Why Irregular Heartbeats Raise Your Heart Failure Risk

Written by: Dr. Raquel Hammonds
November 24, 2025

Most people think of heart trouble as chest pain or a heart attack — sudden, dramatic, impossible to ignore. But for many, the first warning sign is quieter: a skipped beat, a flutter in the chest, a racing rhythm that seems to come out of nowhere.

These irregular heartbeats, known as arrhythmias, may not always hurt, but they can change how well the heart does its most important job: pumping blood.¹ Left unchecked, they can weaken the heart over time and raise the risk of heart failure, a condition already hitting Black and Brown communities at younger ages and with more severe outcomes.²

Understanding how the heart works and how rhythm affects everything is the first step in protecting your long-term health.

What Your Heart Really Does in the Body

Your heart is more than a muscle. It’s the command center of your circulatory system — a nonstop pump that moves oxygen-rich blood to every part of your body.³

Here’s how it works:

The right side of the heart collects blood from the body and sends it to the lungs to pick up oxygen.³
The left side pumps that oxygen-rich blood out to your brain, kidneys, liver, and every other organ.³
The heart’s rhythm is controlled by an electrical system — like wiring that coordinates each squeeze so blood flows smoothly.³

A healthy heart beats in a steady, predictable pattern. When this pattern becomes irregular, the entire system becomes less efficient.¹

What Happens When Your Heartbeat Becomes Irregular

An irregular heartbeat (arrhythmia) means the heart’s electrical system is misfiring. It can beat:

Too fast (tachycardia).¹
Too slow (bradycardia).¹
Out of sync (atrial fibrillation, or AFib).¹
In skipped or “fluttering” patterns.¹

Here’s why that matters. When arrhythmia is present:

The heart pumps less blood than it should.

If the chambers don’t beat together, blood doesn’t flow smoothly. This forces the heart to work harder with each beat.⁴

Organs receive less oxygen.

Your brain, kidneys, and muscles depend on a steady rhythm. When it’s irregular, they get less fuel.⁴

The heart muscle weakens over time.

Chronic arrhythmias can overstress the heart, causing it to stretch, thicken, or stiffen — all early signs of heart failure.⁴

Blood can pool and form clots.

Especially in atrial fibrillation, blood may sit in the heart instead of flowing. Clots can break off and lead to stroke. This is why arrhythmias should never be ignored, even when they don’t hurt.⁴

Why Black and Brown Communities Are Hit Harder

Irregular heartbeats don’t affect every community the same way. Decades of research show that Black and Brown adults in the U.S. develop high blood pressure, heart failure, and stroke earlier in life, which are the very conditions that make arrhythmias more dangerous.2 But these numbers aren’t the result of individual choices alone. They reflect a long history of structural inequities that shape where people live, the care they receive, and the daily stress their bodies endure.²

For many Black adults, arrhythmias go undiagnosed or undertreated not because symptoms are milder, but because access to specialized cardiology care is limited.² Patients are less likely to receive early rhythm screenings, referrals to heart specialists, or long-term heart monitoring — all key tools for catching irregular heartbeats before they damage the heart.²

This is the environment irregular heartbeats enter, not a neutral one, but one shaped by policy, access, history, and environment. Understanding this helps our community see arrhythmias not as random events, but as predictable outcomes in a system that must change.

Common Symptoms of Irregular Heartbeats

Irregular heartbeats can feel different for everyone. Some people feel them daily; others feel nothing at all.

Here’s what to watch for:

Fluttering or “flip-flopping” in your chest.⁴
A racing heart during rest.⁴
Slow heartbeat with dizziness.⁴
Feeling like your heart skips beats.⁴
Shortness of breath.⁴
Fatigue or low energy.⁴
Chest pressure (not always pain).⁴
Lightheadedness or near-fainting spells.⁴
Swelling in the legs, ankles, or feet.⁴

Any of these symptoms, especially together, deserve medical attention.

How Irregular Heartbeats Raise Heart Failure Risk

When your heart can’t maintain a steady rhythm, it becomes less efficient at pumping blood. That stress builds up over time. Here’s how it leads to heart failure:

The heart gets tired, just like a muscle doing too much work.⁴
The walls thicken, making squeezing harder.⁴
Blood backs up, causing swelling and shortness of breath.⁴
The heart enlarges, stretching out like a balloon that doesn’t return to shape.⁴

This doesn’t happen overnight, but it does happen. And many people don’t know their irregular heartbeat is the cause.

What to Ask Your Doctor and How to Get Checked

You deserve answers, respect, and the right tests. Here’s how to advocate for yourself:⁵

Ask for an EKG (electrocardiogram). This quick test measures your heart’s electrical activity.

Request a heart monitor if symptoms come and go. Ask specifically for a Holter monitor (24–72 hours) or a patch monitor (up to 14 days). This catches arrhythmias that don’t show up in short tests.⁵

Ask for an echocardiogram. This ultrasound shows how strong your heart is and checks for early heart failure.⁵

Discuss your personal risk factors. If you have high blood pressure, diabetes, kidney disease, sleep apnea, or a family history of heart issues — speak up.⁵
Use this exact script if you feel dismissed: “My heart feels irregular at times, and I’d like a full arrhythmia workup. That includes an EKG, a longer-term heart monitor, and an echocardiogram. These symptoms are affecting my quality of life”.

Remember: Your doctor works for you — not the other way around.

A Call to Action for Our Community

Protecting your heart begins with paying attention to changes in your rhythm, your energy, and the way your body feels during everyday activities. If something feels “off,” trust that instinct. Contact your doctor and ask directly for the tests that evaluate rhythm problems, including an EKG, a longer-term heart monitor, and an echocardiogram. These tools can identify irregular patterns early, before they lead to heart failure.