Arrhythmia

There are many reasons why your heart rhythm can get out of sync. Atrial fibrillation (Afib) is the most common type of sustained arrhythmia in the U.S., but there are many other types. Some are passed on through generations (inherited), while others start on their own (acquired). Arrhythmias can also start in different parts of your heart.

Some start in the upper chambers of your heart (atria):

• Atrial arrhythmia.
• Atrial flutter.
• Atrial tachycardia.
• Supraventricular tachycardia (SVT).

And others begin in the lower chambers of your heart (ventricles):

• Brugada syndrome.
• Premature ventricular contractions (PVCs).
• Ventricular fibrillation.
• Ventricular tachycardia.

Still others, like bradyarrhythmias and junctional arrhythmias, start in your heart’s electrical (conduction) system.

What to expect at your first visit

It’s natural to feel anxious when you find out you may have a heart problem. Our compassionate providers understand this. That’s why they ease into your first appointment by getting to know you. You can ask questions and share your concerns with your provider. And they’ll ask you to share your story and answer important questions, like:

• What symptoms are you having?
• When did you first notice these symptoms?
• Are the symptoms getting worse?
• Have you had any testing before this appointment?
• What other health conditions do you have?
• Does anyone in your family have heart problems?

During your visit, your provider will do a physical exam. They’ll check your pulse and listen to your heart with a stethoscope. They’ll also order some blood tests and other tests to check for an irregular heart rhythm and signs of heart conditions. You may have:

• Electrocardiogram (EKG): Checks your heart’s electrical activity at a single point in time.
• Ambulatory monitor: Tracks your heart’s electrical activity over longer periods.
• Stress test: Shows how well the heart responds when working hard.
• Echocardiogram (Echo): Uses ultrasound to look at different parts of your heart and how it works.
• Cardiac catheterization: Lets us look for blockages or narrowing in your heart using a tiny tube (catheter), X-rays and contrast liquid in your coronary arteries.
• Electrophysiology study (EPS): Uses cardiac catheters and computers to measure your heart’s electrical activity and rhythm.
• Tilt table test: Shows how you react to standing up after lying down — will it cause you to faint?
• CT scan (computed tomography scan): Uses X-rays and a computer to create 3D images of your heart and chest.
• Heart MRI (magnetic resonance imaging): Scans your heart with radio waves and magnets to see how the different parts of your heart.

Meet Our Arrhythmia Team

When you come to Cleveland Clinic, you’ll have a care team of providers from multiple specialties. They work together to give you comprehensive and personalized care. Your team may include:

• Cardiologists.
• Electrophysiologists.
• Interventional cardiologists.
• Cardiothoracic surgeons.
• Radiologists.
• Radiologic technologists.
• Pathologists.
• Genetic counselors.
• Nurse practitioners.

Many things guide your arrhythmia treatment plan, including the type of arrhythmia you have and how bad it is. Sometimes, you may not need treatment. Other times, you may have one or a combination of treatments, like:

Lifestyle changes

Making lifestyle changes like these can improve arrhythmia:

• Avoiding tobacco, caffeine and other stimulants.
• Cutting back on alcohol.
• Managing your blood pressure and sugar.
• Achieving and maintaining a healthy weight for you.

Your care team is here to support you. We can connect you with support groups, counselors and more as you make lifestyle changes.

Medications

Your provider may prescribe medications like antiarrhythmic drugs or blood thinners (anticoagulants). You may also take medications to treat other conditions that could cause abnormal heartbeats.

Other treatments

Sometimes, you may need different treatments to manage or stop arrhythmias. Your care team will go over recommended options. You may have:

• Cardioversion: Synchronizes your heart with an electrical impulse so you can have a normal heartbeat.
• Catheter ablation: Uses a thin tube in a small area of heart tissue to send high-frequency electrical energy to stop abnormal heart rhythm.
• Pulmonary vein isolation: Treats different types of atrial fibrillation.

Implantable devices

Some arrhythmias respond well to implantable devices like a permanent pacemaker or implantable cardioverter defibrillator (ICD). Your provider may also recommend biventricular pacemakers and defibrillators — or cardiac resynchronization therapy (CRT).

Surgery

There are many reasons why your care team may recommend surgery to treat arrhythmia. For example, if atrial fibrillation doesn’t respond to other treatments, you may need a maze procedure. Or if heart disease contributes to your arrhythmia, you may have valve surgery or coronary artery bypass surgery (also known as CABG).

Another option could be the Convergent procedure (CONVERGE). Using a combination of minimally invasive surgery and catheter ablation, this is a new treatment option for advanced, ongoing (persistent) atrial fibrillation. This hybrid approach lets us use the best features of two proven treatments to improve atrial fibrillation in most of the people we treat.

What To Expect After Arrhythmia Treatment

It can take time to find the best medication or treatment for your arrhythmia. And some treatments and surgery require a few weeks (or even months) of recovery. Your provider will go over what to expect after treatment.

Some abnormal heart rhythms come and go. You may need to manage other types for the rest of your life. You’ll have follow-up appointments to make sure your arrhythmia stays under control with medications or treatment.

Traveling for Heart Care at Cleveland Clinic

Traveling can be stressful — particularly if you’re coming here from another city, state or even another country for heart care. That’s why we try to make things as easy and convenient as possible for you. Need to figure out how to get to and from the airport? Ask us for directions. Wondering where to stay or shop? We’re on it. We even have a hotel right on campus. Our travel guide has the answers you need.

And if you’re an international patient, our experienced and compassionate Global Patient Services (GPS) team can help guide you while at Cleveland Clinic. From connecting you with the healthcare providers you need and helping you schedule appointments to providing language translation services and coordinating follow-up care when you return home, we’re here for you.

Taking the Next Step

People often say, “My heart skipped a beat,” to describe excitement or surprise. But it’s not good when your heart does that in real life. Whether it feels like your heart is skipping or racing, it could be an arrhythmia. And it’s a sign to make an appointment with expert healthcare providers. Cleveland Clinic’s leading cardiology team will find the best treatment for you. And, if necessary, we’ll help you make lifestyle changes so your heart can keep a steady rhythm.