Arrhythmia

An irregular heartbeat can be unnerving. The good news is that we can successfully treat even the most serious arrhythmias. As leaders in correcting abnormal heart rhythms, we’re here to help you live an active, healthy life.

What is arrhythmia?

Any kind of irregular heartbeat is an arrhythmia. Your heart might beat too fast, too slow or in an erratic pattern.

An irregular heartbeat can often be harmless. But sometimes, it can make the heart unable to pump enough blood to the brain and other organs, causing serious, even life-threatening conditions.

Understanding types of irregular heartbeat

Doctors describe arrhythmias by their speed and location in the heart. Some types of arrhythmias are:

• Tachycardia, a common type of arrhythmia, is a fast heartbeat of more than 100 beats per minute when resting.
• Bradycardia is a slow heartbeat of less than 60 beats per minute when resting.
• Ventricular arrhythmias happen in the ventricles (lower heart chambers).
• Supraventricular arrhythmias happen above the ventricles, usually in the atria (upper heart chambers).

Types of ventricular arrhythmias

Some ventricular arrhythmias are harmless while others are very serious and can cause sudden cardiac arrest or death. The different kinds of ventricular arrhythmias include:

• Premature ventricular contractions, the most common type of arrhythmia and usually harmless
• Ventricular fibrillation, where the ventricles quiver in a fast, irregular pattern
• Ventricular tachycardia, which can be dangerous in older adults and people with heart conditions that can lead to fainting (syncope), ventricular fibrillation and sudden cardiac death

Types of supraventricular arrhythmias

Supraventricular arrhythmias are tachycardias (rapid heartbeats) and the types include:

• Atrial fibrillation (AFib), a rapid, irregular heartbeat
• Atrial flutter, a rapid, but regular heartbeat
• AV nodal reentrant tachycardia, a common type of rapid heartbeat that begins in the atrioventricular node, which is a kind of electrical gatekeeper located between the atria and ventricles
• Premature atrial contractions, a common type of irregular heartbeat
• Wolff-Parkinson-White syndrome, a rare congenital heart disease involves an extra electrical pathway in the heart

Irregular heartbeat symptoms

Everyone feels an abnormal heart rhythm occasionally. But if it happens often or for no apparent reason, it could be a sign of arrhythmia.

If you experience any of these symptoms, call your doctor or 911:

• A fast or slow heartbeat
• Heart palpitations where the heart skips a beat or beats too hard or fast
• Chest pain
• Shortness of breath
• Sweating
• Weakness, dizziness and light-headedness
• Loss of consciousness, blackouts or fainting (syncope)

What causes an irregular heartbeat?

An arrhythmia happens because of a problem with the heart's electrical system. When the heart is pumping correctly, tiny electrical currents signal the heart to beat. With an irregular heartbeat, the heart may have extra, missing or slow signals. Or the signals may not travel normally through the heart.

Causes of heart arrhythmia include:

• Injury from a past heart attack or surgery
• Health issues, such as Long QT syndrome and other inherited electrical disorders of the heart (congenital heart disease) or thyroid disorders
• Heart failure
• Cardiomyopathy, an enlarged heart
• Substances, such as caffeine, nicotine or diet pills
• Highly emotional states, such as shock or stress

Ventricular arrhythmia can also be caused by:

• Abnormally low levels of electrolytes, such as sodium, calcium or potassium
• Accidental electrical shocks
• Coronary artery disease

If untreated, arrhythmia can create health problems over time, such as:

• Blood clots: An abnormal heart rhythm can prevent proper blood flow through the heart, causing blood to back up. Blood clots can form, which raises the risk of having a stroke.
• Heart failure: AFib can weaken the heart’s chambers and result in heart failure and other conditions.

Arrhythmia diagnosis

Sometimes, you may feel an irregular heartbeat as a fluttering sensation in your chest. Other times, your doctor might detect an arrhythmia in test results or when listening to your heartbeat.

To confirm an arrhythmia diagnosis, we’ll perform a thorough physical exam. We may order additional tests, too, such as:

• Laboratory testing: Blood work and other lab tests can detect abnormal electrolyte or thyroid hormone levels, which can be signs of heart arrhythmia.
• Heart function tests: Several tests can help doctors check the function of your heart. These include:
  • Electrocardiogram (EKG)
  • Echocardiogram
  • Coronary angiography
  • Chest X-ray, CT scan or MRI
• Portable monitoring, which includes two main types:
  • Holter monitoring uses a small, battery-powered EKG that continuously monitors your heart rate and rhythm, usually for 24 to 48 hours.
  • Event monitoring records heart rhythms when symptoms occur, usually over about a month.
• Stress test: This test looks at how your heart functions when it’s working hard, like during exercise. If you’re unable to exercise, we’ll give you medication to simulate exercise during the test.
• Cardiac catheterization: In these minimally invasive procedures, we insert catheters, which are thin tubes with a tiny camera, through a blood vessel to examine the arteries and heart.
• Nuclear cardiology imaging: This type of imaging includes positron emission tomography, or PET scan, which uses a safe dose of radioactive material to evaluate blood flow through the heart.

Find out more about our heart and vascular testing and diagnosis.

Arrhythmia treatment

After a thorough exam and testing to identify your specific type of arrhythmia and its causes, we’ll develop a personalized treatment plan to control your heartbeat. Treating any underlying conditions is often a first step.

Your doctor may prescribe medications to help regulate your heartbeat. We also may recommend:

• Cardiac ablation: In this procedure, we thread catheters through a blood vessel to your heart. Energy travels through the catheters to treat the tissue that is causing the heart arrhythmia.
• Electrical cardioversion: This quick procedure that’s performed under anesthesia uses a mild electric shock to return the heartbeat to a normal rhythm. You’ll usually go home an hour or two after the procedure.
• Implantable cardioverter-defibrillator: When this small device, which we implant in your chest or abdomen, detects an arrhythmia, it sends a mild electric shock to correct the heart’s rhythm.
• Pacemaker: This small device that we implant in your chest keeps your heart beating regularly – not too fast or too slow.
• Hybrid ablation procedure: This minimally invasive procedure can correct heart rhythm almost painlessly and more effectively than other procedures.

Are you at risk for heart disease?

Knowing your risk factors of heart disease – the leading cause of death in the U.S. – can help you lower your chances of developing it. Our heart health quiz estimates your risk, determines which of your risk factors are controllable and gives you an idea what to do next based on your results.

Take the heart health quiz