Holy Name Medical Center Blog

When Your Heart
Skips a Beat

Posted by Shalin P. Desai, MD
Cardiac Electrophysiologist
Holy Name Medical Partners on February 15, 2021
Shalin P. Desai, MD, Cardiac Electrophysiologist

Heartbeats that are too fast, too slow or otherwise irregular may be harmless, but should not be ignored as some can lead to harmful symptoms or heart injury. Heart rhythm disorders, called arrhythmias, can predispose a person to stroke, heart failure or even death, and can signal underlying cardiac damage. Arrhythmias might also cause someone to faint or fall, leading to serious injury.

Arrhythmias are more common in older people, but they can happen at any age. Lifestyle factors like obesity, high blood pressure and smoking can also play a role in their onset.

The symptoms of arrhythmias can affect quality of life and safety. They include:

  • palpitations or fluttering of the heart
  • shortness of breath
  • exercise intolerance
  • fatigue
  • lightheadedness
  • chest pain and pressure

Fortunately, there are good diagnostic tools, such as electrocardiograms (EKGs) and wearable heart monitors, to identify the source of a heart rhythm disorder. Medications can be prescribed to suppress arrhythmias, and catheter-based procedures, known as radiofrequency ablation, can pinpoint the exact source of the arrhythmia, and then treat it.

A Short Circuit in the Heart’s Electricity

The normal human resting heart rate averages 60 to 100 beats per minute; anything outside that range is considered an arrhythmia. Tachycardia is a fast heart rate of more than 100 beats per minute. Bradycardia is a heart rate of less than 60 beats per minute. A simple way of describing an arrhythmia is a short circuit in the heart’s electrical system.

Arrhythmias can originate in the upper chambers of the heart, the atria, or the lower chambers of the heart, the ventricles.

Types of Tachycardia

A supraventricular tachycardia is an arrhythmia of the upper chambers (“above the ventricles”) that occurs when the heart beats too fast. Heart palpitations begin and end abruptly. Some common arrhythmias are:

  • Atrial fibrillation (AFib), a rapid and irregular heart beat that is one of the most common arrhythmias
  • Atrial flutter is similar, but the rapid heart beats are more regular

Both of these can lead to more serious complications, such as a stroke. Both require medications to control the heart rate and blood thinners to reduce the risk of stroke.

Tachycardias of the ventricles, the lower chambers, can be more serious as they interfere with the process of blood being pumped to the rest of the body. A ventricular tachycardia often means there is underlying heart disease, such as coronary artery blockages and clots.


Bradycardia occurs when the heart beats too slowly to provide sufficient blood flow to the body. In severe cases, bradycardia can cause a patient to experience fatigue and even faint.

A slow heart rate is not always a problem. People who are particularly physically fit can efficiently pump an adequate supply of blood with less than 60 beats per minute while their heart is at rest.

Medications and Other Treatments

The goal of treatment is to restore the heart’s rhythmic electrical impulses to normal. Options include:

  • Medication to regulate the heart beat and/or blood thinners to prevent stroke
  • Implantation of a pacemaker or defibrillator, small devices that put a heart back into normal rhythm or shock it into rhythm
  • A minimally invasive, catheter-based procedure called radiofrequency ablation, which uses heat energy to destroy the heart tissue that triggers the arrhythmia

Sometimes stress or a panic disorder can mimic the symptoms of an arrhythmia. Don’t leave it to chance. Be mindful of your heart at all times. Do not delay getting a medical evaluation if you have symptoms of a heart rhythm disorder. If your symptoms are severe, call 9-1-1 and get to the nearest emergency room.

Shalin P. Desai, MD, is a cardiologist with special clinical training in electrophysiology. He is board-certified in cardiovascular disease, clinical cardiac adult echocardiography, clinical cardiac electrophysiology, nuclear cardiology and internal medicine. To make an in-person or telemedicine appointment with him, call 201-833-2300 or visit www.cardiovascularspecialistsnj.com.