What is arrhythmia (heart rhythm disorder)?

Arrhythmia is an unusual condition that occurs when the electrical activity of the heart exceeds normal limits, and the heart beats too quickly, too slowly, or with an irregular rhythm. In addition, arrhythmias can occur in the absence of abnormalities in the form or function of the heart, and their frequency increases when there are heart abnormalities. Symptoms include palpitations, pulsation defects, shortness of breath, chest pain, fainting, and sudden death, and their severity varies from negligible to life-threatening. Even if you have an arrhythmia, you may not experience any symptoms and only become aware of the arrhythmia when you have an electrocardiogram during a health check or visit a hospital for other physical or mental problems. Therefore, in everyday life, it is necessary to detect abnormalities through self-checking of the pulse and health checkups. In daily clinical practice, it is necessary to detect or predict arrhythmias as much as possible through physical examinations and electrocardiograms, and to accurately evaluate and respond appropriately.

Features and characteristics

The diagnosis is made via an electrocardiogram.
Treatments can be broadly divided into two categories: nonpharmacological and pharmacological.

Catheter ablation (non-pharmacological therapy)

The diseases covered included atrial tachyarrhythmias, such as atrial fibrillation/flutter, atrial tachycardia/premature complexes, and ventricular tachyarrhythmias, such as premature complexes and ventricular tachycardia. Using state-of-the-art 3D mapping systems, we identified the circuits and sources of arrhythmias and treated them with a variety of energy sources, including radiofrequency, cryocoagulation, and pulsed fields. Currently, approximately 300 catheter ablations are performed annually.

Implantable cardiac electrical devices (non-pharmacological therapy)

Pacemakers are used to treat bradyarrhythmias, such as sick sinus syndrome and atrioventricular block. Implantable cardioverter defibrillators (ICDs) are used to treat life-threatening arrhythmias, such as polymorphic ventricular tachycardia and ventricular fibrillation. Cardiac resynchronization (biventricular pacing) therapy is used for heart failure that occurs or worsens due to electrical asynchrony. Approximately 200 implantable cardiac electrical device surgeries are performed annually. Recently, we have been administering cutting-edge medical treatments, such as leadless pacemakers, conduction system pacing, and ICDs, where both the leads and the device are implanted subcutaneously. An implantable electrocardiogram may also be used to identify the cause of unexplained syncope or cerebral infarction. We provide acute care for cases of cardiac arrest in cooperation with the Emergency and Critical Care Center and continue with chronic-phase evaluation and treatment.

Cardiac arrhythmia surgery/cardiovascular surgical approach (non-pharmacological therapy)

Surgical treatment is also performed according to the necessity and indications for complex arrhythmias, such as atrial fibrillation associated with ischemic and non-ischemic heart disease, and arrhythmias caused by various mechanisms. For patients requiring extensive epicardial approaches or complications from ablation therapy, we provided treatment in cooperation with the Department of Cardiovascular Surgery.

Drug therapy

We provide acute and chronic anti-arrhythmia drug treatment using not only antiarrhythmic drugs such as pilsicainide, bepridil, verapamil, beta-blockers, and amiodarone, but also anticoagulants for thrombosis caused by atrial fibrillation, antihypertensive drugs, and anti-heart failure drugs such as SGLT-2 inhibitors.