Tachycardia vs Bradycardia: What Is Worse?

The normal resting heart rate for most adults is between 60 and 100 beats per minute. But certain conditions can cause the heart rate to dip or increase, conditions medically known as bradycardia and tachycardia, respectively. While racing or fluttering heart rate can be harmless and situation-specific, some heart arrhythmias may be life-threatening. Read through to evaluate tachycardia vs bradycardia and best practices to avoid risk.

How Does the Heart Beat?

The human heart consists of four chambers – two atria, the upper chambers of the heart, and two ventricles, the lower chambers of the heart. The heart’s rhythm is controlled by the sinus node, the heart’s natural pacemaker. With each contraction of the heart muscles, a signal flows from the atria to the ventricles which then pump blood out of the heart into the body.

Heart Arrhythmia and Its Types

The heart has a specialised cardiac conduction system, the mechanics that control the heart’s rate and rhythm. As the heart beats, an electric signal passes through the heart which causes the heart to contract and pump blood. On average, a normal heart rate at rest is about 72 beats per minute. Heart arrhythmia, or irregular heart rate, occurs when the heart rate falls below or goes beyond normal. 

Heart arrhythmia is of two types:

1. Tachycardia

Tachycardia is marked by a heart rate that increases above normal. The resting tachycardia heart rate is more than 100 beats per minute.

The main causes of tachycardia include:

• Fever or illness
• High or low blood pressure
• Significantly high caffeine intake
• Smoking or tobacco abuse
• Overactive thyroid
• Not enough blood in arteries
• Heart problems
• Side effects of certain medication
• Electrolyte imbalance
• Alcohol abuse or alcohol withdrawal
• Reduced red blood cell volume
• Use of illegal drugs

2. Bradycardia

Bradycardia is marked by a heart rate that drops below normal. The resting bradycardia heart rate is lower than 60 beats per minute.

The main causes of bradycardia are:

• Age-related damage in the heart tissue
• Damage to heart tissue due to heart attack or heart disease
• Inflammation of the heart tissue
• Genetic heart defects
• Complications post heart surgery
• Underactive thyroid
• Electrolyte imbalance
• Sleep apnea
• Inflammatory diseases
• Use of illegal drugs

Tachycardia vs Bradycardia

The difference between tachycardia and bradycardia is the speed at which the heart beats per minute. But besides this basic difference, there’s more to understand about tachycardia vs bradycardia. Listed below are the categories under which they are differentiated.

1. Type

The different types of tachycardia include:

A. Supraventricular Tachycardia – When the electrical signals in the heart’s upper chamber get distorted. Its classifications include:

• Atrial fibrillation – Rapid and uncoordinated heart signals
• Atrial flutter – Similar to atrial fibrillation but more organised and structured heartbeat.
• Paroxysmal atrial tachycardia (PAT) – Regular and rapid heartbeat that starts and stops abruptly.

B. Paroxysmal supraventricular tachycardia (PSVT) – Rapid heartbeat caused due to abnormal electrical pathways of heart cells.

• Ventricular Tachycardia – When the electrical signals in the heart’s lower chamber get distorted. There are two types of ventricular tachycardia. These are: 
• Ventricular tachycardia occurs when the lower chambers of the heart beat too rapidly. Ventricular fibrillation occurs when the heart’s electrical signals get distorted.

C. Sinus Tachycardia – It is caused by a heart rate that increases typically in response to exercise and stress. It usually settles automatically with time and is considered normal.

The different types of bradycardia include:

A. Sinus Bradycardia – When the heart rate drops below 60 beats per minute, it’s a case of sinus bradycardia. Sinus Bradycardia can be normal, especially in the case of athletic people.

B. Sinus Pause – It happens when the functioning of the sinus node, the heart’s natural pacemaker responsible for sending electrical signals in the heart, is impaired. It either sends weak signals or fails to send signals to all. Depending upon the cause, the risk of complications varies.

C. Sick Sinus Syndrome – this happens when the sinus nodes responsible for sending signals are sick or scared. A person may experience a combination of bradycardia and tachycardia also called the Tachy-Brady Syndrome. It is typically seen in people with atrial fibrillation.

D. Heart Block – This is caused due to blockage in the conduction network. As the electrical pathway gets damaged, it slows down or stops the heartbeat. Heart block, or atrioventricular block, is classified into three stages:

• First-degree heart block – Rarely exhibits any symptoms. It requires no treatment until symptoms become evident.
• Second-degree heart block – Symptoms begin to surface as there is a slow and irregular heartbeat.
• Third-degree heart block – Bradycardia heart rate is very low with almost no electrical signals reaching the ventricles, the lower chambers of the heart. Third-degree heart block has clear symptoms requiring immediate medical assistance.

2. Symptoms 

Symptoms of tachycardia are:

• Rapid heartbeat
• Palpitations
• Light-headedness
• Shortness of breath
• Chest pain

Symptoms of bradycardia include:

• Fatigue
• Poor concentration
• Fainting
• Dizziness
• Light-headedness
• Shortness of breath

Tachycardia vs Bradycardia: What is Worse?

Both bradycardia and tachycardia are caused when the cardiac conduction system fails to work properly. Depending upon the cause of impairment, the electrical imbalance may lead to bradycardia or tachycardia. In either case, prompt medical intervention is required to ascertain the cause of heart arrhythmia.

Treatment of Tachycardia

Tachycardia can occur in people of any age group. Some children are born with the condition. Tachycardia is not life-threatening and it does not increase the risk of heart disease or stroke.

But a fast heartbeat or tachycardia can trigger problems if not treated appropriately. The medical practitioner will diagnose the type of tachycardia through an ECG (electrocardiogram). Medication, pacemaker implants, heart surgery and associated treatments can help bring the condition under control. If tachycardia is triggered due to another underlying medical condition, appropriate treatment for the problem can help correct tachycardia concerns.

Bringing about lifestyle changes, avoiding stress stimulants and abstaining from the use of illegal products can help improve tachycardia heart rate.

How to Reduce the Risk of Tachycardia?

The risk of tachycardia can be reduced by taking the following steps:

• Keep blood pressure in control
• Keep cholesterol levels in check
• Quit smoking
• Avoid the use of tobacco products
• Maintain a healthy BMI
• Eat a well-balanced diet
• Limit your alcohol intake
• Cut down on caffeine intake
• Manage stress levels

Treatment of Bradycardia

Bradycardia can be a serious problem if the heart rate drops well below the lowest normal of 60 heartbeats per minute. As the heart fails to pump enough oxygen-rich blood to different parts of the body, it can lead to organ failure and death.

Bradycardia can be normal for fitness lovers. Thus, such people do not show any symptoms of bradycardia or experience health concerns. But people who have symptoms of bradycardia must seek immediate medical treatment. An ECG along with TMT, a stress exercise test, will help diagnose the type of bradycardia.

Treatment for heart-related bradycardia includes lifestyle changes, medication, or implantation of a pacemaker. Bradycardia caused due to other reasons like underactive thyroid, sleep apnea, or inflammatory diseases like rheumatic fever and lupus requires appropriate medical treatment to correct the condition.

Bradycardia caused by malfunctioning of sinus nodes can trigger heart attack and other cardiac complications. Prolonged or severe bradycardia can cause heart failure.

How to Reduce the Risk of Bradycardia?

The risk of bradycardia can be reduced by taking the following steps:

• Exercise regularly
• Eat a low-fat, low-salt, low-sugar diet
• Maintain a healthy BMI
• Keep blood pressure levels in check
• Keep cholesterol levels under control
• Quit smoking
• Consume alcohol in moderation
• Eliminate stress

Conclusion

The heart is responsible for pumping oxygen-rich blood to the body. It beats 60-100 beats per minute to maintain a healthy blood supply. But certain factors can trigger heart arrhythmia or irregular heartbeat. Bradycardia and tachycardia are the two forms of heart arrhythmia. While bradycardia is marked by a drop in heart rate below 60 minutes per minute, tachycardia refers to an increase in heart rate beyond 100 beats per minute. 

Both bradycardia and tachycardia are caused due to impaired conduction functioning within the heart. Tachycardia vs bradycardia; while any can escalate into serious issues, bradycardia is claimed to be a more silent killer. A healthy lifestyle, medicines, and implanting pacemakers are the preferred line of treatment for bradycardia and tachycardia.