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Graham Adsit, MD, electrophysiologist, explains what an arrhythmia is and describes the symptoms of an irregular heartbeat. Dr. Adsit also talks about treatment options and the advantages of seeking care from Arrhythmia Program.

An arrhythmia, or dysrhythmia, is an irregular heartbeat or abnormal heart rhythm. Your heart should have a steady rhythm. Even as you exert yourself and your pulse gets faster, it will still be steady without skips or extra beats.

Arrhythmias happen when the heart's electrical system, which regulates its pumping action, sends faulty signals to the heart muscle. This causes the heart to pump less effectively, and may cause any or all of the following symptoms.

  • Palpitations
  • Dizziness
  • Fainting
  • Shortness of breath

With a few exceptions, all arrhythmias are treatable. This is especially true in our program, where leading arrhythmia experts specialize in treating complex abnormal heart rhythm problems.

An irregular heartbeat can be harmless or life-threatening, so proper diagnosis and treatment are essential. A benign arrhythmia may require a periodic check-in, while more serious types of arrhythmias may require careful monitoring, medication or surgery. If left untreated, serious arrhythmias can lead to complications such as:

  • Fainting spells
  • Stroke
  • Cardiac arrest

Bradycardia vs. Tachycardia

The heart’s electrical system controls the heart’s rhythm or beating. An arrhythmia is a condition in which the electrical activity of the heart is irregular or is faster or slower than normal. The two main types of arrhythmias are:

  • Bradycardia (a slow heart rate of less than 60 beats per minute)
  • Tachycardia (a rapid heart rate of more than 100 beats per minute)

Some arrhythmias originate in the atria (the two upper chambers of the heart), while others originate in the ventricles (the two lower chambers of the heart). Despite the vast number of arrhythmias and related conditions, the Arrhythmia Program physician specialists have the experience and expertise patients need to alleviate their problem.

Originating in the Atria

  • Atrial fibrillation (AF) occurs when uncoordinated electrical signals emitted in the atria cause the atria to quiver instead of beat normally. Atrial fibrillation increases the risk of stroke and can lead to congestive heart failure. Learn more about the specialized expertise available through our Atrial Fibrillation program
  • Atrial flutter is another, more organized form of arrhythmia that occurs when rapidly fired signals cause the muscles in the atria to contract quickly, leading to a fast, unstable heartbeat. 
  • Paroxysmal atrial fibrillation (PAF), a form of AF in which symptoms occur intermittently. Treatments may include cryoballoon ablation
  • Paroxysmal supraventricular tachycardia (PSVT) involves both the ventricles and the atria. It is not life-threatening but may cause symptoms. A series of early beats in the atria speeds up the heart rate. An electrophysiology study is often used to make an accurate diagnosis. Possible treatment options for PSVT include medications or catheter ablation
  • Sick sinus syndrome (SSS) is a group of signs or symptoms that indicate that the heart’s sinoatrial (SA), or sinus node, is not working to as it should. The sinus node contains special "pacemaker" cells that generate the electrical signals that regulate the pace and rhythm of the heartbeat. 
  • Wolff-Parkinson-White (WPW) syndrome is a condition in which an abnormality in the pathway between the atria and ventricles causes electrical signals to arrive at the ventricles too soon and to be transmitted back to the atria. Rapid heart rates may develop.

Originating in the Ventricles

  • Ventricular tachycardia (VT) is a fast heart rate that starts in the ventricles. VT may or may not be life-threatening, but is a common cause of cardiac arrest and sudden death. VT may have many causes including cardiomyopathy (heart muscle disease), coronary artery disease, valvular disease, an isolated rhythm problem or a genetic condition such as catecholaminergic polymorphic ventricular tachycardia, or CPVT.
  • CPVT is a rare, inherited cardiac condition that causes sudden rhythm disturbances, especially during physical activity or a moment of emotional stress. Left untreated CPVT can cause poor blood flow and lead to sudden cardiac death. While CPVT is often diagnosed in childhood, it can go undetected. For accurate diagnosis, an exercise ECG or event monitor may be used. Possible treatment options for CPVT include medications or implantable devices, such as a defibrillator. If you or a family member have been diagnosed with CPVT, it is important that family members are screened. Our team offers genetic screening for heart conditions.
  • Ventricular fibrillation (VF) occurs when disordered electrical activity causes the ventricles to contract in a rapid, unsynchronized manner. Sudden death follows unless immediate medical help is provided.

Disorders Related to Arrhythmias

  • Conduction disease is a heart rhythm condition that leads to fainting, or syncope. It happens when electrical signals from the atria fail to reach the ventricles, resulting in a slow heart beat (bradycardia) and inadequate flow of blood to the brain.
  • Bundle branch block is a delay or obstruction in the transmission of the heart’s electrical impulses that impairs the heart’s ability to pump efficiently. 
  • Syncope is a temporary loss of consciousness (fainting) usually related to temporary insufficient blood flow to the brain. 
  • Premature beats (contractions) briefly interrupt the heart’s normal rhythm when the heart beats happen earlier than expected. Very common, premature beats cause one to feel the heart “skipped a beat” or did a “flip-flop.” Premature beats can originate anywhere in the heart 
  • Cardiomyopathy is any disease of the heart muscle that inhibits the heart’s ability to pump blood effectively. In some instances, the disruption leads to arrhythmias. There may be multiple causes of cardiomyopathy, including viral infections. Genetic cardiomyopathies include Long Q-T syndrome, arrhythmogenic right ventricular dysplasia (ARVD), hypertrophic cardiomyopathy (HCM) and Brugada Syndrome. A consultation with a cardiac geneticist and testing with cardiac MRI are valuable resources for patients with genetic cardiomyopathies, resources readily available at our various heart and vascular locations.

Complete Diagnostic Capabilities

Many techniques are used to determine the cause of an abnormal heart rhythm, whether bradycardia (a slow heart rate), tachycardia (a rapid heart rate), atrial fibrillation (an irregular heartbeat) or one of the many other heart rhythm disorders.

We offer the full spectrum of state-of-the-art diagnostic tests, including electrophysiology studies, cardiac MRI, genetic testing, event monitors and tilt table tests.

Comprehensive Treatment Options

As part of an academic medical center, our physicians use the latest technology and research results to provide the most advanced treatments for atrial fibrillation.

Learn more about treating arrhythmias.

Research and Clinical Trials

Conducting research to better understand arrhythmias, including atrial fibrillation and other conditions, is an important part of our mission as an academic medical center.

Our patients may participate in heart and vascular clinical trials of new treatment techniques, medications and devices, such as pacemakers and implantable defibrillators. We are committed to bringing the latest treatments and technology to our patients through research and clinical trials.

Arrhythmia Physician Specialists

The multidisciplinary team includes board-certified electrophysiologists (cardiologists who specialize in the electrical activity of the heart and the diagnosis and treatment of heart rhythm disorders), cardiac surgeons and other heart and vascular specialists. Their combined skills and experience make it possible to successfully treat even the most complex cases of arrhythmia. These cases might include patients who have complicated conditions with multiple diagnoses.

Virtual Visits Are Available

Safe and convenient virtual visits by video let you get the care you need via a mobile device, tablet or computer wherever you are. We'll assess your condition and develop a treatment plan right away. To schedule a virtual visit, call 414-805-3666.

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