Lots of things can make your heart race - a scary movie, sprinting up a flight of stairs, or "accidentally" running into your crush at the grocery store. But sometimes that fast heart beat can signal a potential heart problem. How do you know when your rapid heartbeat is more than just a nuisance?

What is an arrhythmia?
A heart arrhythmia, which can be an irregular heart rhythm or a very fast regular heart rhythm, occurs when the electrical impulses within the heart do not function properly. An arrhythmia can cause the heart to beat too fast (tachycardia), too slow (bradycardia), or irregularly, which can range from being just a nuisance to being a signal for a serious heart condition.

UAB Cardiologist Tom McElderry, M.D., explains that there are two basic means by which heartbeat can be controlled - either through the body's own regulatory cells, or by medical intervention."Patients can have a small group of cells that initiate a rapid heartbeat, which can occur suddenly or over a minute or so." When the body cannot maintain a regulated heartbeat, a cardiac ablation is performed to restore normal rhythm to the heart when medications do not suffice.

An ablation can be performed either surgically, through a traditional open heart procedure or a minimally invasive procedure, or non-surgically with the use of catheters. During an ablation, the very precise pathway for the electrical impulses that cause the heart to beat is restored, creating a regular heartbeat.

"A cardiac ablation is the most common mechanism for regular tachycardias and, fortunately, the easiest for us to perform," McElderry says. "The heartbeat is controlled by using an extra electrical pathway that connects the top (atria) and bottom (ventricles) chambers of the heart."

Why UAB Electrophysiology expertise?
Patients in need of medical intervention for a cardiac arrhythmia benefit from UAB's knowledgeable electrophysiology group, which is among the most experienced in the nation. Because we perform approximately 600 procedures each year, we have extensive know-how in the diagnosis and successful treatment of all types of complex arrhythmias.

The UAB Heart and Vascular Center is one of the largest in the Southeast, encompassing 55,000 square feet of the newest technology available, including three procedural suites dedicated to electrophysiology.

Arrhythmia symptoms
You should always see your doctor if you are feeling an unusual fluttering in your heart, but certain symptoms can increase the likelihood that you're experiencing a serious heart condition. Call 911 if any of the following occurs:

• Dizziness or fainting

• Shortness of breath

• Extremely fast or slow heartbeat

• Chest pain

"While many arrhythmias are not life threatening, they can place significant strain on the heart and even cause loss of consciousness," McElderry says. "Atrial fibrillation and atrial flutter are arrhythmias that cause the atria to beat so quickly that blood flow in the atria slows, which can lead to blood clot formation and stroke.

"If your doctor is able to capture the fast heartbeat on an echocardiogram (ECG) or ambulatory monitor, he or she will be able to determine the best therapy for your arrhythmia" he says.

While certain lifestyle changes can keep your heart healthy (eating a healthy diet, exercising and not smoking), most of these do not affect arrhythmias. "There is actually very little that can be done to prevent arrhythmias," McElderry says. "Avoidance of caffeine and energy drinks seem to be the most beneficial."

For more information on arrhythmias, visit UAB's Heart Health Library. To schedule an appointment with a physician, call UAB HealthFinder at 1-800-UAB-8816.