Your heart has an intricate electrical system that enables it to pump in a smooth, co-ordinated manner. If something in this system isn’t working as it should, you can develop a heart rhythm problem ­(known medically as an arrhythmia).

Our heart rhythm specialists offer state-of-the-art care for people with arrhythmias. We have technologies and advanced procedures to support accurate and timely diagnosis and arrhythmia management.

Find a cardiologist

If you are experiencing any cardiac symptoms: chest pain, palpitations, shortness of breath. dizziness or fainting or signs of heart failure (swollen ankles, unable to lie flat or waking short of breath) you should contact your GP or present to an emergency department for assessment.

If you require urgent attention dial 000 (Triple Zero) and ask for an Ambulance.

What is a heart arrhythmia?

Arrhythmia is a term used to describe abnormalities in heart rate or rhythm. In a healthy heart, electrical signals create a regular, co-ordinated heartbeat. A problem in this electrical system can cause your heart to beat too slowly, too quickly, or irregularly. Some heart arrhythmias are serious, but many are not.

People don’t usually feel their heart beating. If you notice that your heartbeat is fast, slow, or irregular, it’s important to see your doctor.

Types of arrhythmias

There are various types of heart arrhythmia. They are classified by which part of the heart they start in and how they affect your heart rate. Some arrhythmia types include:

Atrial fibrillation – this very fast heartbeat is caused by disrupted electrical activity in the heart’s upper chambers (atria), which causes them to twitch instead of contract. Atrial fibrillation (also known as AFib and AF) is the most common heart arrhythmia, and can lead to blood clots, stroke, heart failure and other complications if it’s not managed.

Atrial flutter – this rhythm is like atrial fibrillation, only less erratic. Atrial flutter can sometimes turn into atrial fibrillation and vice versa.

Supraventricular tachycardia (SVT) – this type of arrhythmia is also caused by abnormal electrical activity in the heart’s upper chambers (the atria). It can cause a rapid heart rate that stops the heart’s chambers from filling with blood properly between beats, which may disrupt blood flow to the body.

Ventricular tachycardia – this fast heartbeat is caused by abnormal electrical activity in the heart’s lower chambers (ventricles). This rhythm can lead to a cardiac arrest if it continues without treatment.

Ventricular fibrillation – this involves abnormal activity in the ventricles that causes the heart to pump in a very fast, chaotic manner. Because the heart cannot pump effectively in this rhythm, urgent medical care is needed to restore a regular rhythm and prevent cardiac arrest.

Tachybrady syndrome – in this condition, the heart rate varies between very fast and very slow. It is  also known as sick sinus syndrome because it involves an issue with the sinus node – your heart’s inbuilt pacemaker.

Ectopic heartbeats – these involve having extra heartbeats or skipped heartbeats. They can happen in the upper or lower chambers and sometimes occur in a healthy heart.

Paroxysmal arrhythmias – these are arrhythmias that suddenly start and stop, with episodes lasting from seconds to several days. They do not occur all the time (occur is paroxysms).

Heart block – this condition involves a delay or blockage in the transmission of electrical messages through the heart. Heart block can lead to a slow heart rate (bradycardia) and irregular pumping of the heart.

Long QT syndrome ­(LQTS) – in this condition, disrupted electric activity causes the heart’s lower chambers to take longer than normal to contract and release.

Wolff-Parkinson-White (WPW) syndrome – this disorder involves a malfunction in the electrical pathways between the heart’s upper and lower chambers. Electrical signals get to the lower chambers too early and can ‘bounce back’ to the upper chambers. This can lead to a fast heart rate.

Symptoms of heart arrhythmia

Arrhythmia symptoms include:

  • feeling dizzy or lightheaded
  • shortness of breath
  • chest pain
  • fainting
  • anxiety
  • fatigue
  • slow, racing or irregular heartbeat
  • pounding or fluttering feelings in your chest
  • sweating.

Arrhythmias may not cause any symptoms, and your doctor may pick up an arrhythmia during a check-up. People with a healthy heart can also have irregular heartbeats at time, such as during periods of stress.

However, an irregular heartbeat can be a symptom of an arrhythmia or another heart disorder, so it’s important to see your GP if you have arrhythmia symptoms.

Causes of arrhythmia

Certain conditions can cause cardiac arrhythmia, including:

  • coronary heart disease
  • a heart attack
  • congenital heart conditions (conditions you are born with)
  • heart failure 
  • cardiomyopathy (enlarged heart)
  • heart valve problems
  • diabetes
  • high blood pressure
  • obstructive sleep apnea
  • thyroid problems
  • some medications
  • heavy alcohol consumption or illicit drug use.

Arrhythmia prevention

You may not be able to prevent a heart rhythm disorder. However, you can help keep your heart healthy by:

  • managing your blood pressure and cholesterol levels
  • getting treatment for diabetes, thyroid problems or other health conditions
  • achieving and maintaining a healthy weight
  • quitting smoking
  • eating a healthy diet and drinking less alcohol
  • being physically active
  • staying socially connected
  • doing things to reduce stress and support your mental wellbeing
  • getting a Heart Health Check.

If you have an arrhythmia that comes and goes, various things (including caffeine, alcohol, tiredness, nicotine and stress) can trigger arrhythmia episodes. It can help to work out and try to avoid your arrhythmia triggers.

Referral for arrhythmia management

If you have symptoms of a heart rhythm disorder, your GP might refer you to a cardiologist (heart specialist) for further investigations and treatment.

To start your treatment for arrhythmia with us, ask your GP for a referral to one of our experienced cardiologists.

Your doctor can address the referral to a specific cardiologist, or simply to ‘Dear Doctor’.

Find a cardiologist near you.

Search a specialist

Arrhythmia testing and diagnosis

To diagnose an arrhythmia, your doctor or heart specialist will ask about your symptoms and family history. They might also arrange for you to have some tests.

Blood tests

Blood tests can show signs of a heart attack and measure the levels of substances that can affect your heart and blood vessels (such as blood sugar, cholesterol and fats).

Physical examination

Your doctor will probably check your blood pressure and heart rate and listen to your heart with a stethoscope.

Electrocardiogram (ECG)

This test measures the heart’s electrical activity and allows doctors to check for an irregular electrical rhythm.

Holter monitor

This test involves wearing a portable ECG to monitor the electrical activity of your heart, usually over a 24-hour period.

Ambulatory blood pressure monitoring

In this test, you wear a portable device that checks your blood pressure as you go about your daily activities, usually over 24 hours.

Echocardiogram (heart ultrasound)

This test uses sound waves to get a picture of your heart. It allows doctors to see the heart’s valves and chambers and check how well your heart is pumping.

Exercise tests

Also known as ‘stress tests’, they check how your heart responds to physical activity. Exercise tests involve monitoring your heart while you ride an exercise bike or walk on a treadmill.

Loop monitor implant

This involves implanting a tiny monitor under your skin to record your heart's electrical activity and check for arrhythmias. Your doctor can then monitor your heart rhythm remotely via a device you keep at home.

Electrophysiology study

In this test, doctors use implanted electrodes to map out the electrical pathways in your heart and check for electrical abnormalities.

Depending on the results of your tests, your GP or general cardiologist might refer you to a cardiologist who specialises in heart rhythm management.

Heart rhythm disorder treatment

There are various treatments for arrhythmia. Your doctor will recommend treatment based on the type of arrhythmia you have and factors like your age, general health, lifestyle and preferences.

Medical (non-invasive) treatment for arrhythmias

Medications – your doctor might prescribe medications to help regulate your heart rhythm or lower your heart rate. If your arrhythmia puts you at risk of stroke, you might be prescribed blood thinning medications.

Lifestyle changes – if you’re living with an arrhythmia, it can help to make some heart-healthy changes. Your doctor might advise you to:

  • get to know your arrhythmia triggers
  • reduce your alcohol intake
  • get or stay physically active
  • manage other health conditions, such as diabetes or high blood pressure
  • know when to get urgent medical help
  • go to cardiac rehabilitation – a structured program of heart health education and tailored exercise.

Invasive (surgical) treatment for arrhythmia

In some cases, your doctor might recommend a procedure to help regulate your heart rhythm.

These include: 

Electrical cardioversion – done under general anaesthetic, this procedure involves placing electrodes on the chest and delivering an electrical impulse to restore the heart’s normal rhythm. It is commonly used to manage atrial fibrillation.

Ablation – this procedure involves using heat energy to create tiny scars on parts of the heart to stop them from sending abnormal electrical signals.

Pacemaker – these small devices sit under the skin of your chest and produce small electrical impulses that help your heart stay in a regular rhythm. 

Implantable defibrillator – these small devices sit just under the skin and monitor your heart. If they detect a dangerous rhythm, they can deliver a controlled electric shock to help restore a normal rhythm.


Your recovery time will depend on which procedure you have, along with factors like your age, general health, and lifestyle. If you have a procedure that doesn’t require a general anaesthetic, you can often go home the same day. You might need to stay in hospital for a few days if you’ve had a general anaesthetic or if your doctor needs to monitor your heart closely after a procedure.

You might benefit from rehabilitation to help you get stronger and return to activities like work, sport and driving. Other health professionals, such as physiotherapists, dietitians and exercise physiologists, might work with you to create habits that promote heart health.

Your heart specialist can discuss how long it is likely to take to recover from your procedure with you.


Reviwed by A/Prof. Eoin Jude O’Dwyer, Cardiologist and A/Prof. Vijay Solanki, Cardiologist at Northern Beaches Hospital.


Find a specialist or doctor

Use our online directory

Find a specialist


Our hospitals

Find out more about the cardiology services at our hospitals.

Contact us for more info

Our Assistance

... ... ... ...