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An arrhythmia can occur when the electrical signals that control the heartbeat are delayed or blocked. This can happen when the special nerve cells that produce the electrical signal don’t work properly or when the electrical signal doesn’t travel normally through the heart. An arrhythmia also can occur when another part of the heart starts to produce electrical signals, adding to the signals from the special nerve cells and disrupting the normal heartbeat.
Stress, smoking, heavy alcohol use, heavy exercise, use of certain drugs (such as cocaine or amphetamines), use of certain prescription or over-the-counter medicines, and too much caffeine or nicotine can lead to arrhythmia in some people.
A heart attack or an underlying condition that damages the heart’s electrical system also can cause an arrhythmia. These conditions include high blood pressure (hypertension), coronary artery disease, heart failure, overactive or underactive thyroid gland (too much or too little thyroid hormone produced), and rheumatic heart disease.
For some arrhythmias, such as Wolff-Parkinson-White syndrome, the underlying heart defect that causes the arrhythmia is present at birth (congenital). Sometimes, the cause of an arrhythmia can’t be found.