Understanding arrhythmia
The heart's rhythm is set by its own electrical system, and that system can misfire in many ways: single early beats that feel like a flutter or a thud, runs of racing heartbeat, a rhythm that turns irregular altogether (as in atrial fibrillation), or a heartbeat that runs slower than the body needs.
Two things make rhythm complaints tricky. First, the sensation and the seriousness don't always match — dramatic-feeling palpitations are often benign, while some important rhythms cause almost nothing you'd notice. Second, arrhythmias are frequently intermittent, so a single normal ECG in the office doesn't settle the question. That's why monitoring over days or weeks is often the heart of the workup.
What you might notice
People with rhythm disturbances often describe:
- Fluttering, pounding, or "skipped beat" sensations
- Episodes of racing heartbeat that start or stop suddenly
- Light-headedness or near-fainting spells
- An irregular pulse noticed on a watch or blood-pressure cuff
- Unexplained drops in stamina or breathlessness
How we evaluate it
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In-office ECG
A 12-lead tracing at rest — the starting point of every rhythm evaluation.
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Holter & extended patch monitoring
Wearable recorders worn from 24 hours up to two weeks to catch rhythms that come and go.
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Echocardiogram
Ultrasound of the heart's structure — rhythm problems are evaluated in the context of the heart they occur in.
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Targeted lab work
Thyroid, electrolytes, and related tests that can drive or worsen rhythm disturbances.
Every test above is described — prep included — on the diagnostics & testing page.
How we manage it
Management starts with naming the rhythm precisely, because the plans differ completely: reassurance and trigger management for benign extra beats; rate or rhythm medication and stroke-risk assessment for atrial fibrillation; and referral for electrophysiology procedures when they're the right tool.
Dr. Marsh spends real time on triggers and context — sleep, alcohol, caffeine, stimulants, stress, and thyroid health — because for many patients that's where the wins are. When a procedure such as ablation or a pacemaker is appropriate, she coordinates with electrophysiology colleagues at Windrose Regional and remains your cardiologist before and after.