Know the risks of having an irregular heartbeat

Published Jan. 28, 2010 @ 11 p.m.

BERNARD LIM, M.D.: A Springfield cardiac electrophysiologist provides the answers on what are the dangers of having an irregular heartbeat. He also discusses the symptoms, what doctors test for and the risk of dying. 

What are the symptoms?

It is quite common to experience a few skipped beats now and then and these are usually harmless. However, if you experience a lot of them on a regular basis, or get lightheaded and dizzy from them, these may be the signs of a more serious problem and you should have a doctor look at you.

Am I at risk of dying?

If you have a history of a heart attack or heart failure, the skipped beats or palpitations that you are experiencing may be the sign of a more serious condition called ventricular tachycardia and you should definitely be seen by a cardiologist soon.

What will the doctor do?

The doctor will, after taking a history and physical examination, order an ECG, which is like taking a snapshot of the electrical activity in your heart, or a 24 or 48 hour Holter monitor which is analogous to getting a movie of the electrical activity in your heart. If your symptoms do not occur that frequently, like once a week or 2 to 3 times per month, then the doctor may order an event monitor. You will be asked to keep a diary of your symptoms so that the doctor can correlate your symptoms with the findings on the Holter or event monitor.

What do these tests show?

The Holter monitor and event monitors will attempt to correlate your symptoms of skipped beats or palpitations with any electrical disturbances (or arrhythmias) in your heart.

What will the doctor do if tests show an arrhythmia?

If the tests do show an arrhythmia, your doctor may decide to refer you to a cardiac electrophysiologist, a cardiologist who specializes in treating electrical disturbances of the heart.

What will the cardiac electrophysiologist do?

Depending on how frequent your symptoms are and also how severe the symptoms are, the cardiac electrophysiologist may decide to do additional tests, treat you with medications, an ablation procedure or implant a pacemaker or a defibrillator.

What kind of tests?

Your cardiac electrophysiologist may decide to do an EP (electrophysiology) study to find out the type of electrical disturbance or arrhythmia that you may have. This will involve you going to the hospital and will involve inserting wires into the blood vessels in your groin and neck.

What kind of medications?

Depending on your diagnosis, the cardiac electrophysiologist may decide to treat you with beta blockers or calcium channel blockers which are designed to either slow down your heart rate and reduce the number of skipped beats or palpitations or he or she may decide to give you antiarrhythmic medications which are more powerful medications which are designed to suppress the electrical disturbances in your heart. If you have a condition called atrial fibrillation, your doctor may also put you on coumadin, a blood thinner which reduces your chance of having a stroke.

What is an ablation procedure?

A procedure performed by cardiac electrophysiologists where wires are inserted into the blood vessels in your groin and your neck and heat energy is applied to the muscle tissue in your heart to cauterize the area that is causing the electrical disturbance in your heart.

This procedure is very frequently done for supraventricular tachycardias (arrhythmias arising from the top chambers of the heart or the atria) and ventricular tachycardias (arrhythmias arising from the bottom chambers of the heart or the ventricles).  A very common procedure is ablation for atrial fibrillation, a condition which affects hundreds of thousands of Americans each year.

What is a pacemaker or a defibrillator?

A pacemaker is a device that can regulate your heart beat. A defibrillator is a special pacemaker which has the ability to shock your heart out of a dangerous rhythm called ventricular tachycardia or ventricular fibrillation.

Bernard Lim M.D., PH.D., is a cardiac electrophysiologist for Prairie Cardiovascular Consultants.

On the Net:

WebMD: Heart Disease and Abnormal Heart Rhythm

Medline Plus: Heart Palpitations

Reuters: Heart procedures beats drugs for irregular heartbeat

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