Heart Rhythm Services
You might have referred to it as “my heart skipping a beat,” a “racing heart” or an “irregular heartbeat.” Medical professionals will call it an arrhythmia and it affects many Americans of all ages. Sometimes the heart can beat too fast, too slow or just plain be disorganized. Whatever the issue, it can be debilitating when it causes you to miss out on your active lifestyle.
- Bradycardia (slow heartbeat): Bradycardia is a slow heartbeat that occurs less than 60 beats per minute, particularly if the low heart rate happens at times when active, leaving the person feeling tired or lightheaded. It’s not uncommon for some highly athletic individuals, to have a heartbeat lower than 60 beats per minute during rest, which is normal. To require treatment, most of those conditions have to precipitate symptoms that impair your quality of life.
- Tachycardia (rapid heartbeat): Tachycardia is a condition that can be dangerous because the fast beat interferes with the heart’s pumping action. When the heart pumps too fast, the ventricles do not have time to fill with the appropriate amount of blood. How dangerous it is, usually depends upon which chamber of the heart the abnormality originates.
AFib: Atrial Fibrillation (AFib) is a condition in which the upper chambers of the heart (the atria) beat in a rapid, uncoordinated and disorganized fashion, resulting in a very irregular and frequently fast heart rate. When the heart’s atria are in AFib, they quiver instead of beating effectively.
The Importance of Treating AFib:
- Risk of stroke. AFib is a major factor for stroke, making you five times more likely to have a stroke. In fact AFib accounts for 20% of all stroke.
- With AFib comes a deterioration of other cardiovascular conditions and can be a disease accelerator of other illnesses.
- AFib compromises quality of life and functional capacity, keeping you from doing the activities you love.
- High costs. AFib increases healthcare utilization. Medical costs are as much as five times higher than those without the disease.
Prairie Heart Institute Southern Illinois Healthcare’s Heart Rhythm Services addresses the urgency associated with AFib.
Prairie Heart Institute Southern Illinois Healthcare has developed Heart Rhythm Services Program to diagnose and treat arrhythmias. Our goal is to determine the underlying cause and help you get back to doing what you love. Rhythm disorders are a very individualized science. Be sure to have clear discussions with your physician about your symptoms.
Signs & Symptoms of Arrhythmia
Some of the common symptoms include:
- Decrease exercise tolerance
- Fainting or near fainting
Diagnosing Rhythm Disorders
A heart rhythm specialist (Electrophysiologist) is specifically trained in arrhythmia and uses special diagnostic tools to determine the root cause of your disorder and treat it accordingly. Tests may include:
- ECG (EKG) or electrocardiogram – a snapshot of the heart rhythm at a time
- Holter/event monitoring – continuous recording of the heart rhythm for 24-48 hours
- Event monitor – monitors the heart rhythm for prolonged periods of time and stores episodes when you have symptoms
If based on history and findings we suspect that your heart rhythm disorder might be treated with an ablation procedure (see below), we may recommend performing an electrophysiology study.
Treatments for a Rhythm Disorder
- Lifestyle Changes
- Implanted Cardioverter Defibrillators
- Cardiac Ablation
Heart Rhythm Services FAQ
What Happens in an EP study?
- The procedure is performed in a special room called an EP laboratory. Upon arriving, you will be given a local anesthetic and conscious sedation.
- During the procedure, the electrophysiologist will insert a catheter, usually through the veins in the groin area up to the heart.
- The catheter has special electrodes at the tip used to gather data and electrical measurements. The electrocardiogram (EKG) that you had in the office was an overall view of the electrical activity of the heart. The catheters in an EP study in turn, with their small antennas, will capture the precise electrical activity of the tissue inside the heart. This electrical mapping helps the doctor pinpoint the problematic tissue.
- During the procedure, we may stimulate your heart or give medications in an attempt to reproduce your symptoms in a monitored, controlled environment.
- Once the cause is confirmed the doctor will then determine what will be the appropriate course of treatment. In many cases, an ablation procedure may be performed at that time.
- The procedure usually takes about two hours, but you may be asked to remain still for four to six hours in the recovery area to monitor you appropriately.
What is an Ablation Procedure?
- After confirming diagnosis, a special catheter may be advanced in the groin (usually at the same time of the EP study). That catheter can heat and create small areas of scar tissue at the locations responsible for the abnormal rhythm.
- In order to precisely determine which areas require creating scar tissue, we use several tools to locate the catheter, including fluoroscopy (X-ray), ultrasound, the electrical recording of the catheter itself and occasionally a special GPS-like location tool for catheters.
Scars created by ablation are very small and usually created in areas that do not contribute substantially to the pumping function of the heart, therefore there is no negative impact in heart function.
Ablation is usually performed with sedation given by a trained nurse whose job is to make sure you are safe and comfortable. Please tell the nurse if you experience any pain. Some more prolonged ablation procedures (such as ablation for atrial fibrillation) are performed under general anesthesia; therefore you should not have any recollection of the procedure.
Do I Need a Pacemaker?
In the event that your symptoms are attributed to a slow heart beat, a pacemaker may be helpful. Pacemakers are fairly sophisticated, small devices that stay in the shoulder area and are connected to the heart via cables that are inserted via the vein that runs under the collar bone. A pacemaker will ensure that your heart rate does not go below a specified, programmable rate.
If you have heart failure or dilated heart, a pacemaker may be indicated in order to pace specific locations in the heart that will make the pump function become more effective. We call this cardiac resynchronization therapy.
Do I Need a Defibrillator?
A defibrillator is like a small emergency response team that stays implanted under the shoulder and acts if the heart goes to a dangerous heart rhythm.
Certain cardiac conditions such as chronic systolic heart failure (CHF), Brugada syndrome, long QT syndrome, short QT syndrome, arrhythmogenic right ventricular dysplasia can be high risk for a dangerous heart rhythm disorder: ventricular fibrillation that causes sudden cardiac death.
However, not everyone with those cardiac conditions needs a defibrillator and not everyone with those conditions may want to have a defibrillator. Therefore consultation and a thorough discussion to individualize care is important.