Arrhythmia and heart failure: what to know

An arrhythmia is a problem with the heart's rate or rhythm. Heart failure means the heart is not pumping or filling well enough to meet the body's needs. A rhythm that is persistently too fast, too slow or irregular can reduce pumping efficiency; changes caused by heart failure can also make abnormal rhythms more likely.

Atrial fibrillation is one arrhythmia that may coexist with heart failure. Either condition can cause breathlessness, reduced exercise tolerance, fatigue or palpitations, while heart failure may also present with swollen ankles, a cough when lying down or rapid weight gain from fluid retention. Symptoms alone cannot show which condition is responsible, so clinicians may check the pulse, heart tracing, blood pressure, blood tests and heart structure or function.

Treatment depends on the rhythm, its effect on circulation, the type of heart failure and other health conditions. The plan may include medicines to control heart rate or rhythm, reduce fluid build-up, support heart function or lower the chance of blood clots when indicated.

Take prescribed medicines exactly as directed and do not stop a heart or blood-thinning medicine without medical advice. Keep a simple record of palpitations, breathlessness, swelling, faintness and any change in what activity you can manage. If your care team has asked you to track weight, pulse or blood pressure, record readings consistently and report changes using the thresholds they gave you.

Arrange a medication review if symptoms change or side effects develop. Bring a complete list of prescriptions, over-the-counter medicines and supplements because some products can affect heart rhythm, blood pressure, fluid balance or medicine interactions.

Seek emergency help for chest pain, severe or sudden breathlessness, fainting, blue or grey lips, new confusion, or palpitations accompanied by collapse or marked weakness. These signs can mean the heart is not maintaining adequate circulation or that another urgent problem is present.

Contact your clinician promptly for worsening ankle or abdominal swelling, breathlessness that increasingly limits normal activity, needing more pillows to breathe comfortably, a persistent change in pulse, or rapid weight gain when you have been asked to monitor fluid retention.

Ask which rhythm you have, whether it is affecting heart function, and what each medicine is intended to do. Clarify which home measurements are useful, what change should trigger a call, whether any medicines or decongestants should be avoided, and when your next heart tracing, blood test or review is due.