Stethoscope and heart

Guido Vrola

Has your heart ever skipped a beat—and not because you’re in love? Irregular heartbeats, known clinically as ‘arrhythmias,’ are not uncommon.

“Arrhythmias are electrical problems that disrupt the normal electrical function of the heart,” says Dr. Mitchell Faddis, head of cardiac electrophysiology for Washington University Physicians. There are multiple types of arrhythmias, some of which are long-term conditions while others are fleeting episodes.

“Atrial fibrillation is the most common electrical disturbance. It is caused by the effects of high blood pressure, obesity, sleep apnea and diabetes on the heart,” Faddis says.

Adults 65 and older have a greater incidence of atrial fibrillation than younger people, and men are more likely than women to develop this type of arryhthmia. “By age 80, 10 percent of the population has atrial fibrillation,” Faddis says. “Atrial fibrillation is essentially an electrical ‘storm’ in the top chambers of the heart. Generally, the symptoms are tied to how fast the pulse becomes. Many maintain a normal pulse rate in spite of the atrial fibrillation and have few symptoms as a result. The main medical concern is that atrial fibrillation promotes the formation of blood clots in the heart that can lead to a stroke.”

Diagnosis is made based on results of an electrocardiogram (EKG), which measures electrical activity in the heart. “In some cases, a diagnosis cannot be made without studying the heart’s electrical system using catheters that record electrical signals from the inside of the heart,” adds Dr. Andrew Krainik, a cardiac electrophysiologist with BJC Medical Group of Missouri and on staff in the Arrhythmia Center at Missouri Baptist Medical Center.

“Often, recording and diagnosing an arrhythmia is hampered by the fleeting, transient nature of the problem,” he notes. “Recording an arrhythmia has been likened to ‘catching fireflies in the dark,’ where you are completely dependent on the firefly turning on its light when you are looking in the right direction.”

Once an arrhythmia is diagnosed, treatments may include medication or more invasive approaches, such as implantable pacemakers or defibrillators. “Perhaps the most impressive treatment option for some heart rhythm disorders involves an electrophysiology study and catheter-based ablation,” Krainik says. “This procedure, which is performed through the large veins of the groin, involves the careful positioning of electrical recording catheters on the inside of the heart. This is done in order to identify and characterize the properties of the arrhythmia. When a vulnerable site is identified, a catheter that delivers radiofrequency energy to that area can extinguish the arrhythmia. In this way, many arrhythmias can be cured.”

Both Faddis and Krainik promote heart-healthy habits to help prevent arrhythmias. Maintaining a healthy weight, exercise, a balanced diet and being tobacco-free are among the factors known to reduce the risk of all types of heart disease.