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Arrhythmia


Overview

The heart has its own electrical system that tells it to beat. An arrhythmia is an abnormal electrical path in the heart which makes the heart beat either too fast or too slow. This can cause the heart to pump less effectively.

Abnormal heart rhythms occur in many people who do not have heart disease. Heart rhythm problems can result in a slow heartbeat (bradyarrythmia) or a fast heartbeat (tachyarrhythmia). An electrophysiologist is a heart rhythm specialist and may need to be consulted if the problem is serious. Symptoms of a rhythm problem can include a racing heart, fainting, trouble breathing or a change in color (looking pale or gray). Common tests to diagnose an arrhythmia include an:

  • Electrocardiogram (ECG)
  • Holter study to watch for the problem over 24 hours
  • Exercise stress test to watch for problems during exercise)
  • An electrophysiology study (see animated video below)

Normal heart – in a healthy heart with proper blood flow, the blue droplets representing oxygen-poor blood travel to the lungs, and the red oxygen-rich droplets circulate through the body.

 

A heart undergoing an electrophysiology study to diagnose an arrhythmia.



Treatments

Some arrhythmias are mild. If the arrhythmia causes no symptoms, treatment may not be needed. One or more of the treatments below may be needed if the rhythm problem affects heart function or cause symptoms. 

  • Medication
  • Cardioversion – used for atrial fibrillation, supraventricular tachycardia atrial flutter or ventricular tachycardia. A small electrical shock is delivered to the chest to reset the heart's rhythm. 
  • Ablation – a minimally invasive procedure to eliminate the abnormal tissue causing the irregular heart rhythm. Ablation may be the treatment of choice for an abnormal heart rhythm. See animated video below.
  • Pacemaker insertion a pacemaker is a small device implanted under the skin to regulate the heartbeat. Small wires are placed inside the heart through the big veins leading to the upper body. The pacemaker sends electrical signals to the heart through these wires which can then regulate a slow or irregular heartbeat.
  • Cardioverter defribrillator (ICD) insertion  an ICD is similar to a pacemaker and is a small device placed under the skin. Small wires from the ICD lead to the inside of the heart through the large veins from the upper body. The ICD sends electrical signals to the heart to correct the heart rhythm. It’s like having a personal cardioversion machine inside the body.
  • Surgery – usually performed only when all other options have failed. Surgical ablation is major surgery that requires general anesthesia and opening the chest to expose the heart. The site of the arrhythmia is located, then destroyed or removed.

Ablation – Ablation eliminates the abnormal tissue causing the irregular heart rhythm. An Inova pediatric electrophysiologist guides a catheter to the heart and locates the tissue to be treated. Radiofrequency energy passes through the catheter to the precise problem area and destroys the tissue causing the irregularity.