Comprehensive treatments for heart rhythm and arrhythmia disorders

An arrhythmia (also referred to as dysrhythmia) is an abnormal rhythm of the heart, which can cause the heart to pump less effectively. The heart may pump too fast, too slow or irregularly.

About 2.2 million Americans are currently diagnosed with atrial fibrillation, the most common rhythm disorder, and the number is expected to double in the next 30 years.

As one of the top programs in the nation treating heart rhythm disorders, Ohio State offers cutting-edge care to treat arrhythmias, including medications, device implants (such as pacemakers and defibrillators), ablation procedures, surgical procedures and pioneering minimally invasive procedures that improve the accuracy and precision of treatment. We are the only hospital in central Ohio and one of the first heart and vascular centers in the world to do rotor mapping of atrial fibrillation for ablation of rotors in the heart, using focal impulse and rotor modulation (FIRM) guided therapy.

Physicians who treat heart rhythm disorders are known as electrophysiologists. The Electrophysiology team at Ohio State’s Richard M. Ross Heart Hospital consists of the largest group of electrophysiologists in central Ohio, as well as more than 100 nursing staff members dedicated to the care of patients with arrhythmias.

Types of Arrhythmia

There are different kinds of arrhythmia. When the heartbeat is too slow (fewer than 60 beats per minute), it’s called bradycardia or bradyarrhythmia. When the heartbeat is too fast (more than 100 beats a minute), it’s called tachycardia or tachyarrhythmia. Arrhythmias can occur in the upper chambers (atria) or the lower chambers (ventricles) of the heart.

  • Atrial arrhythmia – This type is often caused by dysfunction of the sinus node, impulse generating tissue and the heart’s natural pacemaker. It can also be caused by the development of another pacemaker or circuit within the atrium (the upper chamber where blood enters the heart) that takes over the function of the sinus node.
  • Ventricular arrhythmia – This type originates from the ventricle (the lower chamber where blood is pushed out of the heart) and takes over for the natural pacemaker. Ventricular arrhythmias can be life-threatening, and immediate medical attention should generally be sought.
  • Atrial fibrillation – This is the most common abnormal heart rhythm disorder, when the electrical signals come from the atria at a very fast and erratic rate. The ventricles then contract in an erratic manner because of the erratic signals coming from the atria.

Some heart rhythm disorders can be inherited arrhythmias, which are based on your genes.

State-of-the-Art Facilities

Ohio State’s Ross Heart Hospital has an entire floor dedicated to the care of patients with arrhythmia. The staff members of this specialized unit, from our physicians to our nurses and support staff, are experts in the care and management of heart rhythm disorders. We coordinate care between your physicians and staff to improve efficiency and outcomes.

What Are Heart Rhythm Problems?

John Hummel, MD, a heart rhythm specialist at Ohio State’s Heart and Vascular Center, explains the causes, symptoms and treatments of abnormal heart rhythms.

Pacemaker Implanted Directly in Heart

Ohio State was one of the first in the country to implant a tiny, high-tech pacemaker, only 24 millimeters long, directly into the heart of patients, without surgery.

Our Arrhythmia Services

Ohio State's Electrophysiology Services include: 
  • Six state-of-the-art invasive heart rhythm procedure laboratories equipped with sophisticated imaging and mapping technologies, including a magnetically directed robotic Stereotaxis system, the only system of its kind in central Ohio). An additional, specially equipped cardiac operating room is staffed by a special team that performs safe extraction of chronically implanted lead systems.
  • Dedicated 30-bed inpatient unit for arrhythmia management
  • Twenty-five recovery units staffed by nurses who specialize in pre- and postoperative management of arrhythmia patients
  • Two teams for specialized cardiac anesthesia support
  • Specialty clinics for genetically related arrhythmias, with patient access to genetic counseling, gene therapy and testing to identify genetic tendencies toward arrhythmias. We also have a clinic specializing in sarcoidosis-related arrhythmias and non-response to cardiac resynchronization therapy, which we run in cooperation the Ross Heart Hospital’s team of heart failure specialists.
  • Outpatient care through cardiac device and antiarrhythmic medication specialty clinics
  • 24/7 coverage, including inpatient consultation for all services at Ohio State
  • Outreach centers throughout central Ohio deliver Ohio State’s expertise conveniently to surrounding communities

Advanced Care for Arrhythmia Management

Ohio State’s cutting-edge patient care is the result of the latest research and developments in the field of arrhythmia management. Our Heart Rhythm Disorders team can perform even the most complex procedures, attracting patients and referrals from the entire Midwest region. These procedures include:
  • Ablation for atrial fibrillation, for the elimination of a difficult heart rhythm problem
  • Ablation of ventricular tachycardia, utilizing endocardial and epicardial techniques to reduce life-threatening arrhythmias and shocks from an implanted defibrillator
  • Extraction of chronically implanted pacemaker and defibrillator leads
  • Closure of the left atrial appendage to prevent stroke
  • Implantation of pacemaker, defibrillators and biventricular pacemaker-defibrillator systems
  • Implantation of subcutaneous defibrillators and subcutaneous rhythm monitoring devices
  • Ablation of supraventricular tachycardia
  • Investigational device and ablation procedures

Antiarrhythmic Medications Clinic

At the Ross Antiarrhythmic Medications Clinic, our team provides FDA mandated side effect monitoring for patients taking chronic antiarrhythmic medications.

Patients can expect a comprehensive visit, as we provide testing at the time of a patient’s appointment. We provide electrocardiograms, pulmonary function tests, chest x-rays and other appropriate lab tests. Our pharmacists have specialized training in antiarrhythmic medication management.

Medications that we monitor include:

  • Amiodarone (Cordarone®, Pacerone®)
  • Disopyramide (Norpace® or Norpace CR®)
  • Dofetilide (Tikosyn®)
  • Dronedarone (Mutaq®) 
  • Flecainide (Tambocor®)
  • Mexiletine (Mexitil®)
  • Propafenone (Rythmol® or Rythmol SR®) 
  • Quinidine (Quinidex®)
  • Sotalol (Betapace® or Betapace AF®)

Patients who have enrolled in this clinic have been shown to have better rates of compliance with the recommended monitoring tests. They have also benefited from our pharmacists’ clinical interventions, resulting in positive outcomes in their care.

For more information, contact The Ohio State University Ross Antiarrhythmic Medications Clinic at 614-293-0932.

Delivering Personalized Care

Ohio State electrophysiologists have the ability to consult with specialists across the medical center to develop the best plan for your care. You can trust that they will create a treatment plan that considers all aspects of your health and lifestyle.

Symptoms and Conditions

Symptoms of Arrhythmia

The effects of arrhythmia on the body are often the same whether the heartbeat is too fast, too slow or irregular. Some symptoms of arrhythmias include, but are not limited to:

  • Weakness
  • Fatigue
  • Palpitations
  • Lightheadedness

The symptoms of arrhythmias may resemble other conditions, so it is important to talk to your doctor for a diagnosis.

Types of Arrhythmia

There are different kinds of arrhythmia. When the heartbeat is too slow (fewer than 60 beats per minute), it’s called bradycardia or bradyarrhythmia. When the heartbeat is too fast (more than 100 beats a minute), it’s called tachycardia or tachyarrhythmia.

Arrhythmias can occur in the upper chambers (atria) or the lower chambers (ventricles) of the heart.

  • Atrial arrhythmia – This type is often caused by dysfunction of the sinus node, impulse generating tissue and the heart’s natural pacemaker. It can also be caused by the development of another pacemaker or circuit within the atrium (the upper chamber where blood enters the heart) that takes over the function of the sinus node.
  • Ventricular arrhythmia – This type originates from the ventricle (the lower chamber where blood is pushed out of the heart) and takes over for the natural pacemaker. Ventricular arrhythmias can be life-threatening, and immediate medical attention should generally be sought.
  • Atrial fibrillation – This is the most common abnormal heart rhythm disorder, when the electrical signals come from the atria at a very fast and erratic rate. The ventricles then contract in an erratic manner because of the erratic signals coming from the atria.

Why is arrhythmia a problem?

The problem with arrhythmia is that the body may not receive enough blood because the heart cannot pump out an adequate amount with each beat.

When the electrical signal is causing the heart to pump too fast, the heart does not get an adequate amount of blood in its chambers.

When the electrical signal is causing the heart to pump too slowly or too irregularly, not enough blood is pumped out to the body from the heart.

Atrial Fibrillation

Atrial fibrillation is associated with a wide range of symptoms. Some patients experience only a slight decline in endurance, but otherwise have a fairly normal level of daily activity.

Most people with atrial fibrillation, however, endure more incapacitating symptoms, including palpitations, stroke, shortness of breath and significant intolerance of exercise.

Over time, chronic atrial fibrillation leads to permanent changes in your heart. These changes not only diminish the effectiveness of medicines prescribed for atrial fibrillation, but uncontrolled atrial fibrillation may lead to heart failure. Atrial fibrillation also increases your risk of stroke.

Learn more about Atrial Fibrillation Treatments



Our Treatments

Arrhythmia Treatments

Arrhythmia Treatments

Our physicians work closely with every patient to create individualized treatment plans.

Arrhythmia Medications

In its earliest stages, medications are the most appropriate treatments of atrial fibrillation. Doctors prescribe anti-arrhythmic drugs to convert arrhythmias to normal rhythms. Other medications include heart-rate control drugs and drugs to reduce the risk of blood clots and stroke.

After two years, the effectiveness of medication alone is approximately 30-40 percent. Also, a significant number of patients suffer from side effects that may impact the long-term safety of anti-arrhythmia medication.

Catheter-Based Anti-Arrhythmia Procedures

For arrhythmias that medication cannot control, Ohio State cardiologists may perform catheter ablation. Ablation is a technique to permanently remove faulty electrical pathways from your heart by using electrical impulses to induce arrhythmia and then destroying the abnormal tissue that is causing it.

During the procedure, your doctor will insert a few flexible catheters (thin tubes) into your blood vessels, which usually only requires a needle stick in either the femoral vein or artery. Your cardiac electrophysiologist will then advance the catheters toward your heart to perform the ablations, using the most advanced computerized mapping systems available in the world, which limit the use of X-ray to mere minutes. Some newly developed systems that are only available in a handful of laboratories worldwide may be available to patients who qualify to participate in research studies.

Ohio State’s Ross Heart Hospital is the only hospital in central Ohio to offer the next generation in catheter-based treatment options: the Stereotaxis magnetic navigation system.

This system uses magnet-guided catheter therapy aimed at curing arrhythmias. Two powerful magnets encased on pivoting arms on either side of the patient offer electrophysiologists ultra-precise catheter control, regardless of the distance or complexity of the path traveled through the blood vessels and heart.

Rather than guide the catheter in by hand, our physicians control the whole process with joystick technology and high-resolution digital imagery. This magnet-guided ablation technique is safer for patients than the older, stiff catheters because the flexible-tipped catheter uses “gentle touch” technology for soft and consistent tissue contact.

Surgical Interventions

Ohio State is the only central Ohio hospital to perform the thoracoscopic maze procedure in the treatment of atrial fibrillation. This minimally invasive thorascopic procedure is performed through four pencil-sized incisions in the chest. It is the most advanced surgical procedure for atrial fibrillation available today.

Surgeons use bipolar electrical energy sources to remove tissue (ablation) in the atrial muscle, isolating the areas causing the condition. The thoracoscopic approach gives surgeons a clear view of the heart, enabling unmatched precision without X-rays. The procedure allows the surgeon to ensure that all sources of the irregular heartbeat are treated.

This minimally invasive approach allows most patients to leave the hospital after only two days. The small incisions used in the operation result in limited discomfort compared to standard surgical procedures. The procedure takes about 3-1/2 hours to complete.

The operation is highly effective for patients with either intermittent or chronic atrial fibrillation. Only individuals who have undergone a previous open chest procedure – either lung or heart – are unable to undergo a thoracoscopic maze procedure, due to the scar tissue that forms as a result.

Arrhythmia Leaders & Doctors

Our leaders

emile daoud

Emile Daoud, MD, FACC

Dr. Daoud is the section director of Electrophysiology and a professor of Clinical Medicine at The Ohio State University Wexner Medical Center. Dr. Daoud has been named one of America’s Best Doctors and a Top Ten Faculty Educator at Ohio State in 2009.


Dr. Daoud performed the first ablation procedure in the United States for atrial fibrillation, using the circular pulmonary vein mapping catheter. In addition, Dr. Daoud is widely published in more than 100 peer-reviewed manuscripts and participates in several clinical trials through Ohio State’s Electrophysiology Research Program.

john hummel

John Hummel, MD, FACC

Director, Clinical Electrophysiology Research

Dr. Hummel is a professor of Clinical Medicine at The Ohio State University Wexner Medical Center. Dr. Hummel is routinely named one of America’s Best Doctors.


He has published a number of abstracts and peer-reviewed journal articles, as well as a textbook in electrophysiology. Dr. Hummel frequently speaks to national and international audiences on various topics in the field of cardiovascular electrophysiology.

KalbfleischSteven

Steven Kalbfleisch, MD

Medical Director, Cardiac Electrophysiology

Dr. Kalbfleisch is a cardiologist and a professor of Clinical Medicine at Ohio State's Wexner Medical Center. He was named one of America’s Best Doctors in 2009.


Dr. Kalbfleisch has authored numerous abstracts and peer-reviewed journal articles. He is a frequent presenter on cardiovascular research and technology. His specialty interest is in electrophysiology, and his research focuses on the clinical application of ablation therapy to treating cardiac arrhythmias.

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