Conditions · Houston
Too fast, too slow, or irregular. Arrhythmia is the umbrella term, and the first job is never treatment — it is proving which rhythm you actually have.
A normal heartbeat starts in the sinus node, spreads across the atria, passes through the AV node, and reaches the ventricles. An arrhythmia is a failure somewhere along that path: the signal starts in the wrong place, travels a route it should not, or fails to travel at all.
Clinically that shows up as a rhythm that is too fast, too slow, or irregular — and some people have more than one. The label matters less than a tracing recorded while you feel it.
Palpitations — skipped, fluttering, racing, or pounding beats. Lightheadedness. Fatigue that does not match your activity. Breathlessness on exertion that is new. Fainting, or nearly fainting. Or nothing at all: a watch alert, a pre-operative ECG, or a routine physical.
Symptoms correlate poorly with seriousness. Dramatic palpitations are often benign; a silent rhythm can matter a great deal. That is precisely why the rhythm has to be recorded rather than guessed.
An office ECG captures roughly ten seconds. If your symptoms are weekly, it will almost certainly be normal, and a normal ECG proves very little. Matching the tool to how often your symptoms happen is the entire diagnostic strategy:
Echocardiography, thyroid studies, and a sleep-apnea history belong in the same workup, because each of them can drive a rhythm and each changes the plan.
Once the rhythm is named, the options are reasonably clear: observation, medication, catheter ablation to treat the circuit directly, or a device where the problem is a heart too slow or a risk of a dangerous fast rhythm. For AFib there is also a stroke-prevention decision made independently of everything else.
Treating a rhythm nobody has recorded is how people end up on a medication for years without a diagnosis.
Fainting, chest pain, severe breathlessness, or new neurological symptoms are emergency-department problems. Call 911. Do not wait for an appointment for any of those.
A new diagnosis, palpitations you cannot explain, a watch alert you cannot ignore, or a medication that has made you feel worse are clinic problems. Those can usually be seen this week.
Procedures are performed at Houston Methodist, Memorial Hermann, Baylor St. Luke’s, and HCA hospitals across the Texas Medical Center, Clear Lake, and Pearland corridors. Clinic follow-up is at TMC, Clear Lake, or Pearland, Monday–Friday, 8am–5pm. One number: (832) 972-7300.
Dr. Boone evaluates you, performs the procedure, and keeps the follow-up. There is no hand-off to a different physician for the part that matters.
No. An ECG records about ten seconds. If your symptoms come and go, a normal tracing tells you only that your rhythm was normal during those ten seconds. That is what longer monitoring is for.
Usually not, but they deserve to be identified rather than dismissed. The goal is to record your rhythm while you are feeling it and then say something definite.
No. Call (832) 972-7300. If another physician is sending records, fax (855) 538-7649.
Rhythm is the subspecialty. Come here when the diagnosis is still unsettled, when ablation or a device is being discussed, or when the medication choice is not straightforward.
Sometimes. Consumer devices are good at flagging irregularity and not good at proving what it is. Bring the recording — it is a useful starting point, not a diagnosis.
Related: Atrial fibrillation · Bradycardia & tachycardia · All conditions · Patient guide
The first visit should end with a suspected rhythm and a concrete way to prove it.
