Arrhythmia (Irregular Heart Rhythm)

What is arrhythmia?

Any change from the normal sequence of electrical impulses that causes the heart to beat too fast, too slow or erratically, is considered an arrhythmia.

What are the symptoms?

  • Chest pain
  • Irregular or rapid heartbeat
  • Shortness of breath
  • Fatigue
  • Dizziness

What treatment options are available?


An electrophysiology (EP) study can help determine exactly what your heart rhythm problem is and how it can be controlled. A specially trained doctor, an electrophysiologist, performs the study by reading electrical signals received from electrode catheters that have been inserted into the heart.

Arrhythmias may be stopped by using the electrode catheters to regulate (pace) the heartbeat. Sometimes the heart is given an electric shock (defibrillation) to stop an arrhythmia.
In some cases, a catheter ablation may be performed during the EP study to treat an arrhythmia. The entire procedure takes from one to four hours.

Catheter Ablation

Catheter Ablation treats an irregular heart rhythm by sending energy waves through a special electrode catheter to destroy (ablate) a few of the problem cells in your heart that are causing arrhythmia, leaving the rest of your heart muscle unharmed.

To pinpoint the places in the heart where an ablation should be done, an electrophysiologist conducts an electrophysiology (EP) study that reads where signals begin in the heart and how often these signals are sent. The entire procedure takes two to six hours. You can usually stop taking heart medications after a successful ablation.


A pacemaker is a small, lightweight, electronic device that's placed inside your body to keep your heart beating at the right pace. It helps keep your heart from beating too slowly, but it doesn't stop your heart from beating on its own. The pacemaker "listens" to your heart. When the heart's own electrical system sends a signal and the heart beats, the pacemaker waits and does nothing. When the heart's system misses a signal, the pacemaker sends a signal to replace it.

Pacemaker implantation is not open heart surgery. Rather, it’s a fairly simple surgical procedure, but it does require a lifelong commitment. The most common method used to insert a pacemaker is called endocardial (inside the heart) implantation. This procedure may take two to three hours. Your doctor may use an alternative method, called epicardial ("outside the heart") implantation. Epicardial implantation takes longer than endocardial implantation and requires more recovery time.

Pacemaker batteries last about five to 10 years before they need to be replaced. With proper care, a pacemaker can help keep you feeling good for many years to come.

Atrial Fibrillation Ablations

Atrial Fibrillation (A.F.) is the rapid, irregular heartbeat that frequently occurs after coronary artery bypass graft surgery and heart valve surgery.

For years, the only method that doctors had to treat AF was with medicine. This has proven to be only moderately effective. One of the newest advances in treating this disease is AF ablation, this can be done peripherally, through a vein in the groin, as an adjunct during open heart surgery or in the operating room, using one of the new minimally invasive surgical techniques. During the ablation, a catheter with a special radio-frequency catheter is placed in the area that is commonly demonstrated as the site of origin of these irregular beats. The tissue is heated and the tissue's ability to produce an electrical current is eliminated.


A-Fib Mini-Maze

Not everyone with Atrial Fibrillation needs to have an open-heart procedure. If you are suffering from only AF and have no heart valve issues, the minimally invasive Mini-Maze procedure may be for you. The Mini-Maze is performed on a beating heart through endoscopes or flexible tubes inserted on each side of the chest. A tiny camera and video-guided instruments are inserted into the endoscopes to get to the heart and create a pattern of scarring, or ablation, with radio frequency energy which interrupts the impulses that cause AF. 
Since this procedure does not require open-heart surgery, there is no long recovery period. The tiny incisions mean less pain, smaller scars, and a quicker return to normal activities. 

Cardiac Resynchronization Therapy

In healthy people, the four chambers of the heart contract in synchrony to move blood through the body. However, in many patients who have heart failure, the electrical impulses that coordinate the contractions of the heart's chambers may be impaired.

Cardiac Resynchronization Therapy improves the pumping efficiency of the heart through the use of the Medtronic InSync ICD system. An Implantable Cardioverter Defibrillator (ICD) is a small, lightweight electronic device that is placed inside your body to help control your heart rhythm (speed and pattern of your heartbeat). The device sends tiny electrical impulses at the precise times needed to make each chamber contribute to better pumping action. Other functions in the same device are programmed to monitor the electrical conduction system of the heart and to deliver corrective impulses when needed. An ICD can do one or more of the following:

  • Antitachycardia pacing (ATP): The ICD can send out a series of pulses to override a fast rhythm. This may feel like fluttering in your chest, or may not be felt at all.
  • Cardioversion: If ATP doesn't slow a fast rhythm, the ICD can give the heart one or more small shocks. These shocks can break up the fast rhythm. They may feel like thumps in your chest.
  • Defibrillation: If the ICD senses a very fast, irregular rhythm, it quickly sends a strong shock to the heart to override the fast rhythm. You may feel this as a strong kick in your chest.
  • Bradycardia Pacing: An ICD's main job is to slow a fast heart rhythm. At rare times, your heart may beat too slowly. This may happen if you have a second heart rhythm problem that causes a slow heartbeat. Your heart may also beat too slowly after an ICD shock. Most ICDs can send out pulses to get a slow heartbeat back to the right speed.
The ICD function is often referred to as "an emergency room in the chest," protecting patients from potentially lethal heart rhythms using defibrillation therapies. ICD implantation is not open heart surgery. Rather, it's a minor procedure that's done in an operating room or cardiac catheterization lab. You may still feel symptoms when you have a fast heart rhythm, but your ICD will stop them. If you do feel symptoms, follow your doctor's advice on what to do next. Tests such as an ECG may be performed. Your ICD's battery will also be checked.

ICD batteries last three to seven years. Your doctor will know well in advance when the battery needs to be replaced. The battery won't run down unexpectedly. With an ICD, you'll know that your heart rhythm problem can be managed.

Cardiac Resynchronization Therapy is intended to complement, not replace, heart failure drug treatment and dietary modification.