Arrhythmia

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► About Arrhythmia

► Symptoms

► Causes and Risk Factors

► Diagnosing Arrhythmia

► Treatment Options

► Living with Arrhythmia

► Additional Resources

► Request a Heart Specialist

About Arrhythmia

Arrhythmias, or heart rhythm disorders, occur when the heart beats too fast, slow, or irregularly. The most common arrhythmia is atrial fibrillation (AFib). Left untreated, arrhythmias are a leading cause of stroke and can cause severe health issues or death.

BayCare provides extensive care for arrhythmias through its team of specialized heart rhythm experts. With their extensive training and experience, BayCare’s heart rhythm disorder specialists, cardiologist specialists and cardiac electrophysiologists ensure high-quality heart care including advanced diagnostic and treatment options throughout West Central Florida.

Types of Arrhythmias

  • Atrial Fibrillation

  • Atrial Flutter

  • Bradycardia

  • Long QT Syndrome

  • POTS

  • Sick Sinus Syndrome

  • Supraventricular Tachycardia

  • Ventricular Tachycardia

  • Ventricular Fibrillation

  • Wolff-Parkinson-White Syndrome

Also known as AFib, it’s the most common arrhythmia. This happens when the atria of the heart beats faster than and out of sync with the ventricles of the heart.
Similar to AFib, this type of arrhythmia usually causes a fast heart rate. Atrial flutter happens when the upper chambers (atria) beat extremely fast causing the lower chambers (ventricles) of the heart to beat inefficiently. Many people that have an atrial flutter develop AFib over time.
Bradycardia is a heart rhythm disorder where the heart beats too slow, typically fewer than 60 beats per minute. This can be dangerous as the heart may not beat enough to pump blood throughout the body. When the slow heartbeat is caused by another heart rhythm disorder, it’s called bradyarrhythmia.
Long QT syndrome is a heart rhythm disorder where the heart’s electrical signal takes longer than normal to reach the lower chambers of the heart (ventricles) to beat. It can be something you’re born with (congenital) or something that develops over time (acquired disease).
Postural orthostatic tachycardia syndrome (POTS) is a complicated heart rhythm disorder that causes a fast heartbeat (tachycardia) when you move your body from sitting down or lying down (postural) to standing up (orthostatic). In someone with POTS, their body cannot properly balance blood pressure and heart rate when they stand up, causing dizziness, fainting (syncope) and extreme exhaustion or fatigue.
An uncommon heart rhythm disorder of the sinus node, sick sinus syndrome happens when the sinus node fails to control the heartbeat pattern, which causes the heart to beat slow, fast, or pause for long periods of time. It is sometimes called sinus node disease.
Supraventricular Tachycardia (SVT), also known as Paroxysmal Supraventricular Tachycardia (PSVT), this arrhythmia starts in the upper chambers (atria) of the heart. This abnormally fast heart rhythm can be abrupt and may last for a few seconds to a few hours before your heart returns to a normal rhythm.
Ventricular Tachycardia (VT) is caused by abnormal electrical signals that begin in the lower chambers (ventricles) of the heart that cause it to beat too fast, affecting the way your heart pumps. VT causes poor blood flow to the rest of your body and can eventually lead to ventricular fibrillation (V-fib).
Ventricular fibrillation (V-fib) is a dangerous and life-threatening type of arrhythmia that starts in your ventricles. This happens when the electrical signals that tell your heart muscle to pump cause your ventricles to fibrillate or quiver instead, which in return causes less blood flow to your body. This condition can cause sudden cardiac arrest (SCA) and requires immediate medical attention.
This happens when there is an extra electrical pathway between the upper and lower chambers of the heart muscles, which can lead to an abnormally fast heart rhythm. This arrhythmia is usually present at birth but may not cause problems until the person gets older.

Symptoms

You may not always feel symptoms of an arrhythmia, and they may only become noticeable during physical activity. Common symptoms include:

  • Chest pain
  • Heart palpitations
  • Paleness
  • Sweating
  • Rapid heartbeat or palpitations
  • Fainting (syncope)
  • Light-headedness or dizziness
  • Shortness of breath
A woman consults with a doctor about her arrhythmia, discussing symptoms and treatment options in a medical setting.
These symptoms can be constant or sporadic, and their severity can range from mild to life-threatening. If you are experiencing any of these symptoms, please talk to a primary care physician.
Find a Primary Care Provider

If you're experiencing pressure, heaviness or pain in the chest, arm or below the breastbone alone or in combination with sweating, nausea, extreme shortness of breath or irregular heartbeats, you may be having a heart attack. Call 911 immediately.

Causes and Risk Factors

Some common causes of abnormal heartbeats are:

  • Abnormal levels of potassium or other substances
  • Heart attack, or a damaged heart muscle from a past heart attack
  • Congenital Heart Disease
  • Heart Failure
  • An enlarged heart
  • An overactive thyroid gland
  • Medication or drug side effects

Risk factors for developing a heart rhythm disorder may include:

  • Smoking
  • Drinking alcohol or caffeine
  • Having a high BMI (body mass index)
  • Being overweight or obese
  • High blood sugar
  • Having sleeping issues like sleep apnea
  • Taking medications that contain certain stimulants

Diagnosing Arrhythmia

To diagnose an arrhythmia, your cardiologist may refer you to an electrophysiologist (EP), a cardiologist who specializes in heart rhythm disorders. Some tests an EP may use to diagnose a heart rhythm disorder include:

  • Blood Tests

  • Cardiac CT or MRI

  • Electrocardiogram

  • Genetic Testing

  • Holter Monitor

  • Loop Recorder

  • Stress Test

  • Echocardiogram

  • Tilt Table Test

  • Electrophysiologist Study

  • Diagnostic Cardiac Catheterization

Blood tests, including electrolyte level testing, may be recommended. Most blood tests can be performed at a BayCare Lab near you. 
These non-invasive tests show detailed images of the heart’s chambers, valve and muscles. MRI uses radio waves and magnets while a CT scan uses x-ray beams to create the images of your heart and its arteries. This can help your doctor see if there are any abnormalities causing an arrhythmia. MRI or CT scans can be scheduled at a BayCare Imaging Center.
Also known as an ECG or EKG, this non-invasive test measures the heart's electrical activity and helps to show any arrhythmias. ECG or EKG testing is often performed in your cardiologist’s or primary care physician’s office.
Your cardiologist or electrophysiologist may do genetic testing to check for inherited conditions.
This is a small, portable device worn around the neck or body that’s designed to detect heart rhythm changes. Holter monitors are typically ordered by a cardiologist and worn for one to three days. Results are then reviewed by your cardiologist.

A loop recorder is a small, implanted device designed to record the heart’s rhythm 24 hours a day for up to three years. Loop recorders can be placed by your cardiologist in their office or by an electrophysiologist inside the electrophysiology lab. Loop recorder implantation is performed at these BayCare facilities:

This test involves exercising on a treadmill or using medications to stress the heart while being closely monitored. When extra images are taken before and after exercising, it’s called a nuclear stress test. These tests can detect coronary blockages that might be causing arrhythmias. Stress tests can be performed at the following BayCare hospitals:

This non-invasive test/imaging study uses sound waves to produce images of the heart's chambers, valves and walls. It helps to show the heart’s overall function and structure. Echocardiograms can be scheduled at a BayCare Imaging Center.
This is a diagnostic test designed to understand your body’s heart rhythm, heart rhythm and blood pressure as your body changes angles on a table. Tilt table testing can be performed at the following BayCare locations:

This is a specialized test where an EP physician tests and maps the heart’s electrical systems to look for heart rhythm problems. It’s typically performed in a hospital using catheter-based technology and highly specialized equipment. EP studies are performed at the following BayCare hospital locations:

This procedure allows your cardiologist to test pressures inside your heart and look at how the coronary arteries are functioning. If blood vessels are narrow or blocked, it can cause arrhythmias. To view the arteries, a specialized cardiologist uses an imaging process called coronary angiography where contrast material and x-rays are used to see and photograph areas of the heart’s blood vessels as the contrast moves through. If needed, your cardiologist can also take a biopsy through the catheter as well. Cardiac catheterizations are performed at the following BayCare locations:

Treatment Options

Treatment for an arrhythmia depends on the type of heart rhythm disorder diagnosed. Generally, your cardiologist or electrophysiologist may recommend:

  • Lifestyle Changes

  • Medications

  • Surgery

  • Cardiac Ablation

  • Implantable Cardiac Defibrillator

  • Pacemaker

  • Cardioversion

Your cardiologist may recommend lifestyle changes including avoiding stimulants like caffeine, nicotine, certain medications, and alcohol. Talk with your doctor about a heart-healthy diet and exercise plan that are appropriate for your specific condition. Before you take any over-the-counter medications and supplements, talk with your cardiologist about how they may impact your specific arrhythmia.

Different types of medications can be used to manage arrhythmias. These drugs are typically prescribed by your cardiologist or electrophysiologist.

  • Anti-arrhythmic medications: These drugs help regulate heart rate and prevent arrhythmias and work by reducing the movement of abnormal electrical signals in the heart tissue or decreasing the abnormal signals from the sinus node of the heart. Examples of these medications include adenosine, digoxin, amiodarone, propafenone  and flecainide.
  • Calcium channel blockers: Though normally used to treat the symptoms of coronary artery disease, these drugs can slow your heart rate and reduce the risk of an arrhythmia occurring.
  • Beta blockers: These medications work by blocking the effects of the body hormone adrenaline and slowing your heart rate down.
  • Anticoagulants: Also called blood thinners, these are drugs that help to prevent the blood from clotting and are often prescribed to reduce the risk of a stroke.
For some arrhythmias like atrial fibrillation (AFib), surgical procedures like Cox Maze may be a treatment option. Open-heart surgeries are performed at the following BayCare hospitals:
Cardiac ablation uses radiofrequency (heat), cryoablation (cold), or pulsed electroporation (non-thermal) to disrupt the abnormal electrical signals in the heart that are making it beat out of normal rhythm. Ablation procedures are available at the following BayCare hospitals:
Implantable Cardiac Defibrillator (ICD) is a device implanted near the heart for those at high risk of sudden cardiac arrest from a heart rhythm disorder. If the heart goes into an abnormal rhythm, an ICD sends an electric shock to the heart to stop the abnormal rhythm. ICDs can be implanted at these BayCare hospitals:
This device senses when your heart is beating irregularly, too slowly, or too fast. It sends a signal to your heart that makes your heartbeat at the correct pace. Pacemakers can be implanted at these BayCare hospitals:
During this procedure, low-energy electrical current or medication is used to restore the heart’s normal rhythm. Cardioversion can be performed at the following BayCare hospitals:

Living With Arrhythmia

With proper clinical care and management, you can live a long, healthy and active life with a heart rhythm disorder.  Below are some tips for living with a heart rhythm disorder:

  • Keep a symptom journal: If you notice symptoms, it can help to track what you were doing before they started. Write down details like what you ate or drank, any activities you were doing, or any medications or supplements you took.
  • Have a plan for fainting (syncope): Fainting can be a symptom of several different arrhythmias. It's important to recognize signs that may lead to fainting, such as dizziness. If you're prone to fainting, sitting down on the floor or ground can help prevent injury.
  • Consider a medical ID necklace or bracelet: Wearing a medical ID item may alert bystanders and first responders of your condition quickly.
  • Understand your risk for sudden cardiac arrest (SCA): Some rhythm disorders can cause a fatal heart rhythm leading to SCA. Talk to your cardiologist or electrophysiologist to make a plan for SCA, which may include getting an ICD device, having your loved ones trained in CPR, or having an automated external defibrillator (AED) at home.

Additional Resources

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BayCare HealthChat

Heart Rhythm Disorders
March 08, 2023

Heart arrhythmias are an irregular heartbeat. It feels like a fluttering or a racing heart sometimes and can often be harmless. However, some heart arrhythmias may be indicative of serious underlying conditions. Listen to Dr. Rodrigo Bolanos, the electrophysiology lab director, director of Arrhythmia Services at Bostick Heart Center at Winter Haven Hospital, and the Co-chair of the Arrhythmia Committee for BayCare Health System discuss heart rhythm disorders and when you should see a specialist.

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