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Arrhythmia (Irregular Heartbeat)

Arrhythmia is a heart rhythm problem caused by a glitch in the electrical impulses to the heart. It can cause symptoms such as heart palpitations, a fast or slow heartbeat, shortness of breath, and chest pain.

Heart arrhythmia treatments at UPMC's Cardiac Electrophysiology Program include drugs, cardioversion, and minimally invasive ablation therapy.

Contact the UPMC Heart and Vascular Institute

To request an appointment, contact the UPMC Heart and Vascular Institute:

What Is Arrhythmia?

During arrhythmia, the heart either beats:

Almost everyone experiences an occasional skipped heart beat, fluttering, or racing heart beat. While most events are harmless, some people have arrhythmias that are bothersome and sometimes dangerous.

Why choose UPMC's Cardiac Electrophysiology Program?

The UPMC Cardiac Electrophysiology Program is the largest in western Pennsylvania and one of the largest in the United States.

We offer a full range of treatments for the most therapy-resistant cases of cardiac arrhythmias, including:

  • Arrhythmia medications
  • Medical devices, such pacemakers and defibrillators
  • Radio-frequency ablation
  • Catheter- and surgical-based procedures

What distinguishes our electrophysiology program?

  • Our subspecialty centers — for evaluating and managing atrial arrhythmias, as well as infected implanted pacemakers and other heart-rhythm devices.
  • Our program leaders — pioneers of novel ablation procedures for restoring normal heart rhythm.

Arrhythmia Symptoms and Diagnosis

Some cardiac arrhythmias occur without symptoms.

Others may cause noticeable symptoms, such as:

  • Heart palpitations or fluttering
  • Skipped or extra heart beat
  • Weakness
  • Fatigue
  • Dizziness or light-headedness
  • Fainting
  • Shortness of breath
  • Chest discomfort

Diagnosing arrhythmia

At the UPMC Heart and Vascular Institute, your initial evaluation for arrhythmia includes:

  • A thorough physical exam.
  • An evaluation of your medical history.
  • An assessment of your symptoms.

In particular, the doctor will listen to your heart with a stethoscope.

Following your exam, your doctor may order additional tests to help confirm an arrhythmia diagnosis.

These tests may include:

  • Blood tests
  • Chest x-rays
  • An electrocardiogram
  • An echocardiogram
  • A Holter monitor
  • An event recorder
  • An electrophysiology (EP) study

If your doctor detects an arrhythmia, he or she will work with you to determine the best cardiac arrhythmia treatment.

Testing results
Your doctor or nurse will tell you when to expect your test results and will call you when they're available. 

Learn More About Heart Arrhythmia Symptoms and Testing

From our Health Library at

Arrhythmia Treatment

Some less serious types of arrhythmia do not require treatment, but you should have regular checkups.

If you do require treatment, most often your doctor will prescribe heart arrhythmia medications to control your irregular heartbeat.

At the UPMC Heart and Vascular Institute's Cardiac Electrophysiology Program, the goals of arrhythmia treatment are to:

  • Minimize stroke risk
  • Control heart rate
  • Restore normal heart rhythm

Heart arrhythmia medications

To slow the heart rate:

  • Digitalis
  • Verapamil
  • Diltiazem
  • Metoprolol
  • Atenolol

To maintain a regular heart rhythm:

  • Sotalol
  • Propafenone
  • Amiodarone

To prevent clot formation and help reduce the risk of stroke:

  • Blood thinners such as:
    • Warfarin (Coumadin®)
    • Aspirin

Procedures for treating arrhythmia

  • Cardioversion — delivers an electrical shock to “reset” the heart by converting an irregular or fast heart rhythm to a normal heart rhythm.
  • Ablation therapy — a minimally invasive procedure to remove or destroy (ablate) the abnormal tissue responsible for the arrhythmia.

During ablation therapy, we position a thin wire (catheter) inside your heart near the pulmonary veins.

Types of ablation therapy for arrhythmias

  • Radio-frequency ablation uses radio energy to apply heat to the tip of the catheter to cauterize the heart tissue.
  • Cryoablation uses extreme cold to freeze and scar the heart tissue.

Our program leaders are experts at ablation techniques and have authored book chapters and research publications on the subject.

Stereotactic Body Radiation Therapy (SBRT) for Arrhythmias of the Heart's Lower Chambers

SBRT is an experimental treatment for refractory ventricular tachycardia (V-tach), an abnormally rapid heart rate in the heart's lower chambers.

Doctors use SBRT if standard treatments like medications and catheter ablation fail to control your V-tach.

SBRT involves the delivery of focused, single dose of radiation to a small area of the heart causing heart rhythm abnormality. Doctors use scans to find the area of the heart causing the arrhythmia and where to target treatment.

SBRT can treat a deeper area of the heart than catheter ablation.

Potential risks from SBRT include damage or scarring to tissue around the heart. Doctors will use imaging scans and technology to reduce the risk as much as possible.

In most cases, this noninvasive treatment is completed under an hour, and you can go home the same day. You will have frequent, thorough follow-up visits to check for efficacy and long-term potential side effects.

Is SBRT an option for me?

Currently, SBRT is only an option for people with refractory V-tach who have tried other treatments without success.

Early data suggest SBRT can be successful when other treatments fail in people with V-tach. Since we’re still studying SBRT, more data is needed to confirm long term safety and efficacy.

Exploring new arrhythmia treatments

Our doctors are performing research into the underlying causes of heart arrhythmias and are using their discoveries to develop improved methods for diagnosing and treating them.

Arrhythmia Educational Materials

The UPMC Heart and Vascular Institute offers educational information and videos about arrhythmias and other heart and vascular diseases and treatments.

Many people find these resources helpful in answering their questions about their condition and preparing them for their procedure or diagnostic test.

The links below will open a new browser window.

From our Health Library at