At the Arrhythmia Center of Florida, we focus on issues related to cardiac arrhythmia. Take time to learn more about this condition, its symptoms, its diagnosis, and how it can be treated.
Learn more about arrhythmias in Dr. Luis Annoni’s podcast.
What Is a Cardiac Arrhythmia?
A cardiac arrhythmia is an abnormality in the heartbeat—whether the rhythm is too slow, too fast, or irregular. In some cases, a cardiac arrhythmia could be nothing to worry about. For other patients, an arrhythmia could turn life threatening. Even a harmless irregularity in the heartbeat should be carefully observed in case the situation changes. Arrhythmias can be caused by any change or complication that forms in the electrical pathway that runs from the upper chambers of the heart to the lower chambers. Sometimes this can result in a heart beating under 60 beats per minute, or a heart that beats over 100 times in a minute. Some irregular heartbeats will vary chaotically between the two extremes without a discernible pattern.
Symptoms of Cardiac Arrhythmia
Arrhythmia patients will often notice a racing heartbeat or a peculiar fluttering sensation in their chest or neck. They also may note that their hearts seem to be literally “skipping a beat.” Other symptoms of an arrhythmia include:
- Dizziness or fainting
- Difficulty breathing
- Chest pain
Cardiac Arrhythmia Diagnosis
There are several approaches for diagnosing and observing a cardiac arrhythmia. Some methods include:
- Electrocardiogram (EKG) - This test records electrical signals from the heart. This procedure is conducted by placing several electrodes around the chest and arms. The patient’s experience is painless and noninvasive. The test poses no risk to the patient. This allows us to detect abnormal heart rhythms.
- Echocardiogram - The echocardiogram creates images of the patient’s heart using ultrasound waves. This is also a painless, safe, and noninvasive procedure. A physician can use the imaging to detect structural abnormalities of the heart, locate blood clots, and observe the valves as they function.
- Electrophysiology Study (EP Study) - For a more detailed image of the heart’s behavior, a physician may recommend this minimally invasive procedure. Catheters run through blood vessels toward the heart where electrical signals are recorded and translated. An EP study can also induce an arrhythmia, resulting in a more accurate diagnosis for patients who only notice symptoms intermittently.
- Tilt Table Test - This test is recommended for patients with a suspected arrhythmia who experience symptoms such as lightheadedness, dizziness, or fainting. The patient is tilted at an angle of 60 to 70 degrees for 30 to 45 minutes while his heart and blood pressure are monitored.
- Transesophageal Echocardiogram (TEE) - During this procedure, an ultrasound transducer is run down the patient’s throat to the esophagus, where the heart can be observed with clear, detailed imaging.
- Holter Monitor - The Holter monitor also records heart rhythms, but unlike the event recorder, it continuously records each heartbeat, whether an irregular rhythm has been detected or not. For this reason, the Holter monitor is usually only worn by patients for a week or less.
- Implantable Loop Recorder - This recorder is temporarily implanted inside the patient. Although it is more invasive than other heart monitors, the implantable loop recorder is a commonly chosen approach for patients with intermittent arrhythmias that are difficult to detect based on symptoms alone.
Cardiac Arrhythmia Treatment Options
Depending on the state of your arrhythmia, you may be recommended to undergo a variety of different treatments. Some of your options could include:
- A-FIB Ablation - Treatment is often recommended for patients with A-FIB, this procedure ablates heart cells that cause A-Fib.
- Cardioversion - A cardioversion is a nonivasive procedure that can restore a normal heart heart rate in patients with an arrhythmia.
- Lifestyle Changes - In some cases lifestyle changes may be the only treatment a patient needs when an arrhythmia is discovered. Even when further action is necessary, your doctor will probably recommend certain changes to supplement the chosen medication or procedure.
- Blood Thinners - When an arrhythmia patient is at risk for blood clots or a stroke, blood thinning medications are prescribed. These medications are also recommended before tests or treatments that may inadvertently dislodge an unknown blood clot.
- Medications - Further medications can help control the symptoms of an arrhythmia or lower risk factors for other serious conditions, such as high blood pressure or heart disease.
- Pacemaker - This implantable device monitors the patient’s heart rate and steps in to maintain heart rate with electrical pulses.
- Cardiac Resynchronization therapy (CRT) - During this procedure, a physician implants a type of pacemaker, called a Bi-Ventricular Pacer, which works to keep both the right and left ventricles beating in sync with each other.
- Implantable Cardioverter Defibrillator (ICD) - This device functions similarly to a pacemaker. It monitors the rhythm of the heart and delivers an electrical pulse when an abnormality is detected. A bi-ventricular ICD is often used if the right and left ventricles are out of sync.
- Atrioventricular Nodal (AVN) Ablation - This treatment is often recommended for patients struggling with atrial fibrillation and supraventricular tachycardia. This procedure ablates the cells and tissue around the heart that are suspected of causing the arrhythmia.
- Inappropriate Sinus Tachycardia (IST) Ablation - This approach can treat patients with a high heart rate caused by the sinus node. An IST Ablation, along with a pacemaker, can sometimes help with this hard-to-treat condition.
- Premature Ventricular Contraction (PVC) Ablation - This procedure ablates the heart tissue that is causing a PVC arrhythmia. This type of arrhythmia, which results in extra beats from the lower chambers of the heart, is usually not considered dangerous for the typical patient.
- Supraventricular Tachycardia (SVT) Ablation - SVT arrhythmias, which occur in the upper chambers of the heart, are the most common form of arrhythmia. This procedure ablates the heart cells that cause the heart to beat fast.
- Ventricular Tachycardia Ablation - This procedure can prevent a ventricular tachycardia from turning into a serious case of ventricular fibrillation, which can ultimately lead to a sudden cardiac death.
Catheter Ablation for Cardiac Arrhythmia
If you’ve been diagnosed with an arrhythmia, your doctor may be recommending a catheter ablation as treatment. This procedure targets the cause of your arrhythmia and could successfully return to your heart rate to a normal rhythm.
An ablation is a minimally invasive procedure that runs catheters through large veins into your heart, where a doctor will direct electrical impulses that will either block or destroy the heart tissue that is causing your arrhythmia. After the procedure, patients may spend the night in the hospital under observation, and the at-home recovery period can last up to a week.
Although catheter ablation carries a small risk for patients, it is considered a very safe medical procedure. Patients who listen to their doctor’s instructions on rest and avoiding infection tend to make quick, full recoveries without any complications.
If you or a family member is having cardiac issues, the best first step is to get educated. Never hesitate to ask questions about terms and procedures. Our staff is happy to answer your questions and discuss any concerns you may have.
The most common kind of arrhythmia is called an atrial fibrillation, which results in a racing heartbeat, usually averaging between 300 and 600 beats per minute. Atrial fibrillation occurs when the atrioventricular (AV) node receives several electrical impulses at once from the upper chambers of the heart. In these cases, the AV node typically only allows a few impulses to successfully travel to the lower chambers of the heart. This results in a heart that appears to be racing or beating chaotically, but a heart that is not pumping enough blood throughout the rest of the body.
Atrial fibrillation can be a sign of a deeper problem, such as high blood pressure, heart disease, lung disease, heart failure, cardiomyopathy, or a pulmonary embolism.
Chronic untreated atrial fibrillation can create serious consequences for the patient. This arrhythmia can lead to blood clots, stroke, heart failure, or sudden cardiac death.
A cardioversion is a noninvasive procedure that can restore a normal heart rate in patients with an arrhythmia. Electrodes are placed around the chest and transmit electric shocks to the heart. This is an outpatient procedure that is performed quickly, usually only taking a few minutes after the patient has been sedated. It typically provides instant results.
In most cases, cardioversion is very safe. Some patients may notice minor burns or irritation to the skin. In some rare cases, cardioversions can dislodge blood clots which could cause a stroke or pulmonary embolism. If you are at risk for blood clots, be sure to be checked before the procedure and talk to your doctor about taking blood thinning medications.
Watchman left atrial appendage closure device to reduce the risk of stroke from Atrial Fibrillation and eliminate the use of blood thinners/anticoagulation medication. We now offer the Watchman device that is permanently implanted in the left atrial appendage, which is believed to be the source of the majority of stroke causing clots in people with non- valvular A Fib. For more information on the Watchman device go to www.watchmanimplant.com and ask your doctor if the Watchman device is good for me?
To learn more about the cardiac conditions we treat and procedures we offer, watch our video for discussions with our physicians.