The human heart will beat well over 2 billion times over the course of an average lifetime. It's easy to take such remarkable reliability for granted, but we don't.

Mount Sinai Heart's Cardiac Arrhythmia Service provides expert management for all heart rhythm disorders in a comfortable, professional and state-of-the-art environment. Our team of board-certified electrophysiologists, and dedicated nurses includes recognized leaders in the field with expertise in the treatment of patients of all ages, including children. Every member of our team is committed to provide unsurpassed patient care and attentive service to ensure a positive experience for patients and their families.

As a regional leader in the treatment of heart rhythm disorders, Mount Sinai Heart's Cardiac Arrhythmia Service performs more than 2500 procedures every year to treat the complete range of rhythm disorders. These include more than 400 radiofrequency ablations to correct abnormal heartbeats at the source. In addition, we perform more than 700 cardiac rhythm device implants annually. These life-saving devices are pacemakers to correct abnormally slow heart rhythms, defibrillators designed to interrupt dangerously fast heart rhythms, and biventricular defibrillators that work on the two lower chambers of the heart (the ventricles) to restore pumping efficiency in patients with heart failure.

The Cardiac Arrhythmia Service's electrophysiology laboratories use advanced technology to image the beating heart in real time and to precisely identify the source and characteristics of complex cardiac arrhythmias.

Mount Sinai's electrophysiologists are among a select few in the country trained to utilize a new robotic system to perform radiofrequency ablation to cure arrhythmias. Mount Sinai is one of only a handful of sites nationally with this robot and is the only site in the Tri-state area with the robot.

All patients of the Cardiac Arrhythmia Service and their families will benefit from the clinical excellence, leading edge technology and unsurpassed level of personal service that is the essence of Mount Sinai Heart.

Consultation services and pacemaker/defibrillator follow-up evaluations are provided for patients with previously implanted cardiac devices.

Heart rhythm disorders cause many different symptoms or no symptoms at all.

Individuals may have an arrhythmia without symptoms. The abnormal rhythm may be detected when feeling the pulse, or when your doctor listens to the patient’s heart or takes your blood pressure. It also may be diagnosed with a test called an electrocardiogram (ECG).

Irregular heartbeats, lightheadedness, fainting, chest pain and/or shortness of breath are signs that an arrhythmia may be serious.

Episodes of Dizziness or Lightheadedness

Dizziness is a common symptom that has many causes, including temporary conditions that are not serious. It is often described as feeling "far-away" or off balance. Individuals may feel as if they will faint or "black out."

Palpitations

Palpitations are a common complaint that many people describe as a skipping, pounding, fluttering, flip-flopping, racing, or sudden stopping of the heartbeat. You may feel your heart speed up when you climb a flight of stairs or drink too much coffee. The rapid beating may last for seconds, minutes or even hours.

A rapid heartbeat with other symptoms such as shortness of breath, chest pain or pressure, lightheadedness or fainting (syncope) may be due to a potentially life-threatening arrhythmia called ventricular tachycardia.

Blackouts or Fainting (Syncope)

If the heart rate is too fast (tachycardia) or too slow (bradycardia) the blood supply to the brain may be reduced. If either arrhythmia lasts longer than six seconds, it can cause loss of consciousness, or fainting. The medical term for fainting is syncope.See your doctor is you have unexplained episode of fainting.

Shortness of Breath

Shortness of breath, or dyspnea, may be a sign of heart failure or of a slow or rapid heart rate that impairs the heart's ability to fill, causing blood to back up into the lungs. The most common arrhythmia associated with shortness of breath is atrial fibrillation. It also may be a symptom of more serious ventricular arrhythmias.

Skipped Beats or Premature Heartbeats

Premature heartbeats occur when the heart's regular rhythm is interrupted by early or premature beats. It may feel as if the heart has skipped a beat. Usually it is not serious. If the beat arises from locations in the atria (upper chambers) it is called premature atrial beat. Premature ventricular beats arise from the ventricles (lower chambers). Sometimes they are called premature ventricular contractions, or PVCs. A person experiencing these abnormal heart rhythms may also feel faint, lightheaded, or may lose consciousness.

Chest Pain

Chest pain is sometimes caused by rapid heart rhythms (tachycardias) that increase the heart’s need for oxygen.  When the heart is unable to obtain enough oxygen, the person will experience pain. In addition to chest pain, a person with a rapid heart rhythm may experience pressure or aching in the chest and shortness of breath.  These are serious warning signs that should send you to a doctor.

Chest pain also may be caused by coronary artery disease (CAD), a condition in which the blood supply to the heart is reduced because of clogged blood vessels. The medical term for this type of pain is called angina pectoris. Angina may be the warning sign of a heart attack (myocardial infarction). Chest pain due to cardiac causes may be associated with nausea, vomiting, sweating, shortness of breath, abnormal heart rhythms or weakness.

See your doctor if you have any unexplained episodes of chest pain.

Fatigue

Fatigue is a common complaint with many causes, most of which are unrelated to the heart. It is normal to feel tired following hard work or exercise, sustained stress, anxiety or grief. Most illnesses can cause fatigue. Some medications and other medical treatments also may be a cause. People may feel tired when the heart rate is very slow (bradycardia) or rapid (tachycardia).

Vasovagal Syncope (fainting)

Vasovagal syncope, also called the common faint, is caused by low blood pressure or a slow heart beat or both, usually triggered by outside influence. For appropriate treatment it needs to be evaluated carefully. For diagnosis it is necessary to perform tests such as the tilt table test, ambulatory monitoring or, at times, an electrophysiology study. Sometimes the cause is not heart related, for instance when low blood sugar is to blame, but fainting can still dangerous simply because of the potential for injuries from falling.

Heart Block (slow heartbeat)

When electrical impulses generated in the upper chambers of the heart are not properly transmitted to the lower chambers, heart block happens. The heart then beats too slowly, reducing the oxygen that gets to the body and brain. It may cause symptoms of weakness, shortness of breath and fainting.

Supraventricular Tachycardia

Supraventricular tachycardia is an abnormal heart rhythm, or arrhythmia, that starts in the upper chambers of the heart. It causes a rapid and regular heart beat. It is the commonest cause of episodic palpitations in relatively young patients. Diagnosis is made by recording heart rhythm during an episode of palpitation. This condition can be cured in the majority of patients safely by radiofrequency catheter ablation.

Atrial Fibrillation (AF or A Fib)

More than 2 million people in the United States have atrial fibrillation, making it a very common heart rhythm disorder. In Atrial Fibrillation, the heartbeat is irregular and rapid, sometimes beating as often as 300 times a minute, or about four times faster than normal.  In the vast majority of cases, atrial fibrillation isn't life threatening by itself; however it can lead to complications including other rhythm problems, chronic fatigue and congestive heart failure. The risk of having a stroke is five times higher for those with A Fib.

Atrial Flutter (AFL)

Atrial flutter (AFL) is similar to A Fib because it too is characterized by a rapid heartbeat. Instead of many disorganized signals, however, AFL is caused by a single electrical wave that circulates very rapidly in the atrium, about 300 times a minute, leading to a very fast, steady heartbeat.

Ventricular Tachycardia (VT)

Characterized by a very fast heart rate, VT usually is seen in the setting of other serious heart disease. Occasionally, it occurs in people with normal hearts. It usually requires prompt treatment, sometimes with medication. Sometimes it is treated with radiofrequency ablation or surgery. Often people with VT are protected by implantation of a defibrillator. Because VT can lead to ventricular fibrillation, it is considered a serious condition that warrants aggressive monitoring and treatment.

Cardiac Arrest

Cardiac Arrest, caused by ventricular fibrillation (VF), poses the greatest threat and accounts for half of all cardiac deaths. In VF, the heartbeat is rapid and chaotic, which causes the lower heart chambers, or ventricles, to go into a spasm. Sometimes, however, a heart attack can lead to VF. VF is abrupt and happens without any warning and it halts all heart functioning. The lack of oxygen throughout the body, and especially to the brain, is deadly. Also known as cardiac arrest, sudden cardiac death is due to an electrical circuitry problem. It is not a the same as a heart attack, or myocardial infarction, which is a circulatory problem caused by clogged blood vessels that cut off the supply of blood to the heart. Although CPR can provide some benefit, the only truly effective VF treatment is defibrillation, which relies on paddles or electrodes to "shock" the heart back to normal rhythm. Without treatment, loss of consciousness comes in seconds, and death is inevitable.

Congestive Heart Failure

Congestive heart failure requiring pacemakers and defibrillators occurs in all ages of the population including pediatric patients and those with congenital heart disease. Sick sinus syndrome (SSS) is not a specific disease, but a group of signs or symptoms that indicate the heart’s natural electrical pacemaker, which is called the sinoatrial node, is not functioning properly. In SSS, the heart rate can switch back and forth between a slow rate (bradycardia) and a fast rate (tachycardia). A permanent pacemaker, sometimes in combination with medication, is the primary treatment.

A circulatory heart attack (Myocardial Infarction) occurs when arteries are clogged to the point of decreasing or stopping the flow of blood to the heart muscle. A lack of oxygen damages or kills heart muscle causing a heart attack. Recognizing symptoms and getting prompt emergency treatment can eliminate, prevent or limit the amount of heart muscle damage.

A special pacemaker that works in both chambers of the heart (resynchronization therapy) in combination with medication can prove very effective in improving symptoms in a selected group of patients with heart failure.