Explaining arrhythmia: What you need to know about symptoms and treatments

Cardiac ablation for atrial fibrillation
A patient with atrial fibrillation is undergoing catheter ablation.

As the director of the University of Chicago Medicine Center for Arrhythmia Care and an expert in the management of heart rhythm disorders, I concentrate on advanced therapies for complex arrhythmias, namely atrial fibrillation and ventricular tachycardia. In particular, I specialize in catheter ablation, which offers the possibility to cure common heart conditions.

Within medicine, there’s a tendency to treat and contain diseases so that the illness or its symptoms are less severe. What drew me to the field of electrophysiology is that targeted therapies can completely eliminate a problem with a single ablation.

What are heart arrhythmias?

Heart arrhythmias occur when the heart beats too quickly, too slowly or irregularly. Sometimes, it's just a single skipped beat, but there are also sustained arrhythmias lasting more than 30 seconds that can occur for hours or days, even years. Occasionally, the heart’s electrical signals get caught in a little short-circuit loop — those can be little flutters called atrial flutter or ventricular tachycardia. Atrial fibrillation (AFib), the most common abnormal sustained heart rhythm disturbance across the globe, is characterized by fast, irregular beats that start in the upper heart chambers. AFib can make your heart prone to blood clots because its organized contractions have gone astray. This also can promote the development of, or exacerbate, heart failure.

What causes arrhythmias?

Arrhythmias can be caused by pre-existing conditions like coronary artery disease, diabetes, heart failure or high blood pressure. They also can be worsened by lifestyle choices — things like smoking, excessive alcohol consumption or stress. There are many different causes, so that's why it’s important to get an accurate diagnosis by seeing a heart rhythm specialist.

What are the symptoms of an arrhythmia?

It depends on the arrhythmia: If your heart rate is too slow, you can feel tired, dizzy or even faint. If your heart rate is too fast, it can feel like your heart is racing or pounding in the chest. Some patients can be desensitized to abnormal heart rhythms, however. They’ll come in tired and say, ‘I just can't walk as far as I used to.’ Some feel their heart pound every beat. So, everything from feeling nothing to fatigue, shortness of breath, heart pounding and fainting is the spectrum of what we see with arrhythmias. Part of the art of medicine is distinguishing people who actually have symptoms from those who have no symptoms at all.

How serious is a heart arrhythmia?

If you feel an occasional skip in your heart — that’s called a heart palpitation — that’s usually something innocent and benign. A real warning sign for an arrhythmia, however, is fainting. If you lose consciousness, that's something that needs to be evaluated by a doctor. An irregular heartbeat can be a symptom of an underlying problem like heart disease. There’s also greater recognition now that an arrhythmia, if untreated and sustained, can itself lead to heart failure. Fast heart rhythms and heart rates can actually create heart failure. Often, this is fully reversible by correcting the electrical problem.

How do we treat arrhythmias?

Depending on the type of arrhythmia, we use medications, implantable devices like pacemakers, cardioversion or ablation to get the heart beating normally again. Slow heartbeats are often treated with pacemakers, while fast heartbeats can be treated several ways. Cardioversion is frequently used to treat AFib; it involves delivering small pulses of electrical current to the heart through electrodes on the chest. That electrical current re-establishes the heart’s normal rhythm.

Catheter ablation is a minimally invasive procedure that involves pinpointing, then destroying, the tissue causing the arrhythmia with extreme cold, laser technology or heat. Surgery also may be an option for some patients.

Can I exercise if I have an irregular heartbeat?

We believe in preserving the quality of life and improving the longevity of our patients. Exercise — even something as simple as walking — is an important part of staying healthy and preserving a sense of well-being. Patients often develop a fear of exertion in order to prevent triggers; sometimes, this can be taken to an extreme that results in a decline of the person’s psychological and physiological health. If you have an arrhythmia, speak with your doctor about what amount and what type of exercise is right and safe for you.

Depending on the type of arrhythmia you have and whether you have other heart conditions, a pacemaker or a defibrillator, you may have to avoid certain activities like contact sports. Your doctor also may ask you to undergo a stress electrocardiogram, also known as a treadmill test, to measure how well your heart can handle different types of exercise.

Roderick Tung MD

Roderick Tung, MD

Roderick Tung, MD, is an internationally renowned cardiologist and specialist in cardiac electrophysiology. Dr. Tung is an expert in the management of heart rhythm disorders (arrhythmias), with a particular focus on advanced therapies for atrial fibrillation and ventricular arrhythmias.

Read more about Dr. Tung
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