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An arrhythmia is when your heart beats abnormally fast, abnormally slow, or irregularly. Arrhythmias are disorders that affect the electrical system of the heart. Most arrhythmias are benign, but certain types can be dangerous and require treatment. If you have existing heart problems, arrhythmia can be a serious matter.

Types of Arrhythmia

Atrial fibrillation

This is the most common form of arrhythmia. Atrial fibrillation can be brief or sustained, lasting minutes or hours with the heart rate returning to a normal beat between episodes, or more persistent and lasting months and/or years. Atrial fibrillation can be dangerous because it can cause blood clots to form in the top chamber of the heart, or atria. If a clot leaves the atria and becomes lodged in the artery to the brain, it can result in a stroke.

Bradyarrhythmia or bradycardia

This occurs when the heart rate is slower than normal. If the heart rate is too slow, not enough blood reaches the brain. People can faint. Slow heart rates are normal in some people, especially those who are physically fit. For them, a heartbeat slower than 60 beats per minute isn’t dangerous. In others, however, bradycardia can result from serious diseases or other conditions.

Premature (extra) heartbeats

These are usually harmless and can occur without symptoms.

Supraventricular arrhythmias

These are fast heart rates originating in the upper chambers including atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia, atrial tachycardia, and Wolff-Parkinson-White syndrome.

Ventricular tachycardia

This is fast, regular beating of the heart’s lower chambers, known as the ventricles. While a few fast beats are usually OK, episodes lasting more than a few seconds might be dangerous.

Symptoms of Arrhythmia

Many types of arrhythmia cause no signs or symptoms. It can be hard to detect by most people. When present, the most common symptoms are:

  • Chest pain
  • Difficulty breathing
  • Fainting
  • Fatigue
  • Feeling that your heart is skipping a beat, fluttering, or beating too hard or fast (palpitations)
  • Irregular heartbeat
  • Light headedness
  • Pauses between heartbeats
  • Slow heartbeat
  • Sweating

Arrhythmia Risk Factors

Arrhythmia is very common in older adults (60+). Other important risk factors include:

  • A high fat diet
  • Blood chemistry imbalances
  • Diabetes
  • High blood pressure
  • Prior heart attack
  • Sleep apnea
  • Smoking
  • Thyroid abnormalities
  • Weakening heart muscle (cardiomyopathy or heart failure)

How We Treat Arrhythmia

As one of the few facilities in Iowa with a specialized program devoted to treating arrhythmia, our team can treat all types and stages of heart rhythm disturbances.

Arrhythmia Diagnosis

If you have a heart rhythm problem, you may need to consult a electrophysiologist or a cardiologist who specializes in the heart’s internal electrical system.

Electrophysiologists may recommend these tests to diagnose arrhythmia:

3-D mapping systems
Tools to accurately map and identify arrhythmia. This technique is more accurate than the traditional radiation-guided technique and allows radiation-free procedures to be performed.
Electrocardiogram (ECG or EKG)
A test that easily and painlessly measures the electrical activity of the heart.
Holter or event monitor
A monitor that is usually worn for 24-48 hours to record your heart’s activity.
Exercise stress test (treadmill tests)
Given while you walk on a treadmill to see if exercise has an effect on your heart.
Nuclear stress test
Measure the blood flow to the heart during rest and stress. You may be given medications or instructed to exercise on a treadmill to measure your heart function under stress.
Electrophysiology (EP) study, or Intracardiac electrophysiology (EPS)
A study involving placing wire electrodes in the heart to measure electrical activity. The procedure is done in a hospital laboratory by an electrophysiologist, technicians and nurses.

Arrhythmia Treatment Options

Once the cause of the problem has been pinpointed, our team can offer treatments that may not be available everywhere, including:

Education and lifestyle changes

You will be thoroughly examined and educated on how to manage your arrhythmia. Sometimes arrhythmias are harmless. If you have a harmless arrhythmia, you can still live a normal life. Our team will make sure that you understand your condition and can recognize symptoms. Your doctor may also recommend lifestyle changes like eating a well-balanced diet, reducing your salt, fat, alcohol or caffeine intake, and being physically active to maintain a healthy heart. 


We offer a wide variety of medicines, sometimes called anti-arrhythmic agents, to make sure that you receive treatment that is personalized for you.

Pacemaker and Defibrillator implantation

Pacemakers and defibrillators are small, medical devices used to control abnormal heart rhythms. They are usually implanted just beneath the skin, between the shoulder and the chest, sometimes leaving a scar or uncomfortable lump. Electrophysiologists at UI Heart and Vascular Center have pioneered a new way of implanting pacemakers. This new procedure, called submammary device implantation, leaves no visible scarring or lump and is not available at any other hospital in Iowa. 

Single lead implantable cardiac defribillator (Biotronik)

Defribillators are sophisticated electronic devices that use a thin wire, called a lead, to deliver electrical shocks to the heart when the heart becomes dangerously fast. Most defribillators have two or more leads. This method is the first in the US to use only one lead, which means you will have a lower risk of infection or complications, and undergo a shorter implantation time.

Laser lead extraction

A lead is a wire that delivers energy to the heart from a pacemaker or defibrillator. Sometimes the lead may need to be removed because it isn’t working properly or too much scar tissue has formed. In the past doctors removed the lead by slowly pulling it out. Sometimes this would cause extra damage to surrounding tissues. Now, UI cardiologists use special lasers to remove the lead without risking additional damage  to the heart.


Ablation is a minimally invasive heart procedure that uses heat or cold energy to change the path of abnormal electrical impulses. During the procedure, an electrophysiologist inserts a catheter (thin, flexible tube) into a blood vessel, and guides it using advanced imaging equipment.  A small amount of heart tissue where the arrhythmia is coming from is destroyed during ablation, and the heart returns to normal rhythm. Most patients are able to go home either the same day of treatment or the following day.

Cryoablation or catheter ablation procedure

UI Heart and Vascular Center doctors are the first in Iowa to use a new technique called cryoablation to correct abnormal heartbeats. This procedure involves the use of subzero temperatures to destroy cells that cause abnormal heartbeats. The advantage is that only the tissue causing the abnormal heartbeat is affected, leaving the surrounding normal tissue untouched. Fewer patients are likely to need a pacemaker following this type of ablation.

Radiofrequency ablation

Radiofrequency ablation is another minimally invasive option used by UI heart specialists to treat some types of rapid heartbeats. During the procedure, doctors guide a catheter into the heart, and then transmit a painless, radiofrequency energy to destroy carefully selected cells. This stops those cells from giving off electrical signals that stimulate the irregular and fast heartbeat.

Clinical Trials

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Care Team