The word “arrhythmia” describes essential any abnormal heart rhythm that does not originate in the normal sinus node area of the heart. There is a whole range of different types which can lead to an awareness of the heart beat (so called “palpitations”). But the symptoms can be very different and in many patients, an arrhythmia is only recognized when an electrocardiogram is performed.

Here is a list of the most common arrhythmia types:

Atrial fibrillation (AF) is the most common arrhythmia and can happen occasionally (or “paroxysmal”), persistent (episodes that last > 7 days) or even permanent. Most importantly, AF increases the risk of spontaneous clot formation inside the heart. Such a clot could travel to the brain and cause a stroke, which is why most AF patients need to take blood thinning medication. There are specific, anti-arrhythmic medications that can also restore the normal sinus rhythm. An alternative option is a catheter ablation of AF.

Atrial flutter (AFl) is similar to AF, but consists of a regular circular electrical activation inside the right atrial or pre-chamber of the heart. The risk for clot formation is the same as for AF. However, AFl can be cured by a catheter ablation with > 95% success rates, such that medical therapy is mostly second choice if an ablation is not feasible.

Accessory pathway mediated tachycardia (AVRT or WPW syndrome) is an arrhythmia that conducts electrical impulse via an electrical short cut between the atrial and ventricular chambers. In some patients, the diagnosis can be made even from a normal ECG. The heart rate typically jumps suddenly up to 150 – 200 beats per minute and also stops suddenly. Catheter ablation is very successful in these cases > 95%.

Another sudden onset/sudden stop arrhythmia is called AV nodal re-entrant tachycardia (AVNRT) and presents more often in women. The normal AV node is divided in 2 or more parts and causes an abnormally fast electrical conduction. The success rates for catheter ablation is very good (>95%).

Skipped beats, so-called atrial or ventricular extrasystoles can be the pre-cursor for sustained arrhythmia. Key is to find the site of origin in the atria or the ventricles. Ideally a catheter ablation can find this site or sites and eliminate the additional and abnormal electrical impulse. Success rates are mostly > 90%, but depend on the frequency and location of the extra beat.