Story by: David Steen Martin; Reviewed by Kent E. Morris, M.D. on December 1, 2023
A normal heart rhythm is 60 to 100 beats per minute. If your heart is beating too fast, too slow or irregularly, you may have an arrhythmia.
An abnormal heart rhythm doesn’t always require treatment. However, if the arrhythmia is causing significant symptoms or putting your health at risk, an electrophysiologist can help.
One common way electrophysiologists treat heart rhythm disorders is with a minimally invasive procedure called cardiac ablation or catheter ablation.
“Without having to perform open-heart surgery, electrophysiologists use this minimally invasive technique and tools to address the cause of arrhythmias at their source,” said Kent E. Morris, M.D., electrophysiologist with the Norton Heart & Vascular Institute Heart Rhythm Center. “We thread a tiny tube, or catheter, through a blood vessel and up to the heart, where we apply either heat or cold, depending on the situation, to small areas of heart tissue to block abnormal electrical signals that is causing the arrythmia.”
The heart uses electrical impulses to control the timing of your heartbeats. The tiny scars created by cardiac ablation block the electrical impulse causing the arrhythmia. By blocking these abnormal electrical signals at their source, electrophysiologists can restore a normal heart rhythm.
Catheter ablation can be used to treat a wide range of arrhythmias, including supraventricular tachycardia (SVT), atrial fibrillation (A-fib), atrial flutter, ventricular tachycardia (VT) and premature ventricular contractions (PVCs).
If you suspect you have an arrhythmia, talk to your primary care provider. If you have a medical emergency, call 911.
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Before the heart ablation procedure, you will be given medication to sedate you and make you sleepy. These medications are meant to reduce your anxiety and relieve your discomfort.
The cardiac ablation procedure typically takes from one to four hours, but sometimes can take longer. After the procedure you will need to lie still in recovery for several hours to decrease the risk of bleeding.
You may go home the same day or spend the night in the hospital for monitoring. You likely will feel some soreness after the procedure but typically can resume normal activities in a few days.
Medications also can be used to treat heart arrhythmia.
With tachycardia, an electrophysiologist may prescribe a type of medication called a beta blocker or a calcium channel blocker to slow down your heart and restore a normal rhythm.
For A-fib, quivering or irregular heartbeat, or atrial flutter, a similar heart rhythm disorder, you may receive a blood thinner to prevent blood clots and reduce the risk of stroke, and heart rate-controlling medications such as beta blockers or calcium channel blockers, which both slow the heart rate.
One cause of a fast heart rate is supraventricular tachycardia or SVT, which can cause the heart to beat from 150 to 200 beats a minute. SVT occurs when the fast heart rate begins in the upper chambers.
If you have a known diagnosis of SVT, you may be able to stop this by doing something called a vagal or Valsalva maneuver. You may be able to stop an abnormal heart rhythm simply by coughing, holding your breath and straining, dunking your face in ice water, or putting a cold towel on your face. Patients should only try this technique if they have a known diagnosis of SVT.
A procedure called cardioversion also can restore your normal heart rhythm for atrial fibrillation and also in more arrhythmias including ventricular tachycardia (VT), where a fast heart rate begins in the lower chambers of the heart.
During a cardioversion procedure, an electrophysiologist delivers a shock to your heart through paddles or a patch on your chest. This shock essentially can “reset” the electrical impulse in your heart.
Implantable devices can also be use to monitor for or correct an arrhythmia.
An implantable loop recorder is a small device the size of a paper clip that can be implanted under the skin on the chest wall to monitor your heart rhythm for evidence of any abnormal rhythm.
A pacemaker can correct a slow heart rhythm. An electrophysiologist typically implants the pacemaker through the vein under the collarbone, with wires running to the heart. If the heart beats too slow or stops, the pacemaker can send a tiny electrical signal to stimulate the heart. There are also newer “leadless” pacemakers that can be implanted through a vein in the leg. These are small devices that sit only inside the heart and do not have any wires attached.
An implantable cardioverter-defibrillator (ICD) is designed to correct a dangerous potentially life threatening fast heart rhythms that originate in the bottom of the heart. Like the pacemaker, it is typically powered by a device implanted near the collarbone. If the ICD detects an abnormal fast rhythm, it sends out a shock to reset the heart’s rhythm to normal to prevent you from dying from the abnormal rhythms.
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