Cardiac rhythm disorders


If the normal heartbeat is permanently disturbed, this is called cardiac rhythm disorder. A distinction is made as to whether the heart beats too slowly, too fast or irregularly. Cardiac rhythm disorders are also classified according to their place of origin, i.e. whether they originate in the atrium or in the ventricle.

Common cardiac rhythm disorders include:

Bradycardia: a heartbeat that is too slow, < 50-60/min. This can occur, for example, in diseases of the sinus node. The sinus node is in the right atrium and is the "pacemaker" of the heart.

Tachycardia: a heartbeat that is too fast, > 100/min. Tachycardia can originate from the atria or the ventricles. Depending on this, a distinction is made between atrial and ventricular tachycardia.

Atrial tachycardia is not usually life-threatening, but it can increase the risk of stroke.

Ventricular tachycardia is a dangerous cardiac rhythm disorder. It can turn into ventricular fibrillation, which is life-threatening and can lead to sudden cardiac death.

Extrasystoles: single or clustered heartbeats (extra beats) that occur outside the regular basic rhythm.

The causes of cardiac rhythm disorders are manifold. They can occur due to inflammation of the heart muscle or underlie a heart valve defect. Other possible causes are congenital or age-related defects of the stimulus formation and conduction system of the heart as well as overactivity of the thyroid gland.

However, physical and mental strain, stress, hyperthyroidism, obesity, diabetes mellitus, sleep apnoea, disturbances of the mineral balance in the body, alcohol, drugs, caffeine or nicotine can also be triggers for cardiac rhythm disorders.


The symptoms depend on whether the heart is beating too slowly, too fast or irregularly. The place of origin of the cardiac rhythm disorder also has an effect on the symptoms.

If the heartbeat is too slow (bradycardia), the heart beats at less than 50-60 beats per minute. (In a healthy adult of normal fitness, it beats at least 50 times per minute.)  As a result, the body cannot be supplied with sufficient oxygen and nutrients. This can lead to exhaustion, fatigue, dizziness with sudden short-term unconsciousness and shortness of breath on exertion. Top athletes sometimes have even lower resting pulses without symptoms and this is completely normal!

Tachycardia, a heartbeat that is too fast, is when the heart beats permanently at more than 100 beats per minute. Tachycardia is often experienced as palpitations. Tachycardia can originate from the atria or the ventricles. Atrial tachycardia, or atrial fibrillation, is not usually life-threatening but can increase the risk of stroke. In contrast, tachycardia originating in the ventricles is life-threatening. Ventricular fibrillation is where the heart can no longer pump the blood through the body properly due to the too-fast contractions. This can lead to dizziness, shortness of breath, chest pain, unconsciousness and even sudden cardiac death.

One particular rhythm disorder is atrial fibrillation/flutter, a special form of a too-fast pulse that originates from the atrium. It is the most common form of arrhythmia to be treated in people over 60 years of age. It is dangerous because this disorder can also cause strokes, which should be prevented by thinning the blood with special medication. We are also able to treat these arrhythmias effectively by means of a special sclerotherapy using a heart catheter (a procedure known as an ablation with cold or heat applications).


Our cardiology department offers all modern invasive and non-invasive diagnostic and therapeutic procedures. These include:

  • History-taking, physical examination
  • Laboratory tests
  • ECG (electrocardiogram): provides information about damage to the heart or old heart attacks
  • Exercise ECG (ergometry): shows changes that only occur under stress; e.g. too slow or too fast pulse rise and indirectly also circulatory disorders and the patient's fitness
  • Ergo-spirometry for clarifying the stress response in cases of respiratory distress
  • Echocardiography (ultrasound/sonography): shows parts of the heart muscle that are no longer working properly due to insufficient blood supply; heart valve defects and size of the heart chambers and measurement of the heart's strength in the contraction and relaxation phase (both via the left side of the chest, but also via the oesophagus with the help of a brief anaesthetic)
  • Pacemaker / defibrillator follow-up examinations of all common makes
  • Long-term ECG and long-term blood pressure measurements
  • Cardiac catheter examination (coronary angiography): with the help of a contrast medium, it is possible to assess which coronary vessels are constricted and to what extent. The affected coronary vessel can be treated during the procedure.


The therapy depends on the type and severity of the cardiac arrhythmia and is individually adapted to the patient. There are not just medicines to choose from. Pacemaker treatment (if the heartbeat is too slow) or the implantation of a defibrillator (ICD; for ventricular tachycardia) may be necessary.

Sclerotherapy is also possible in our department for many arrhythmias (e.g. "ablations" for atrial fibrillation/flutter, etc.)

The aftercare of these devices takes place at our clinic, so we can guarantee our patients the best possible care.


In addition to medical measures and drug therapy, the patient can make a decisive contribution to their recovery by adopting a healthy lifestyle.

Also crucial is support from family, life partners and friends, all of whom are indirectly affected.

In order to help people with chronic diseases of the cardiovascular system or following a heart attack to make the necessary lifestyle changes, the Havelhöhe Heart School also offers a comprehensive programme.

In group therapy, patients and their partners learn about heart-healthy lifestyles and realise that giving up negative habits very quickly leads to a better quality of life.

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