Arrhythmia Explained by Dr. Abhijit Joshi
Arrhythmias - When an Irregular Heartbeat Becomes a Serious Issue | Dr Abhijit Joshi
Curated by ZOCVI Medical Team
Arrhythmia
OverviewArrhythmia covers irregular or abnormally fast or slow heart rhythms — from harmless occasional palpitations to atrial fibrillation (the most common serious arrhythmia, which raises stroke risk five-fold) to life-threatening ventricular arrhythmias that need immediate defibrillation. Our cardiologists and electrophysiologists explain when palpitations are benign (usually caused by caffeine, stress, dehydration, thyroid issues) versus when they need investigation with a Holter monitor or ECG, how atrial fibrillation is diagnosed and managed with blood-thinners plus rate or rhythm control, when a pacemaker or defibrillator is genuinely indicated, and how catheter ablation now offers a durable cure for many patients with AF or other arrhythmias — a treatment far less known in India than it should be.
Last reviewed: 10 August 2026
Expert Guides
Frequently Asked Questions
Expert answers from our medical team
When are palpitations dangerous?
Occasional palpitations from caffeine, stress, exercise, or dehydration are usually benign in an otherwise-healthy heart. Warning signs that need medical evaluation: palpitations with chest pain, breathlessness, fainting, or dizziness; palpitations lasting more than a few minutes at rest; a very fast, irregular pulse; or palpitations in someone with known heart disease, family history of sudden cardiac death, or advanced age. An ECG and often a 24-hour Holter monitor identify the specific rhythm and guide treatment.
What is atrial fibrillation and why is it serious?
Atrial fibrillation is an irregular fast heartbeat caused by chaotic electrical activity in the upper heart chambers (atria). It affects roughly 1-2% of adults, rising sharply with age. The main danger is stroke — blood pools and clots in the atria, then travels to the brain. AF patients need anticoagulation (blood-thinners) based on their calculated stroke risk (CHA2DS2-VASc score), plus rate or rhythm control with medications or catheter ablation. Modern anticoagulants (dabigatran, apixaban, rivaroxaban) have largely replaced warfarin for most patients.
When is a pacemaker needed?
For symptomatic bradycardia (slow heart rate causing dizziness, fatigue, fainting), complete heart block, sick sinus syndrome, or specific after-heart-attack indications. Modern pacemakers are small (matchbox-sized), reliable, and last 8-12 years on their battery before replacement. Insertion is a minor procedure under local anesthesia, usually 1-2 days in hospital. Cost in India: ₹1.5-4 lakh for single-chamber to ₹3-6 lakh for dual-chamber devices. Insurance typically covers indicated pacemakers.
What is catheter ablation and can it cure my arrhythmia?
Catheter ablation is a minimally-invasive procedure — thin wires threaded through blood vessels to the heart, then radiofrequency energy or freezing is used to destroy the small area of heart tissue driving the abnormal rhythm. For atrial fibrillation, ablation offers a durable cure or major improvement in 60-80% of well-selected patients — better long-term outcomes than lifelong rhythm-control medications. Available at major cardiac centers in India, cost ₹2-5 lakh. Underused because awareness is low; ask your cardiologist if you'd benefit.
What arrhythmia symptoms need emergency evaluation?
Sudden fainting (syncope), near-fainting with heart symptoms, a heart rate persistently over 120 or under 40 at rest, palpitations with chest pain or breathlessness, a survived cardiac arrest, or a strong family history of sudden cardiac death or inherited arrhythmia syndrome. Any of these needs urgent cardiology evaluation — not a routine appointment. Bring family members who witnessed events; their descriptions often clinch the diagnosis when a fleeting arrhythmia has already resolved by the time you reach the clinic.
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