Heart rhythm disorders or arrhythmias are serious medical problems experienced by as many as 3 million Americans each year. In arrhythmia, the heart beats either too quickly (tachycardia), too slowly (bradycardia) or irregularly.
The varying beat of the heart can lead to problems in the rest of the body, as blood is not moved efficiently around the body. Arrhythmias can lead to problems such as palpitations, dizziness, fainting, chest pain, and shortness of breath. These symptoms can lead to heart failure, stroke, and in extreme cases, sudden death.
The doctors responsible for correcting arrhythmias are electrophysiologists. As a specialty within cardiology, an electrophysiologist works with medications, implantable devices, targeted procedures and surgeries to produce a more even heart rate in each patient. Dr. Allen Amorn, a cardiologist and electrophysiologist from Ohio, explains the different types of arrhythmias and details how an electrophysiologist can help.
Atrial fibrillation or AFib is the most common arrhythmia. With AFib, patients can experience blood clots, heart failure, stroke, and other complications. Patients describe the sensations of AFib as a “flip-flopping” sensation in the heart or a feeling of beats being skipped. These issues can also cause nausea, light-headedness, and shortness of breath.
The reason why AFib is so dangerous is because it can cause clotting in the bloodstream. Since the blood is not being moved efficiently in and out of the heart, the blood can build up in a clot. When clots are detached and enter the bloodstream, they can travel to the brain. This causes a stroke. Up to 20 percent of people who experience strokes also have AFib.
AFib is commonly mitigated by medications like blood thinners and other cardiac medications, but it can also require interventions such as catheter ablation, and occasionally cardiac pacemakers.
Sick Sinus Syndrome
According to cardiologist Dr. Allen Amorn, this arrhythmia is caused by the SA or sinus node. This is a natural pacemaker which monitors your body’s need for blood at any given time. It is responsible for healthy heart rate changes, such as what happens when you exercise or fall asleep.
Natural aging, medications, prior heart attack, and other ways, can damage this node and lead to arrhythmia. Pacemaker implantation is the most common treatment for this condition.
Supraventricular tachycardia (SVT) is a serious problem that causes a rapid heartbeat which comes from the upper chambers of the heart. This is caused by abnormal electrical impulses.
There are various forms of SVT which can all cause the same types of symptoms such as rapid heart rate while at rest, shortness of breath, chest pain, dizziness and rarely fainting. This type of problem is usually treated very successfully with a procedure called catheter ablation which can eliminate this problem for life. Alternative treatments can be medications.
Ventricular tachycardia (VT) is another serious problem that causes a rapid heart beat. However in this scenario the problem comes from the lower chambers of the heart. This is a much more serious scenario than SVT but the symptoms can be similar. However risks of fainting and sudden death are more likely with VT.
The challenge is due to the similarity in symptoms, ALL symptoms of racing heart must be taken very seriously and evaluated rapidly to help determine if SVT or VT are present. This can be a life-saving distinction based on appropriate treatment. Treatments can involve medications, catheter ablations, and implantable cardioverter/defibrillators (ICDs). Emergency services (including 911) frequently can be necessary to help treat and stabilize these conditions quickly, especially if fainting or severe dizziness are associated.
Tests for Heart Rhythm
A cardiologist will do an EKG to track your symptoms and present heart rhythm. If the problem does not happen often, you will receive a ambulatory monitor which can be worn for 24 hour up to 30 days.
A button may be pressed when the patient feels their symptoms. Echocardiograms or heart ultrasounds are also useful. These give a picture of how the blood moves within the heart and can help to diagnose problems.
In some cases, catheters can be placed within the heart. This electrophysiology study is performed by an electrophysiologist. This will help determine the cause of heart rhythm disorders by trying to stimulate and arrhythmia to help treat it as well with catheter ablation.
Treatment for Arrhythmias
Medications like blood thinners are commonly taken to help with arrhythmias. Calcium channel blockers and beta-blockers are also prescribed. These medications cannot cure the heart rhythm problem, but they can improve the symptoms felt by the patient. They can prevent episodes, decrease the heart rate, and shorten episodes.
More permanent treatments for heart rhythm disorders include implantable cardioverter defibrillators (ICDs) and pacemakers. Both devices stimulate the heart to produce a healthier rhythm. The defibrillators can also restart a heart rhythm which has faltered.
Ablation is another treatment for serious arrhythmias. With ablation, unhealthy tissue is destroyed within the heart. This surgery can be done through a catheter, allowing benefit without the need for open cardiac surgery.
Electrophysiologists Save Lives
Since they can help people regain a healthier heart function, electrophysiologists can help to save patients’ lives. By diagnosing and treating heart rhythm issues, they can give patients a better quality of life.
Using advanced techniques like medications, catheter ablations, and devices, can help patients regain a better heart rhythm and keep them healthy well into the future. Dr. Allen Amorn, MD emphasizes the importance of being seen by a cardiologist and an electrophysiologist when heart rhythm disorders are detected.