including atrial fibrillation, SVT, PVCs and VT.
Rhythms
Examples
Sinus tachycardia
A fast but normal-origin rhythm that accompanies exercise, fever, anxiety, anaemia, thyroid disease or dehydration. Treatment targets the cause. Inappropriate sinus tachycardia is a rarer, specific diagnosis.
Sinus arrhythmia
A normal variation in heart rate with breathing, particularly in young people. It is not usually a problem.
Multifocal atrial tachycardia
An irregular rapid rhythm arising from several atrial sites, often related to lung disease or acute illness.
Long QT syndrome
A disorder of cardiac repolarisation, inherited or caused by medicines or electrolyte disturbance, that can predispose to dangerous ventricular rhythms. See Inherited Arrhythmia Syndromes.
Escape rhythms
Backup rhythms that take over when the main pacemaker of the heart slows or fails. They may reflect an underlying conduction or sinus-node problem. See Bradycardia.
Context
Age and Clinical Context
Atrial tachycardia
A regular, fast rhythm that starts from a small area in the atria rather than from a re-entry loop. It can be brief or persistent, and mapping may be used to find its source when treatment is needed. See Supraventricular Tachycardia.
Postural tachycardia (POTS)
A condition in which the heart rate rises markedly and stays raised after standing, with symptoms such as light-headedness and fatigue. It reflects autonomic regulation more than a primary electrical disease of the heart and is assessed and managed individually.
Children and younger patients
Younger people can have normal variations, such as sinus arrhythmia, as well as supraventricular tachycardias. Assessment takes age and size into account and may involve paediatric cardiology expertise.
Athletes
Regular training commonly leads to a slower resting heart rate and sometimes pauses or conduction variations that are harmless. Fainting during exercise, or palpitations with a family history, need assessment rather than being assumed to be a training effect.
These notes are general. The meaning of a rhythm finding depends on the person, the symptoms and the clinical context, so any concern is best assessed by a cardiologist.
Evaluation
When to Seek Assessment
Palpitations
Awareness of an unusual or irregular heartbeat.
Chest tightness or breathlessness
Particularly with exertion or during an episode.
Dizziness or fainting
Especially during exertion or without warning.
Family history
Sudden death at a young age, or inherited rhythm disease.
A first assessment normally includes an ECG and may be followed by monitoring such as Holter or an event recorder.
Management
Treatment Depends on the Finding
Many of these findings need no treatment other than explanation. Others call for treating the underlying condition, such as thyroid disease, infection or lung disease, or for reviewing medicines that affect rhythm.
Specialist rhythm treatment, including medication, devices or ablation, is reserved for patients in whom a specific disorder is identified and treatment is expected to help.
If you are unsure which category applies to you, a cardiology consultation can clarify it.
Questions