Heart & Vascular Center

Heart and Vascular (Cardiology)

#14 in the Nation
by U.S. News & World Report

Arrhythmias/Heart Rhythm Disorders

Washington University and Barnes-Jewish Heart & Vascular Center is internationally recognized for its expertise in the evaluation and management of cardiac arrhythmias. We perform more than 1,500 procedures per year for patients with a wide range of heart rhythm disorders, from the common to the complex.

Understanding Heart Rhythm Disorders

The heart beats because of electrical signals that flow through its natural electrical system and through the individual heart muscle cells. The term "arrhythmia" refers to any change from the normal sequence of electrical impulses in the heart, resulting in a disruption of the normal heart rhythm.

This can cause the heart to pump less effectively. Some arrhythmias are so brief that the overall heart rate or rhythm isn't greatly affected. But if arrhythmias continue, they can cause the heart rate to be too slow or too fast or the heart rhythm to be erratic.

Tachycardia (Fast Heart Rate)

Tachycardia refers to a fast heart rate (more than 100 beats per minute). Symptoms include palpitations, rapid heartbeat, dizziness, lightheadedness and fainting. Ventricular tachycardia is an arrhythmia that starts in the bottom chambers of the heart, known as the ventricles, and it usually is life-threatening. Ventricular tachycardia is most often detected in damaged hearts that have scar tissue, such as after a heart attack. If treated in time, ventricular tachycardia can be stopped with an electrical shock. Medication also can be used to prevent ventricular tachycardia. Placement of an implantable cardioverter defibrillator often is required to provide additional rhythm correction within seconds of an abnormal electrical signal occurring in the heart. Catheter ablation is another treatment that may also be necessary to block or ablate the short circuit in the heart.

Bradycardia (Slow Heart Rate)

A heart rate that's too slow (less than 60 beats per minute) is called bradycardia. Although a slow pulse can be a sign of good health and cardiovascular fitness, a particularly slow pulse at rest and with exercise can be very uncomfortable or even life-threatening. Symptoms related to a slow pulse include fatigue, dizziness, lightheadedness and, in the worst case, fainting. These symptoms can be easily corrected by implanting an electronic pacemaker under the skin to monitor and speed up the heart rhythm as needed.

Heart & Vascular Center Arrhythmia Services

Centers where large numbers of arrhythmia patients are treated, such as the Heart & Vascular Center, report better outcomes for patients and fewer complications. Our experienced physicians have access to the most advanced procedures and latest technology, such as the newest implantable cardioverter-defibrillator devices (ICDs). Not only is the Heart & Vascular Center the regional pacemaker center, it was one of the first in the country to offer arrhythmia ablation procedures and one of the first to implant ICDs in patients at risk of sudden cardiac death.

Clinical strengths include:

Patients benefit from a full range of inpatient and outpatient services, including:

  • consultation for complex electrocardiogram (ECG) analysis and interpretation
  • management of supraventricular tachycardia, including atrial fibrillation and atrial flutter
  • management of ventricular arrhythmias including symptomatic premature ventricular contractions, non-sustained ventricular tachycardia (NSCT), and sustained ventricular tachycardia
  • management of bradycardia
  • comprehensive pacemaker clinic
  • comprehensive implantable cardioverter-defibrillator (ICD) clinic
  • diagnostic evaluation syncope
  • management of the patient who has survived a cardiac arrest
  • management of patients with genetic syndromes associated with arrhythmias including the Long QT syndrome.

Procedures include:

  • Electrical cardioversion of atrial fibrillation and atrial flutter
  • Tilt-table testing
  • Diagnostic electrophysiology studies
  • Catheter ablation of arrhythmias for supraventricular tachycardia, atrial flutter, atrial fibrillation, premature ventricular complexes and ventricular tachycardia
  • Pacemaker implantation for bradyarrhythmias
  • ICD implantation for malignant ventricular arrhythmias and cardiac arrest prevention
  • Electro-anatomic mapping of arrhythmias.

Patients also have the option to participate in a number of clinical trials that evaluate new technology in arrhythmia treatment. These trials are sanctioned by the FDA and make new treatments available to patients.

Our arrhythmia specialists:

  • see more than 800 inpatients and 4,000 outpatients each year
  • have performed more than 1,500 curative arrhythmia ablation procedures for supraventricular tachycardia, with success rates ranging from 95 to 99 percent
  • provide a referral center for complex arrhythmia ablation procedures for atrial fibrillation and ventricular tachycardia in patients transferred from around the Midwest
  • perform 500 pacemaker/ICD implantations each year
To make an appointment with a Washington University heart or vascular specialist at Barnes-Jewish Hospital, call .

Cardiac Arrest Treatments

Cardiac arrest is a true medical emergency and every second counts. Find out more in this "Innovate: Heart" podcast.


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St. Louis, MO 63110
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