Could composer Ludwig van Beethoven have been literally following his heart when he wrote some of his greatest masterpieces?

New research suggests the rhythms in Beethoven's music may have inspired by his irregular heartbeat, the University of Michigan reported. Beethoven is believed to have suffered from cardiac arrhythmia, which causes the heart to beat too fast, too slow, or with an irregular rhythm.

"His music may have been both figuratively and physically heartfelt," said co-author Joel Howell, a professor of Internal Medicine at the University of Michigan Medical School and member of the U-M Institute for Healthcare Policy and Innovation. "When your heart beats irregularly from heart disease, it does so in some predictable patterns. We think we hear some of those same patterns in his music."

A team of researchers studied rhythmic patterns of several Beethoven compositions and found unexpected changes in the pace and keys of the music appeared to match asymmetrical heartbeat patterns. For example, the final movement "Cavatina" in Beethoven's String Quartet in B-flat Major, Opus 130 suddenly changes to C-flat major and has an unbalanced rhythm that has been likened to a "shortness of breath." In the composer's directions he used the German word "beklemmt," which translates to "heavy of heart."

"The arrhythmic quality of this section is unquestionable," the researchers wrote.

Other pieces that appear to contain arrhythmic patterns include the Piano Sonata in A-flat major, Opus 110 and the opening of the "Les Adieux" Sonata (sonata opus 81a, in E-flat major).

"The symptoms and common association of an abnormal heartbeat with so many diseases makes it a reasonable assumption that Beethoven experienced arrhythmia - and the works we describe may be 'musical electrocardiograms,' the readout of modern heart rhythm testing equipment," the essay's lead author is Zachary D. Goldberger, a cardiologist at Harborview Medical Center, University of Washington School of Medicine. "While these musical arrhythmias may simply manifest Beethoven's genius, there is a possibility that in certain pieces his beating heart could literally be at the heart of some of the greatest masterpieces of all time."

The findings were published in a recent edition of the journal Perspectives in Biology and Medicine.