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Living Well

Arrhythmias: What Happens When Your Heart Skips or Adds a Beat?

Last updated: Jan 23, 2017


You may never notice it, but every minute your heart beats between 60 and 100 times. The heart has a complex electrical system—when you walk or run it sends out a signal telling the muscle to pump blood faster, and when you sleep it says to slow down. But what happens when those signals misfire and our heart beats too fast, too slow, or becomes very erratic?

What is an arrhythmia?

  • An arrhythmia is a medical condition that means your heart has an abnormal rhythm.
  • Arrhythmias vary greatly—some people never notice anything unusual while others feel intense symptoms, as if “their heart was beating out of their chest.”
  • When the heart’s workload is reduced or overtaxed for a long period of time, it can cause life-threatening events, such as a stroke or heart attack.

“Arrhythmias can be difficult to diagnose because the symptoms are extremely variable and can affect everyone from healthy young adults to sick elderly patients,” says Jonathan Steinberg, MD, Director of The Arrhythmia Center at Summit Medical Group (SMG). “Identifying these abnormal rhythms is critical because they range from being completely benign abnormalities to universally fatal heart conditions.” 

Any potential sign of an arrhythmia should be investigated. Make an appointment with your primary care physician if you experience symptoms such as: heart palpitations—a feeling of pain, fluttering, or banging in the chest—fainting, dizziness, excessive fatigue, or shortness of breath.

“As people age, they often think it is normal to feel weak or winded when they walk around or climb stairs, but this could be a sign of a dangerous underlying heart condition,” says Robert Altman, MD, Director of Clinical Cardiac Electrophysiology.

The Arrhythmia Center Can Help

Our cardiac electrophysiologists—“electricians of the heart” who specialize in understanding the heart’s timing and electrical system—diagnose and treat the broad spectrum of arrhythmias. With access to more than 80 medical services, they work closely with other physicians to help manage conditions, such as sleep apnea and diabetes, which may worsen existing arrhythmias or cause them to develop.

After a physical exam and complete medical history, your appointment may also include: 

  • Electrocardiogram (EKG)—a test that monitors the electrical activity of the heart.
  • Portable EKG device—many patients are sent home with a portable device that they wear for a day or longer. Since arrhythmias often come and go without warning they may not appear on a single office test.
  • Implantable devices—for patients who require more prolonged monitoring, small devices can be implanted under the skin
  • Echocardiograms—an ultrasound that take pictures of the heart

How to Treat Irregular Heartbeats

Treatment really depends on the symptoms caused by the arrhythmia and the threat it poses to the patient’s health. Some patients simply need reassurance or yearly monitoring, while others need medication or invasive interventions.

Fast heart arrhythmias—known as tachycardias—can be treated with:

  • Medication
  • Cardiac ablation—a minimally invasive procedure in which a thin tube called a catheter is inserted through a vein in the groin to fix the defect in the heart muscle.
  • Implantable cardioverter defibrillator (ICD)—a device placed in the chest that helps the heart maintain a regular beat. This is used in patients who experience, or are at risk for, dangerous tachycardias.

As people age, and their heart muscles weaken, they are more likely to develop slow heart rhythms, called bradycardia, which can be treated with:

  • Pacemaker—a device implanted in the chest that increases the heart rate when rhythms become too weak

Implantable devices are linked to The Arrhythmia Center and monitored remotely by our physicians.

“Managing arrhythmias is a lifelong process,” says Dr. Altman. “But with the proper treatment and screening, many serious events can be prevented. Discuss any potential symptoms with your physician.”


1. Interview with Robert Altman, MD, Director of Clinical Cardiac Electrophysiology at Summit Medical Group (11/21/16).

2. Interview with Jonathan Steinberg, MD, Director of The Arrhythmia Center at Summit Medical Group (11/25/16).