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.

At the University of Chicago Medicine Center for Arrhythmia Care, our team concentrates on advanced therapies for complex arrhythmias, namely atrial fibrillation and ventricular tachycardia. In particular, we specialize in catheter ablation, which offers the possibility to cure common heart conditions.

What are heart arrhythmias?

Heart arrhythmias occur when the heart beats too quickly, too slowly or irregularly. Remember that a heart arrhythmia is different from a heart attack. Heart arrhythmias are caused by electrical problems. Sometimes, it's just a single skipped beat, but arrhythmias can last minutes, hours, days and possibly years. Occasionally, the heart’s electrical signals get caught in a little short-circuit loop. These type of arrhythmias include paroxysmal supraventricular tachycardia (PSVT) atrial flutter and ventricular tachycardia. Atrial fibrillation (AFib), the most common abnormal heart rhythm disturbance across the globe, is characterized by fast, irregular heartbeats that start in the upper heart chambers. AFib can make the heart prone to blood clots because its organized contractions have gone astray, increasing the risk for stroke. AFib also can promote the development of, or exacerbate, congestive heart failure.

What causes arrhythmias?

Arrhythmias can be caused by pre-existing conditions like coronary artery disease, diabetes, sleep apnea, heart failure or high blood pressure. Arrhythmias are also associated with the natural aging of the heart and its electrical system. They can be worsened by lifestyle choices — things like smoking, excessive alcohol consumption, obesity 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. Fatigue and poor exercise tolerance are common symptoms of many arrhythmias. So everything from feeling nothing to fatigue, shortness of breath, heart pounding and fainting is the spectrum of what we see with arrhythmias.

How serious is a heart arrhythmia?

If you feel an occasional skip in your heart —called a heart palpitation — often it’s 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 long-lasting, 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 or heat energy. In rare cases, heart surgery may also be an option for some patients.

Can I exercise if I have an irregular heartbeat?

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.

Hemal Nayak

Hemal Nayak, MD

An expert in cardiac electrophysiology, Hemal M. Nayak, MD, provides care for patients with heart rhythm problems (arrhythmias). He specializes in catheter ablation — a minimally invasive procedure in which high frequency radio waves are used to eliminate abnormal heart rhythms.

Learn more about Dr. Nayak
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Arrhythmia Care

At the University of Chicago Medicine Center for Arrhythmia Care, we work with each patient to deliver high-quality, personalized care, whether you are seeking a first opinion for your condition or turning to us as a last resort.

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