Arrhythmia

Arrhythmia is a heart rhythm problem caused by a disturbance in the electrical impulses to the heart. It can cause symptoms such as heart palpitations, a fast or slow heartbeat, shortness of breath, and chest pain.

Heart arrhythmia treatments at UPMC include medication, cardioversion, minimally invasive ablation therapy, and surgery.

Looking for Arrhythmia Care? 

On this page

• What Is Arrhythmia?
• What Are the Symptoms of Arrhythmia?
• How Do You Diagnose Arrhythmia?
• How Do You Treat Arrhythmia? 

What Is Arrhythmia?

Doctors define arrhythmia as any type of abnormal heart rhythm. During arrhythmia, your heart beats:

• Irregularly (atrial fibrillation)
• Too fast (tachycardia)
• Too slow (bradycardia)

How common is arrhythmia?

Almost everyone experiences an occasional skipped heartbeat, fluttering, or racing heart. Most arrhythmias are harmless and don’t happen often. Some people have arrhythmias that are bothersome and sometimes dangerous.

What are the types of arrhythmias?

Atrial fibrillation (A-Fib) is the most common type of cardiac arrhythmia. It affects nearly 6 million Americans and nearly 10 percent of Americans over the age of 75. Other cardiac arrhythmias include:

• Atrial flutter.
• Supraventricular tachycardia, including Wolff-Parkinson-White syndrome.
• Ventricular tachycardia.
• Ventricular fibrillation.
• Long QT syndrome.
• Sick sinus syndrome.
• Conduction block.
• Premature heartbeats.

What causes arrhythmia?

Abnormal heart rhythms are caused by changes in the electrical impulses in your heart.

What are arrhythmia risk factors and complications?

Arrhythmia risk factors

Cardiac arrhythmias can occur in people who have an otherwise normal heart. They can also occur along with other heart conditions, such as congestive heart failure or coronary artery disease. Untreated high blood pressure (hypertension), sleep apnea, and thyroid disorders also increase your risk.

Certain over-the-counter medications and prescription drugs, as well as excessive alcohol, caffeine, nicotine, and illegal drugs also can lead to the development of cardiac arrhythmias.

Complications of arrhythmia

If left untreated, arrhythmias may increase your risk of developing heart failure, which happens when your heart cannot pump enough blood for your body or blood clots that can lead to a stroke.

Is arrhythmia a serious problem?

Some arrhythmias can be harmless, but others can be very serious — and even deadly.

How can I prevent cardiac arrhythmias?

Preventing heart disease and chronic conditions can reduce the chances that you will develop a cardiac arrhythmia. Exercising, maintaining a healthy weight, and eating a diet that is rich in fruits, vegetables, and whole grains also can help lower your risk. You also should:

• Avoid smoking.
• Control your blood pressure and cholesterol levels.
• Limit alcoholic beverages.

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What Are the Signs and Symptoms of Arrhythmia?

Cardiac arrhythmias cause noticeable symptoms for most people. However, some people with cardiac arrhythmias may not notice any symptoms. Symptoms of cardiac arrhythmia may include:

• Chest pain.
• Difficulty breathing.
• Dizziness.
• Fainting.
• Fluttering heart.
• Lightheadedness.
• Pounding chest (palpitations).
• Skipped or extra heartbeats.
• Sweating.
• Weakness.

When should I see a doctor about my arrhythmia symptoms?

Make an appointment with your doctor if you notice any arrhythmia symptoms. If your symptoms are severe or if you think you might be having a heart attack, dial 911 or go to the nearest hospital Emergency Department.

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How Do You Diagnose Arrhythmia?

At UPMC, your initial evaluation for arrhythmia includes:

• An evaluation of your medical history.
• A review of your symptoms.
• A thorough physical exam.

What to expect during your visit

During your exam, your doctor will listen to your heart with a stethoscope.

Following your exam, your doctor may order additional tests to help confirm an arrhythmia diagnosis. Your doctor or nurse will tell you when to expect your test results and will call you when they're available.

Tests to diagnose arrhythmia

We offer a full range of tests for arrhythmia, including:

• Echocardiogram – This noninvasive test uses sound waves to create images of your heart.
• Electrocardiogram (ECG) – This noninvasive test measures the electrical activity in your heart.
• Electrophysiology (EP) study – This test uses a special catheter that is threaded through your blood vessels and into your heart to map electrical impulses.
• Event recorder – This portable device is similar to a Holter monitor. However, it only records when you are having symptoms.
• Holter monitor – This wearable ECG device records your heart's activity throughout the day.

Arrhythmia prognosis

Can you live normally with arrhythmia?

Arrhythmia is a common, treatable condition. With proper treatment, most people with arrhythmia are able to control symptoms and live a normal, active life.

Does arrhythmia go away?

Some types of arrhythmia may come and go, or go away without treatment. Other types of arrhythmia may go away with treatment. In some cases, arrhythmia may return and require additional treatment.

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How Do You Treat Arrhythmia?

At UPMC, the goals of arrhythmia treatment are to:

• Control heart rate.
• Minimize stroke risk.
• Restore normal heart rhythm.

Some less-serious types of arrhythmia do not require treatment, but you should have regular checkups. If you do require treatment, your doctor may prescribe heart arrhythmia medications to control your irregular heartbeat.

Medicine to treat arrhythmia

Medications can be used to control your heart rhythm and prevent blood clots that can lead to a stroke.

Medications to slow your heart rate include:

• Atenolol
• Digitalis
• Diltiazem
• Metoprolol
• Verapamil

Medications to maintain your regular heart rhythm include:

• Amiodarone
• Propafenone
• Sotalol

Blood-thinning medications to prevent clot formation and help reduce your risk of stroke include:

• Aspirin
• Warfarin (Coumadin^®)

If your doctor prescribes blood thinners for you, UPMC offers a telephone-based anticoagulation clinic to help regulate your blood-thinner dosage.

Nonsurgical procedures to treat arrhythmia

• Cardioversion – This procedure uses special paddles or patches attached to your chest to deliver a shock that can restore your normal heart rhythm.
• Stereotactic body radiation therapy (SBRT) – SBRT is an experimental treatment for ventricular tachycardia (V-tach), an abnormally rapid heart rate in the heart's lower chambers, that has not responded to treatment. SBRT involves the delivery of a focused, single dose of radiation to a small area of the heart causing the heart rhythm problem. Doctors use scans to find the area of the heart causing the arrhythmia and where to target treatment. Currently, SBRT is only an option for people with V-tach who have tried other treatments without success.

Minimally invasive procedures to treat arrhythmia

• Catheter ablation – During catheter ablation, a special catheter is threaded through your blood vessels to your heart, where it uses heat or cold to create a small scar to block the electrical pathway that is causing your heart to beat abnormally.
• Left atrial appendage occlusion procedure/Watchman procedure – The left atrial appendage occlusion/Watchman procedure reduces stroke risk in people with A-Fib by inserting a small device that prevents blood clots from leaving an area in the heart where they commonly form.

Hybrid procedures to treat arrhythmia

• Hybrid ablation – This procedure uses surgical and catheter-based techniques to treat A-Fib by "disconnecting" the source of your abnormal heart rhythm. Hybrid ablation is performed by an electrophysiologist and a cardiac surgeon.

Surgery to treat arrhythmia

• Cardiac rhythm management devices – A pacemaker or an implantable cardioverter-defibrillator (ICD) is surgically placed under your skin to help control your heart rhythm.
• MAZE procedures – Typically used to treat AFib, MAZE procedures are minimally invasive. MAZE uses tiny incisions in your heart to create scar tissue that blocks the electrical pathway that is causing your heart to beat abnormally.
• Surgical left atrial appendage ligation (LAL) – LAL reduces stroke risk in AFib patients by sealing off an area in the heart where blood clots commonly form.

How effective is treatment?

At UPMC, our cardiologists are experts at managing and treating arrhythmia. Your doctors will recommend the treatment that is most likely to be effective for your heart rhythm disorder while considering your lifestyle, preferences, and overall health.

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Why Choose UPMC for Arrhythmia Care?

Our experts use leading-edge technology and techniques to diagnose and treat hundreds of cases of cardiac arrhythmias each year. Our doctors are performing research into the underlying causes of heart arrhythmias and are using their discoveries to develop improved methods for diagnosing and treating them.

By UPMC Editorial Staff. Last reviewed on 2024-10-01.