What are Arrhythmias?
Arrhythmias are an abnormal heart rhythm. If you have a heart arrhythmia, your heart beats abnormally fast, abnormally slow, or irregularly.
Arrhythmias are disorders that affect the electrical system of the heart. Most arrhythmias are benign, but certain types can be dangerous and require treatment. If you have existing heart problems, arrhythmias can be a serious matter.
Types of arrhythmia
Atrial fibrillation is the most common form of arrhythmia. Atrial fibrillation can be brief or sustained, lasting minutes or hours with the heart rate returning to a normal beat between episodes, or more persistent and lasting months and/or years. Atrial fibrillation can be dangerous because it can cause blood clots to form in the top chamber of the heart, or atria. If a clot leaves the atria and becomes lodged in the artery to the brain, it can result in a stroke.
Bradyarrhythmia, or bradycardia, occurs when the heart rate is slower than normal. If the heart rate is too slow, not enough blood reaches the brain. People can faint. Slow heart rates are normal in some people, especially those who are physically fit. For them, a heartbeat slower than 60 beats per minute isn’t dangerous. In others, however, bradycardia can result from serious diseases or other conditions.
Premature (extra) heartbeats are usually harmless and can occur without symptoms.
Supraventricular arrhythmias is are fast heart rates originating in the upper chambers including atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia, atrial tachycardia and Wolff-Parkinson-White syndrome.
Ventricular tachycardia is fast, regular beating of the heart’s lower chambers, known as the ventricles. While a few fast beats are usually OK, episodes lasting more than a few seconds might be dangerous.
Many types of arrhythmia cause no signs or symptoms. It can be hard to detect by most people. When present, the most common symptoms are:
- Feelings that your heart is skipping a beat, fluttering, or beating too hard or fast (palpitations)
- Slow heartbeat
- Irregular heartbeat
- Pauses between heartbeats
- Chest pain
- Difficulty breathing
- Light headedness
Arrhythmia is very common in older adults (60+). Other important risk factors include:
- Blood chemistry imbalances
- Weakening heart muscle (cardiomyopathy or heart failure)
- Prior heart attack
- High blood pressure
- Sleep apnea
- Thyroid abnormalities
- A high fat diet
How We Treat Arrhythmias
As one of the few facilities in Iowa with a specialized program devoted to treating arrhythmia, our team can treat all types and stages of heart rhythm disturbances.
If you have a heart rhythm problem, you may need to see an electrophysiologist, a heart doctor (cardiologist) who specializes in the heart’s internal electrical system.
Electrophysiologists may recommend these tests to diagnose arrhythmia:
3-D mapping systems: Tools to accurately map and identify arrhythmia. This technique is more accurate than the traditional radiation-guided technique and allows radiation-free procedures to be performed.
Electrocardiogram (ECG or EKG): A test that easily and painlessly measures the electrical activity of the heart.
Holter or event monitor: A monitor that is usually worn for 24-48 hours while recording your heart’s activity.
Exercise stress test (treadmill tests): A test that is given while you walk on a treadmill. This test is used to see if exercise has an effect on your heart.
Nuclear stress test: A test to measure the blood flow to the heart during rest and stress. You may be given medications or might exercise on a treadmill so you heart function can be measured under stress.
Electrophysiology (EP) study, or Intracardiac electrophysiology (EPS): A study involving placing wire electrodes in the heart to measure electrical activity. The procedure is done in a hospital laboratory by an electrophysiologist, technicians and nurses.
Once the cause of the problem has been pinpointed, our team can offer treatments that may not be available everywhere, including:
Education and lifestyle changes
You will be thoroughly examined and educated on how to manage your arrhythmia. Sometimes arrhythmias are harmless. If you have a harmless arrhythmia, you can still live a normal life. Our team will make sure that you understand your condition and can recognize symptoms. Your doctor may also recommend lifestyle changes like eating a well-balanced diet, reducing your salt, fat, alcohol or caffeine intake, and being physically active to keep a healthy heart.
We offer a wide variety of medicines, sometimes called anti-arrhythmic agents, to make sure that you receive treatment that is personalized for you.
Pacemaker and Defibrillator implantation
Pacemakers and defibrillators are small, medical devices used to control abnormal heart rhythms. They are usually implanted just beneath the skin, between the shoulder and the chest, sometimes leaving a scar or uncomfortable lump. Electrophysiologists at UI Heart and Vascular Center have pioneered a new way of implanting pacemakers. This new procedure, called submammary device implantation, leaves no visible scarring or lump and is not available at any other hospital in Iowa.
Single lead implantable cardiac defribillator (Biotronik)
Defribillators are sophisticated electronic devices that use a thin wire, called a lead, to deliver electrical shocks to the heart when the heart becomes dangerously fast. Most defribillators have two or more leads. This method is the first in the US to use only one lead, which means you will have a lower risk of infection or complications, and undergo a shorter implantation time.
Laser lead extraction
A lead is a wire that delivers energy to the heart from a pacemaker or defibrillator. Sometimes the lead may need to be removed because it isn’t working properly or too much scar tissue has formed. In the past doctors removed the lead by slowly pulling it out. Sometimes this would cause extra damage to surrounding tissues. Now, UI cardiologists use special lasers to remove the lead without risking additional damage to the heart.
Ablation is a minimally invasive heart procedure that uses heat or cold energy to change the path of abnormal electrical impulses. During the procedure, an electrophysiologist inserts a catheter (thin, flexible tube) into a blood vessel, and guides it using advanced imaging equipment. A small amount of heart tissue where the arrhythmia is coming from is destroyed during ablation, and the heart returns to normal rhythm. Most patients are able to go home either the same day of treatment or the following day.
Cryoablation or catheter ablation procedure
UI Heart and Vascular Center doctors are the first in Iowa to use a new technique called cryoablation to correct abnormal heartbeats. This procedure involves the use of subzero temperatures to destroy cells that cause abnormal heartbeats. The advantage is that only the tissue causing the abnormal heartbeat is affected, leaving the surrounding normal tissue untouched. Fewer patients are likely to need a pacemaker following this type of ablation.
Radiofrequency ablation is another minimally invasive option used by UI heart specialists to treat some types of rapid heartbeats. During the procedure, doctors guide a catheter into the heart, and then transmit a painless, radiofrequency energy to destroy carefully selected cells. This stops those cells from giving off electrical signals that stimulate the irregular and fast heartbeat.
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