Ask the Experts: Understanding Arrhythmia

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Chief of Clinical Cardiology and Professor of Medicine at the University of California, San Francisco 

It’s a disturbance of the electrical activity of the heart—basically, a lack of rhythm.

 

Yes: slow, fast, and irregular. The heart should beat rhythmically between 60 and 100 times a minute. If you’re above or below that, you have slow or fast arrhythmia. If your heart beats irregularly—even if it’s at a normal rate—you have an irregular arrhythmia.  

 

Symptoms can be as simple as feeling palpitations, or people may say something like “my heart skipped a beat.” If your heart races for minutes or hours, or if you’re having brief flutters several times a day, that should be checked.

 

Some people don’t feel the arrhythmia, but they feel its effects—they might get dizzy or short of breath or pass out. If you’re passing out, you should get to a doctor soon. That’s a dangerous symptom because you can injure yourself, plus, passing out can lead to sudden death. I don’t want to scare people—most arrhythmias are minor and can be treated easily. But they can be serious, so people having symptoms should play it safe and see their cardiologist.

 

The basic method is an electrocardiogram (ECG). Depending upon how often the irregular beats occur, someone can wear a Holter monitor, which provides essentially a 24-hour ECG. It’s an event monitor that is worn for several days or weeks and activates only when there’s a problem. If someone has symptoms only rarely, we can implant a small device that records the heart’s activity for about a year.

 

If your arrhythmia is due to stress or is a side effect of a drug, the treatment would be to eliminate the stimulus. Another approach is to prescribe a drug that controls the arrhythmia. And, for arrhythmias caused by structural abnormalities in the heart, we perform what is called an ablation—we insert a catheter to find the problem and then fix it by sending a radio frequency to the damaged area.