Causes, Treatments, After Eating, Lying Down

Palpitations make you feel like your heart is beating too hard or too fast, skipping a beat, or fluttering. You may notice heart palpitations in your chest, throat, or neck.

They can be bothersome or frightening. They usually aren’t serious or harmful, though, and often go away on their own. Most of the time, they’re caused by stress and anxiety, or because you’ve had too much caffeine, nicotine, or alcohol. They can also happen when you’re pregnant.

In rare cases, palpitations can be a sign of a more serious heart condition. If you have heart palpitations, see your doctor. Get immediate medical attention if they come with:

After your doctor takes your medical history and looks you over, they may order tests to find the cause. If they find one, the right treatment can reduce or get rid of the palpitations.

If there’s no underlying cause, lifestyle changes can help, including stress management.

Causes

There can be many. Usually, palpitations are either related to your heart or the cause is unknown. Non-heart-related causes include:

• Strong emotions like anxiety, fear, or stress. They often happen during panic attacks.
• Vigorous physical activity
• Caffeine, nicotine, alcohol, or illegal drugs such as cocaine and amphetamines
• Medical conditions, including thyroid disease, a low blood sugar level, anemia, low blood pressure, fever, and dehydration
• Hormonal changes during menstruation, pregnancy, or just before menopause. Sometimes, palpitations during pregnancy are signs of anemia.
• Medications, including diet pills, decongestants, asthma inhalers, and some drugs used to prevent arrhythmias (a serious heart rhythm problem) or treat an underactive thyroid
• Some herbal and nutritional supplements
• Abnormal electrolyte levels

Some people have palpitations after heavy meals rich in carbohydrates, sugar, or fat. Sometimes, eating foods with a lot of monosodium glutamate (MSG), nitrates, or sodium can bring them on, too.

If you have heart palpitations after eating certain foods, it could be due to food sensitivity. Keeping a food diary can help you figure out which foods to avoid.

They can also be related to heart disease. When they are, they’re more likely to represent arrhythmia. Heart conditions tied to palpitations include:

At the Doctor’s Office

Your doctor will:

• Give you a physical exam
• Take down your medical history
• Want to know about your current medications, diet, and lifestyle
• Ask for specifics about when, how often, and under what circumstances your palpitations occur

Sometimes, a blood test can help your doctor find the cause of your palpitations. Other useful tests include:

Electrocardiogram(EKG): This can be done while you’re at rest or exercising. The latter is called a stress EKG. In both cases, the test records your heart’s electrical signals and can find unusual heart rhythms.

Holter monitoring: You’ll wear a monitor on your chest. It continuously records your heart’s electrical signals for 24 to 48 hours. It can identify rhythm differences that weren’t picked up during an EKG.

Event recording: You’ll wear a device on your chest and use a handheld gadget to record your heart’s electrical signals when symptoms occur.

Chest X-ray: Your doctor will check for changes in your lungs that could come from heart problems. For example, if they find fluid in your lungs, it may come from heart failure.

Echocardiogram: This is an ultrasound of your heart. It provides detailed information about its structure and function.

If necessary, your doctor may refer you to a cardiologist for more tests or treatment.

Treatment

This depends on their cause. Often, palpitations are harmless and go away on their own. In that case, no treatment is needed.

If your doctor doesn’t find a cause, they may advise you to avoid the things that might trigger the palpitations. Strategies may include:

Ease anxiety and stress. Leave a stressful situation and try to be calm. Anxiety, stress, fear, or panic can cause palpitations. Other common ways to stay calm include:

Cut out certain foods, beverages, and other substances. These may include:

Avoid medications that act as stimulants. You may have to steer clear of:

If lifestyle changes don’t help, you may be prescribed medications. In some cases, these will be beta-blockers or calcium-channel blockers.

If your doctor finds a reason for your palpitations, they will focus on treating that reason.

If they’re caused by a medication, your doctor will try to find a different treatment.

If they represent an arrhythmia, you may get medications or procedures. You may also be referred to a heart rhythm specialist known as an electrophysiologist.

Follow Up

Make sure to check in with your doctor. Often, palpitations aren’t serious, but they can be related to abnormal heart valves, heart rhythm problems, or panic attacks.

Always call a doctor if palpitations change in nature or increase suddenly.

Call 911 right away if you have these symptoms along with palpitations:

• Dizziness
• Confusion
• Lightheadedness
• Passing out
• Shortness of breath
• Pain, pressure, or tightness in the chest, neck, jaw, arms, or upper back

4 reasons behind an irregular heartbeat| Geisinger

People say, “My heart skipped a beat,” when they’re scared or excited. But an irregular heartbeat is actually much more common than you’d think. 

“An irregular heartbeat is called an arrhythmia,” says Dr. Pugazhendhi Vijayaraman, cardiac electrophysiologist and director of cardiac electrophysiology at Geisinger Northeast. “There are many different types, which can be temporary or permanent. Often, arrhythmias are harmless; however, if you feel a persistent irregular heartbeat, see a doctor. ”

One type of arrhythmia, a premature ventricular contraction, or PVC, is the most common type of irregular heartbeat. 

A PVC happens when the heart beats too early, which causes a stronger second beat. This causes a fluttering or pounding sensation in the chest. Most people have at least one PVC every day, and many don’t even notice it. 

Things like caffeine, alcohol and stress can cause small, temporary arrhythmias like PVCs. But there are factors that can cause permanent arrhythmias, too.

Here are four potential causes of a persistent, irregular heartbeat:

1. Coronary artery disease
   Your arteries are highways for oxygen and nutrients. However, fat, cholesterol and calcium can build plaques in the arteries, causing coronary artery disease. These plaques make it difficult for blood to flow and can put pressure on the heart.  

   “Coronary artery disease weakens the heart by putting it under too much pressure,” says Dr. Vijayaraman. “As the heart weakens, irregular heartbeats can develop. ”

   Coronary artery disease can cause dangerous arrhythmias like atrial fibrillation, or AFib. It’s a rapid, quivering heartbeat that can lead to heart palpitations, blood clots, heart attack and stroke.
   
   

2. Heart surgery
   Heart surgery is a life-saving operation—it can remove clots and help you get your life back. 

   But, operating on the heart can change the way the heart works, including the way your heart beats. Heart surgery can increase your risk of arrhythmias, so your doctors will often monitor your heart after surgery.  

3. Changes in your heart muscle
   If you’ve had a heart attack, you may have scar tissue on your heart muscle. This scar tissue can cause the heart to beat irregularly by restricting or changing the heart. 

   After a heart attack, there is also risk of cardiomyopathy or an abnormality of the heart. With cardiomyopathy, your heart may swell and make it harder to pump blood. This can also lead to arrhythmia.

4. Electrolyte imbalance
   You’ve likely heard of electrolytes in sports drinks, but they relate to your heart, too.

   “Electrolytes are small traces of metal that conduct electricity, which allows the heart to beat,” explains Dr. Vijayaraman . “Sodium, magnesium, potassium and calcium are all examples of electrolytes. If you have too many or too few electrolytes in your body, it can change the way your heart beats.”

When to see a doctor

While PVCs are normally harmless, certain types of arrhythmias, like atrial fibrillation and ventricular fibrillation (VFib), can lead to cardiac arrest and heart attack. VFib can paralyze the heart—making it unable to pump blood. If left untreated, VFib can lead to cardiac arrest. 

If you feel a persistent irregular heartbeat, your doctor can help diagnose the type of arrhythmia and monitor your heart. They may refer you to an Electrophysiology (EP) lab, where they can test, diagnose and treat arrhythmias.

Get emergency medical attention if you experience dizziness, fainting, shortness of breath and pain in your chest. These symptoms could be a sign of a severe arrhythmia and heart attack. Similarly, if you notice numbness on one side of your body, confusion, facial drooping and muscular weakness, these symptoms could be a sign of a stroke.   

Next steps:

Meet Pugazhendhi Vijayaraman, MD

Learn about heart care at Geisinger

How Serious Is Having An Irregular Heartbeat?

While we may say our heart skips a beat when it comes to falling in love. But when your heart literally skips a beat, it’s known as an arrhythmia.

Day in and day out, you likely don’t notice your heartbeat at all, especially if it’s functioning normally. However, when you experience stress or you’re performing strenuous exercise, you may notice a higher heart rate or even sensations of fluttering in your chest.

However, for individuals living with an arrhythmia, feelings and sensations such as this may occur without any exertion or stress at all.

“Put simply, arrhythmia is the medical name for an irregular heartbeat,” says Shalabh Chandra, MD, an electrophysiologist at Georgia Heart Institute. “There are many different forms of arrhythmias that can cause your heart to beat too quickly, too slowly or irregularly.”

If you’ve been diagnosed with an arrhythmia, is it a serious health issue? Dr. Chandra answers that question and provides key insights about this common heart condition below:

Q: What exactly is an arrhythmia?

Dr. Chandra: The heart’s electrical system is what coordinates each heartbeat and coordinates the contracting and pumping between its chambers. However, when that system is disrupted or not functioning correctly due to damage, disease or other factors, this can cause your heartbeat to become abnormal.

In some cases, an abnormal heartbeat may be temporary and will come and go (episodic) or it can be present all the time (persistent).

Q: What are the different types of arrhythmia?

Dr. Chandra: When your heart beats too fast, it’s called tachycardia. When your heart beats too slow, it’s called bradycardia. When your heart beats too early, it’s called premature contraction. And when your heart beats erratically, it’s called fibrillation.

You may have heard about atrial fibrillation, the most common type of arrhythmia, which is when your heart beats erratically and fast.

Q: What causes an arrhythmia?

Dr. Chandra: An irregular heartbeat can have many causes. If your heart has ever “skipped a beat” when you’re anxious about something, you know that your mental health can affect your heart.

In fact, arrhythmias can have physical, emotional and genetic causes, and in many cases, it’s a combination of several different factors. This can include everything from other medical or heart-related conditions or thyroid disorders.

There’s also an important distinction between triggers and causes. For individuals experiencing arrhythmia episodes, there are certain factors that can trigger an irregular heartbeat, such as dehydration, caffeine and stress.  

Q: Do arrhythmias have symptoms?

Dr. Chandra: When you experience an irregular heartbeat, you’ll likely notice some sensation in your chest and/or heart. Depending on the type of arrhythmia, it may feel like a skipped beat, fluttering or pounding in the chest.

Persistent arrhythmias can cause other symptoms to develop, including fatigue or weakness, dizziness, lightheadedness, fainting, shortness of breath, sweating and chest pain or pressure.

Because these symptoms overlap with those of a heart attack, it’s important to be evaluated by a medical provider. If you’re diagnosed with an arrhythmia, your medical provider can recommend whether treatment is necessary and what type of treatment is best for your unique needs.

Q: Is an arrhythmia dangerous?

Dr. Chandra: It depends. At some point, every person experiences an arrhythmia, which probably feels like your heart is fluttering or racing.

In many cases, these irregular heartbeats are harmless and will resolve on their own. But when they occur persistently, they can be serious.

When your heart’s rhythm is disrupted, it isn’t pumping oxygenated blood efficiently, which can cause harm to the heart and the rest of the body.

If your heart beats too fast, for example, the heart’s ventricles may “quiver,” which can cause an abrupt loss of heart function known as sudden cardiac arrest. Other arrhythmias can also result in more serious health conditions; having atrial fibrillation is associated with a greatly increased risk of stroke.

Q: How are arrhythmias treated?

Dr. Chandra: While arrhythmias can be complex and serious, we have a robust array of diagnostics and treatment options available to treat every type of heart rhythm disorder.

At Georgia Heart Institute, we have an experienced team of fellowship-trained electrophysiologists – experts specializing in the treatment of arrhythmias – along with advanced practice providers, all working together to effectively diagnose and treat your arrhythmia.

Learn more about the innovative and comprehensive services we offer – and easily schedule your appointment online today!

Causes and Best Treatment For Arrhythmia (Irregular Heartbeat): Van H. De Bruyn, MD, FACC, FHRS: General Cardiology

A normal heart beats with a steady rhythm, moving about 2,000 gallons of blood through your body each day. However, in some people, the normal rhythm is off, and blood doesn’t move through their systems efficiently. The abnormal beats, which are called arrhythmias, can be life threatening – or harmless.

Arrhythmias may refer to an irregularly quick or slow heart rate. Tachycardia is the name for a fast heart rate when the heart beats more than 100 times per minute. A slow heart rate is called bradycardia, in which the heart beats slower than 60 beats per minute.

A common type of heart arrhythmia is known as an atrial fibrillation, in when your heart beats rapidly and irregularly, increasing your risk of serious health complications such as stroke and heart failure. Inefficient blood flow caused by an arrhythmia can cause damage to other organs, too, including your lungs and brain.

Causes of arrhythmias

Lifestyle can contribute to your development of a heart arrhythmia. If you’re under a lot of stress or use too much caffeine, alcohol, or illicit drugs, an arrhythmia can arise.

Your health also dictates whether you have an arrhythmia. An overactive or underactive thyroid gland, high blood pressure, diabetes, and sleep apnea can contribute to arrhythmias. Coronary artery disease and the resulting blocked heart arteries may also be the blame. Changes in your heart structure due to genetics or disease (such as scar tissue from a heart attack) are other possible issues contributing to arrhythmia.

Our goals for treatment

At Heart Rhythm Associates, we strive to determine exactly why you’re suffering with a heart arrhythmia. Some arrhythmias are harmless and just reflect your heart’s normal processes. But if yours is putting you at risk for complications, Dr. De Bruyn offers treatment.

If you have an arrhythmia, our goal is to control it within a relatively normal range. If you have heart disease or another underlying condition causing your arrhythmia, we’ll focus on treating it and reducing risk factors for heart disease and stroke. If you have atrial fibrillation (AFib), a treatment goal is to prevent blood clots and reduce your risk of stroke.

Treatments for arrhythmias

Treatments for arrhythmias include medications, ablation, and implantation of devices to control your heart rate. Dr. De Bruyn also recommends lifestyle changes to help you reduce high blood pressure and cholesterol levels, lose excess weight, and quit smoking. You’ll be encouraged to eat a healthy, balanced diet and exercise regularly in most cases.

Those with bradycardia are usually treated with a pacemaker that’s installed in the chest. If your heart beats too slowly or stops, the pacemaker sends out an electrical impulse to stimulate your heart rate to beat steadily.

For fast heartbeats (tachycardias), Dr. De Bruyn may offer medications or cardioversion, which involves using paddles or patches applied to your chest that send electrical impulses to your heart to restore normal rhythms.

Catheter ablation is also a possible treatment. During this procedure, heat is applied through a catheter to areas of heart tissue that are causing the arrhythmia, essentially sealing off the pathway and halting the arrhythmia.

Dr. De Bruyn may recommend an implantable cardioverter-defibrillator (ICD) for men and women who are at a high risk of developing a dangerously fast or irregular heartbeat in the lower ventricles of the heart. The ICD is implanted under the skin of your chest. If the device detects an abnormal heart rate, it sends out an electrical impulse to reset your heart’s rhythm. It can’t cure an abnormal heart rate, but it can reset your heart if one occurs.

Many heart arrhythmias are serious conditions that require expert care. At Heart Rhythm Associates, we’re available to everyone in central Arkansas who suffers from possible cardiac conditions. To take care of your heart health, phone the office or schedule a consultation using this website.

When to Evaluate Heart Palpitations

Palpitations are symptoms of everything from short or long-term stress to a variety of arrhythmias (irregular heartbeats). They may feel alarming, but do not always reflect a serious heart condition.  Joseph Marine, M.D., vice-director of the Division of Cardiology at Johns Hopkins, starts his evaluation by asking his patients what they hear.

What are palpitations?

Palpitations are characterized as a general or heightened awareness of your own heartbeat – whether it’s too fast, too slow, or otherwise irregular. You might feel like your heart is thumping, racing, or fluttering. And you could feel this sensation in your chest or your neck.

“I ask them to tap out what their heartbeat feels like. Then I get a sense of whether we’re dealing with isolated skipped beats or a more sustained arrhythmia,” says Marine. “Patients frequently will feel their skipped beats more at night, when they’re lying in bed and nothing is distracting them from it.”

Diagnosing palpitations

Palpitations can occur for a variety of reasons unrelated to heart disease. These include:

• Overexertion
• Stress
• Caffeine, alcohol, tobacco, or diet pills
• Overactive thyroid
• Hormone changes associated with menstruation, pregnancy, or menopause
• Low blood pressure
• Heart disease or abnormal heart valves
• The body’s response to medications such as thyroid pills, cold medicines, and asthma drugs

Palpitations can also result from a range of heart arrhythmias. These are classified by location, and type of heartbeat. A few common types:

• Supraventricular tachycardia – A rapid heart rate originating above the ventricles (lower heart chambers). It can cause the heart to beat very quickly or erratically. Symptoms might include an overly fast pulse and dizziness.
• Atrial fibrillation – The most common type of arrhythmia, an atrial fibrillation can result in a rapid and erratic heartbeat, which may interfere with blood flow to the ventricles and possibly lead to serious clotting conditions or stroke. Symptoms might not exist at all, or involve chest pain, palpitations, or shortness of breath.
• Ventricular tachycardia – A rapid heartbeat originating in the ventricles (lower heart chambers). When associated with structural heart disease, this arrhythmia may cause loss of consciousness and, in some cases, cardiac arrest or sudden death.

Separating serious palpitations from harmless ones

It’s important to differentiate palpitations caused by stress or minor arrhythmias from those that may point to an underlying heart disease. Inconveniently, palpitations don’t always occur during the time you’re with your doctor.

Marine recommends coordinating an electrocardiogram (ECG) with the irregular heart beat symptoms the patient is having by using a Holter or event monitor.

A Holter monitor is a portable machine you would carry in your pocket or small pouch around your neck or waist for 24 to 48 hours. Electrodes connect your chest to the monitor wires to record your heart rhythms.

An event monitor records heart rhythms for a longer span of time (about a month). The patient activates the monitor whenever he or she experiences an irregular heartbeat.

Treating palpitations

Depending on the severity of the symptoms and underlying cause of the palpitation, your doctor will typically recommend one of three treatment options:

• Preventive care (for non-severe palpitations) – Try eliminating smoking, excess caffeine, and alcohol from your daily regimen; practice general deep breathing and yoga; get plenty of sleep and exercise; regularly schedule “you” time.
• Medications – Your physician might prescribe antiarrhythmic drugs such as beta blockers and calcium channel blockers, both of which have a safe track record. Occasionally these drugs don’t work effectively and stronger antiarrhythmic drugs that directly act on the sodium and potassium channels of the heart might be necessary.
• Catheter ablation – Small wires are threaded through the leg veins into the heart to trigger an arrhythmia, identify the cause, and cauterize the problem area. This treatment is highly effective when the physician can identify an arrhythmia in a specific region of the heart (such as supraventricular tachycardia).

Other outpatient procedures include cardioversion (electric shock sent to the chest wall to synchronize the heartbeat to a normal rhythm), and an implantable defibrillator (a special type of pacemaker that automatically detects and terminates ventricular arrhythmias associated with heart disease).

Sometimes comfort and reassurance are the best medicine

“While palpitations can sometimes signal a more serious condition, they’re often just a sensation of a normal heartbeat,” says Marine. “Confirming that nothing is seriously wrong is sometimes all a person needs. Relaxation techniques and reassurance from a physician – I find that both are very helpful when the cause of palpitations is benign.”

Types, Symptoms, Causes, Diagnosis & Treatments

Overview

What is an arrhythmia?

An arrhythmia (also called dysrhythmia) is an irregular or abnormal heartbeat.

What is my pulse?

Your pulse indicates your heart rate, or the number of times your heart beats in one minute. Pulse rates vary from person to person. Your pulse is slower when you are at rest and increases when you exercise, since more oxygen- rich blood is needed by the body during exercise.

How do I take my pulse?

You can tell how fast your heart is beating by feeling your pulse. You can feel your pulse on your wrist or neck. Place the tips of your index and middle fingers on the inner wrist of your other arm, just below the base of your thumb. Or, place the tips of your index and middle fingers on your lower neck, on either side of your windpipe. Press lightly with your fingers until you feel the blood pulsing beneath your fingers. You may need to move your fingers around slightly up or down until you feel the pulsing.

You can count the number of beats in 10 seconds and multiply by 6 to determine your heart rate in beats per minute. A normal heart rate, at rest, is 50 to 100 beats per minute.

Your Heart Rate: Pulse in 10 seconds x 6 = _

Learn more about your pulse and target heart rate.

Heart Rhythms on ECG

The heart’s electrical system triggers the heartbeat. Each beat of the heart is represented on the electrocardiogram (EKG or ECG) by a wave arm.

The normal heart rhythm (normal sinus rhythm) shows the electrical activity in the heart is following the normal pathway. The rhythm is regular and the node is normal (about 50 to 100 beats per minute).

Tachycardia: fast heart rhythm (greater than 100 beats per minute)

Bradycardia: slow heart rhythm (less than 60 beats per minute)

The Heart’s Electrical System

The atria (the heart’s upper chambers) and ventricles (the heart’s lower chambers) work together, alternately contracting and relaxing to pump blood through the heart. The electrical system of the heart is the power source that makes this possible. Here’s what happens during a normal heartbeat:

Irregular heart rhythms can also occur in normal, healthy hearts. Arrhythmias can also be caused by certain substances or medications, such as caffeine, nicotine, alcohol, cocaine, inhaled aerosols, diet pills, and cough and cold remedies. Emotional states such as shock, fright or stress can also cause irregular heart rhythms.

Arrhythmias that are recurrent or related to an underlying heart condition are more concerning and should always be evaluated by a doctor.

In most cases, treating the underlying condition will take care of the arrhythmia. If not, many medications and procedures are available to eliminate or control the abnormal heart rhythm.

What are the types of arrhythmias?

• Tachycardia: A fast heart rhythm with a rate of more than 100 beats per minute.
• Bradycardia: A slow heart rhythm with a rate below 60 beats per minute.
• Supraventricular arrhythmias: Arrhythmias that begin in the atria (the heart’s upper chambers). “Supra” means above; “ventricular” refers to the lower chambers of the heart, or ventricles.
• Ventricular arrhythmias: Arrhythmias that begin in the ventricles (the heart’s lower chambers).
• Bradyarrhythmias: Slow heart rhythms that may be caused by disease in the heart’s conduction system, such as the sinoatrial (SA) node, atrioventricular (AV) node or His-Purkinje network.

Types of Supraventricular Arrhythmias

Supraventricular arrhythmias begin in the atria

Types of supraventricular arrhythmias include:

Premature atrial contractions (PACs)

Early, extra heartbeats that originate in the atria.

Paroxysmal supraventricular tachycardia (PSVT)

A rapid but regular heart rhythm that comes from the atria. This type of arrhythmia begins and ends suddenly.

Accessory pathway tachycardias (bypass tract tachycardias)

A fast heart rhythm caused by an extra, abnormal electrical pathway or connection between the atria and ventricles. The impulses travel through the extra pathways as well as the usual route. This allows the impulses to travel around the heart very quickly, causing the heart to beat unusually fast (example: Wolff- Parkinson-White syndrome).

AV nodal re-entrant tachycardia (AVNRT)

A fast heart rhythm caused by the presence of more than one pathway through the atrioventricular (AV) node.

Atrial tachycardia

A rapid heart rhythm that originates in the atria.

Atrial fibrillation

A very common irregular heart rhythm. Many impulses begin and spread through the atria, competing for a chance to travel through the AV node. The resulting rhythm is disorganized, rapid and irregular. Because the impulses are traveling through the atria in a disorderly fashion, there is a loss of coordinated atrial contraction.

Atrial flutter

An atrial arrhythmia caused by one or more rapid circuits in the atrium. Atrial flutter is usually more organized and regular than atrial fibrillation.

Types of Ventricular Arrhythmias

A ventricular arrhythmia begins in the heart’s ventricles.

Types of ventricular arrhythmias include:

Premature ventricular contractions (PVCs)

Early, extra heartbeats that originate in the ventricles. Most of the time, PVCs don’t cause any symptoms or require treatment. This type of arrhythmia is common and can be related to stress, too much caffeine or nicotine, or exercise. They can be also be caused by heart disease or electrolyte imbalance. People who have several PVCs and/or symptoms associated with them should be evaluated by a cardiologist (heart doctor).

Ventricular tachycardia (V-tach)

A rapid heartbeat that originates in the ventricles. The rapid rhythm keeps the heart from adequately filling with blood, and less blood is able to pump through the body. V-tach can be serious, especially in people with heart disease, and may be associated with more symptoms than other types of arrhythmia. A cardiologist should evaluate this condition.

Ventricular fibrillation (V-fib)

An erratic, disorganized firing of impulses from the ventricles. The ventricles quiver and cannot generate an effective contraction, which results in a lack of blood being delivered to the body. This is a medical emergency that must be treated with cardiopulmonary resuscitation (CPR) and defibrillation (delivery of an energy shock to the heart muscle to restore a normal rhythm) as soon as possible.

Long QT

The QT interval is the area on the ECG that represents the time it takes for the heart muscle to contract and then recover, or for the electrical impulse to fire and then recharge. When the QT interval is longer than normal, it increases the risk for “torsade de pointes,” a life-threatening form of ventricular tachycardia.

Types of Bradyarrhythmias

A bradyarrhythmia is a slow heart rhythm that is usually caused by disease in the heart’s conduction system. Types of bradyarrhythmias include:

Sinus node dysfunction

Slow heart rhythms due to an abnormal SA node.

Heart block

A delay or complete block of the electrical impulse as it travels from the sinus node to the ventricles. The level of the block or delay may occur in the AV node or His-Purkinje system. The heartbeat may be irregular and slow.

Management and Treatment

How is an arrhythmia treated?

Treatment depends on the type and severity of your arrhythmia. In some cases, no treatment is necessary. Treatment options include medications, lifestyle changes, invasive therapies, electrical devices or surgery.

Medications

Antiarrhythmic drugs are medications used to convert the arrhythmia to a normal sinus rhythm or to prevent an arrhythmia. Other medications may include heart rate-control drugs and anticoagulant or antiplatelet drugs such as warfarin (a “blood thinner”) or aspirin, which reduce your risk of stroke or developing blood clots.It is important that you know the names of your medications, why they are prescribed, how often and at what times to take them, what side effects may occur, and what medications you have previously taken for your arrhythmia.

Lifestyle changes

Arrhythmias may be related to certain lifestyle factors. The following tips can help limit the occurrence of arrhythmias:

• If you smoke, stop.
• Limit your intake of alcohol.
• Limit or stop using caffeine. Some people are sensitive to caffeine and may notice more symptoms when using caffeinated products, such as tea, coffee, colas and some over-the- counter medications.
• Avoid using stimulants. Beware of stimulants used in cough and cold medications and herbal or nutritional supplements. Some of these substances contain ingredients that cause irregular heart rhythms. Read the label and ask your doctor or pharmacist which medication is best for you.
• Your family may also want to be involved in your care by learning to recognize your symptoms and how to start CPR if needed.
• If you notice that your irregular heart rhythm occurs more often with certain activities, you should avoid them.

Invasive therapies

Electrical cardioversion and catheter ablation are invasive therapies used to treat or eliminate irregular heart rhythms. Your doctor will determine the best treatment for you and discuss the benefits and risks of these therapies with you.

• Electrical cardioversion Patients with persistent arrhythmias, such as atrial fibrillation, may not be able to achieve a normal heart rhythm with drug therapy alone. Electrical cardioversion delivers an electrical shock to your chest wall, which synchronizes the heart and allows the normal rhythm to restart. This procedure is done after you receive short-acting anesthesia.
• Catheter ablation: During ablation, energy is delivered through a catheter to tiny areas of the heart muscle. This energy can either “disconnect” the pathway of the abnormal rhythm, block the abnormal pulses and promote normal conduction of impulses, or disconnect the electrical pathway between the atria and the ventricles.
  • Pulmonary vein isolation: In patients with frequent, paroxysmal or persistent atrial fibrillation, isolation of the pulmonary veins is a procedure that uses special catheters to render bands of vein tissue, thought to cause atrial fibrillation, dysfunctional. The goal is to isolate, rather than ablate, the foci responsible for triggering atrial fibrillation through a circumferential conduction block.
• Electrical devices

• Permanent pacemaker: A device that sends small electrical impulses to the heart muscle to maintain a normal heart rate. The pacemaker has a pulse generator (which houses a battery and a tiny computer) and leads (wires) that send impulses from the pulse generator to your heart muscle, as well as sense the heart’s electrical activity. Pacemakers are mostly used to prevent the heart from beating too slowly. Newer pacemakers have many sophisticated features that are designed to help manage arrhythmias, optimize heart rate-related functions and improve synchronization.
• Implantable cardioverter-defibrillator (ICD): A sophisticated electronic device used primarily to treat ventricular tachycardia and ventricular fibrillation — two life-threatening abnormal heart rhythms. The ICD constantly monitors the heart rhythm. When it detects a very fast, abnormal heart rhythm, it delivers energy to the heart muscle to cause the heart to beat in a normal rhythm again.

There are several ways an ICD can restore a normal heart rhythm:

• Antitachycardia pacing (ATP): When the heart beats too fast, a series of small electrical impulses are delivered to the heart muscle to restore a normal heart rate and rhythm.
• Cardioversion: A low-energy shock is delivered at the same time as the heartbeat to restore a normal heart rhythm.
• Defibrillation: When the heart is beating dangerously fast or irregularly, a higher energy shock is delivered to the heart muscle to restore a normal rhythm.
• Antibrachycardia pacing: Many ICDs provide back-up pacing to prevent heart rhythms that are too slow.

Heart surgery

Surgery may be needed to correct arrhythmias that can’t be controlled with medications or nonsurgical treatment methods. Arrhythmia surgery may also be recommended if you need surgery, such as valve surgery or bypass surgery, to correct other forms of heart disease. The Maze and modified Maze procedures are two surgeries used to correct atrial fibrillation.Your doctor will determine the best treatment for you and discuss these options with you, including more information about surgical treatment if it is an appropriate treatment option.

Resources

Doctors vary in quality due to differences in training and experience; hospitals differ in the number of services available. The more complex your medical problem, the greater these differences in quality become and the more they matter.

Clearly, the doctor and hospital that you choose for complex, specialized medical care will have a direct impact on how well you do. To help you make this choice, please review our Miller Family Heart, Vascular & Thoracic Institute Outcomes.

Cleveland Clinic Heart, Vascular & Thoracic Institute Cardiologists and Surgeons

Choosing a doctor to treat your abnormal heart rhythm depends on where you are in your diagnosis and treatment. The following Heart, Vascular & Thoracic Institute Sections and Departments treat patients with Arrhythmias:

• Section of Electrophysiology and Pacing: cardiology evaluation for medical management or electrophysiology procedures or devices – Call Cardiology Appointments at toll-free 800.223.2273, extension 4-6697 or request an appointment online.
• Department of Thoracic and Cardiovascular Surgery: surgery evaluation for surgical treatment for atrial fibrillation, epicardial lead placement, and in some cases if necessary, lead and device implantation and removal. For more information, please contact us.
• You may also use our MyConsult second opinion consultation using the Internet.

The Heart, Vascular & Thoracic Institute has specialized centers to treat certain populations of patients:

Learn more about experts who specialize in the diagnosis and treatment of arrhythmias.

For younger patients with abnormal heart rhythms:

See About Us to learn more about the Sydell and Arnold Miller Family Heart, Vascular & Thoracic Institute.

Contact

If you need more information, click here to contact us, chat online with a nurse or call the Miller Family Heart, Vascular & Thoracic Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.

Becoming a Patient

Treatment Options

Treatment Guides

Diagnostic Tests

Diagnostic tests are used to diagnose your abnormal heartbeat and the most effective treatment method.

Related Health Information

Anatomy

Webchats

Our webchats and video chats give patients and visitors another opportunity to ask questions and interact with our physicians.

Videos and Podcasts

Interactive Tools

Resource Links

Surgical Outcomes

Why choose Cleveland Clinic for your care?

Our outcomes speak for themselves. Please review our facts and figures and if you have any questions don’t hesitate to ask.

Women & Abnormal Heart Beats

Overview

Electrical System of the Heart

The Normal Heart Rate

The heart’s rhythm is coordinated by its own electrical system. With each heartbeat, the electrical impulse begins at the sinus (or sinoatrial, SA) node, also called the heart’s natural pacemaker. The SA node is a cluster of specialized cells, located in the right atrium. The SA node produces the electrical impulses that set the rate and rhythm of your heartbeat. The impulse spreads through the walls of the right and left atria, causing them to contract, forcing blood into the ventricles.

The Heart’s Electrical System

The impulse then reaches the atrioventricular (AV) node, which acts as an electrical bridge allowing impulses to travel from the atria to the ventricles. There is a short delay before the impulse travels on to the ventricles. From the AV node, the impulse travels through a pathway of fibers called the HIS-Purkinje network. This network sends the impulse into the ventricles and causes them to contract. The contraction forces blood out of the heart to the lungs and body.

The SA node fires another impulse and the cycle begins again.

The heartbeat is triggered by electrical impulses that travel down a special pathway through your heart muscle.

Heart Rate and Rhythm Differences Between Men and Women

Women and men are similar when it comes to the basic heart rate and rhythm. However, while the basic electrical system is the same (impulses originating in the SA node, traveling to the AV node, through the HIS-Purkinje, and then starting over), there are differences:

• Women tend to have a faster baseline heart rate
• Women’s ECG readings may be different

Women Have a Faster Baseline Heart Rate Than Men

First of all, on average, women tend to have a faster baseline heart rate than men. This difference is seen in girls, on an average, as young as five years old. There is also a shorter sinus node refractory time – this means that it takes a shorter time for the SA node to recover and become ready to fire an impulse again ¹

Women’s ECG Readings may be Different

The ECG (also called EKG or electrocardiogram) is a test used to record on graph paper the electrical activity of the heart. The picture, drawn by a computer from information supplied by electrodes placed on the skin of the chest, arms and legs, shows the timing of the different phases of the heart rhythm.

The p wave represents the electrical activity of the upper chambers of the heart (atria). There is a short pause followed by the QRS complex – the electrical activity of the lower chambers (ventricles) – and ends with a small T wave, the recovery phase of the ventricles. The QT interval is the distance from the beginning of the QRS to the end of the T wave and represents the time it takes for the heart muscle to contract and then recover, or for the electrical impulse to fire and then recharge.

On average, the QT interval is shorter in men than in women, beginning after puberty with a linear increase through the major part of adulthood to at least age 55. This period corresponds to the time period when androgen levels are highest in men. Therefore, androgen and estrogen levels may explain the gender differences in QT interval².

1. Taneja T, Mahnert BW, Passman R, Goldberger J, Kadish A. Effects of sex and age on electrocardiographic and cardiac electrophysiological properties in adults. Pacing Clin Electrophysiol. 2001 Jan;24(1):16-21.
2. Rautaharju PM, Zhou SH, Wong S, Calhoun HP, Berenson GS, Prineas R, Davignon A. Sex differences in the evolution of the electrocardiographic QT interval with age. Can J Cardiol. 1992 Sep;8(7):690-5.

Certain types of arrhythmias are more prevalent in women than in men.

These include:

• Supraventricular Tachycardia (SVT) or Paroxysmal SVT (PSVT) – a rapid heart rate that originates above the AV node, in the atria. SVT is common in both men and women, but more women have AV node reentrant tachycardia and atrial tachycardia¹.
• Sinus Node Dysfunction (also called sick sinus syndrome) – a slow or irregular heart rhythm that originates in the SA node. The signal starts in the SA node but may be slow or delayed in progressing to the atria, causing a very slow or irregular heart beat.
• AV Nodal Re-entry Tachycardia (AVNRT) – a type of SVT with a fast heart rate that originates in the AV node. Instead of the AV node sending the impulse down one pathway, there are two pathways through the AV node. The impulses travel through one pathway as well as back up through the second pathway. This allows the impulses to travel around the AV node very quickly in a circular fashion, causing the heart to beat unusually fast.
• Long QT Syndrome – a QT interval longer than normal. This increases the risk for life-threatening forms of ventricular tachycardia.
• Postural Orthostatic Tachycardia Syndrome (POTS) – a condition that affects 500,000 Americans, primarily women. Those with POTS have an abnormal response to change in position, related to the autonomic nervous system, causing drop in blood pressure, raise in heart rate and sometimes syncope (passing out), dizziness or lightheadedness².

These arrhythmias occur more often in men, but may present differently in women:

• Atrial Fibrillation – one of the most common irregular heart rhythms. It is a rapid irregular heart rhythm originating in the atria. Men have atrial fibrillation more often than women. Atrial fibrillation can be associated with other types of heart disease. Women are more likely to have atrial fibrillation associated with valve disease, while men more often have atrial fibrillation associated with coronary artery disease. The incidence of atrial fibrillation increases in both men and women with age, and when they also have hypertension and diabetes. The Copenhagen Heart Study showed that women with atrial fibrillation had an increased risk for stroke and cardiovascular death as compared to men. This is particularly true in women who have atrial fibrillation and are older than age 75 ³ ⁴. Women who have paroxysmal atrial fibrillation, a type of atrial fibrillation that is intermittent (or comes and goes), may have a faster heart rate response than men, and tend to have longer episodes ⁵.
• Sudden Cardiac Death is a sudden, unexpected death caused by loss of heart function (sudden cardiac arrest). Sudden cardiac death (SCD) occurs less frequently in women, but is still related to about 400,000 deaths per year in women. The Nurses’ Health Study showed that while the majority of women who had SCD had no prior history of cardiovascular disease before death, they had at least one cardiac risk factor (smoking, hypertension and diabetes had the greatest impact). Family history also played a role in increased risk if one parent died of heart disease before age 60. The study also showed that as with men, the majority of SCD in women was related to an abnormality of the heart rhythm (88%) 5-7. This reinforces the need for careful screening of heart disease risk factors in women and managing these concerns even without symptoms present.

1. Michael J. Porter, MD, Joseph B. Morton, MBBS, Russell Denman, MBBS, Albert C. Lin, MD, Sean Tierney, MD, Peter A. Santucci, MD, John J. Cai, MD, Nathaniel Madsen, MD, David J. Wilber, MD. Influence of age and gender on the mechanism of supraventricular tachycardia. Heart Rhythm 1:4. October, 2004, pp: 393-396.
2. National Dysautonomia Research Foundation, www.ndrf.org/orthostat.htm.
3. Kael WB, Wolf PA, Benjamin EJ, Levy D Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol. 1998 Oct 16;82(8A):2N-9N.
4. Friberg J. Comparison of the impact of atrial fibrillation on the risk of stroke and cardiovascular death in women versus men (The Copenhagen City
5. Hnatkova K, Waktare JE, Murgatroyd FD, Guo X, Camm AJ, Malik M. Age and gender influences on rate and duration of paroxysmal atrial fibrillation. Pacing Clin Electrophysiol. 1998 Nov;21(11 Pt 2):2455-8.
6. American Heart Association Heart Disease and Stroke Statistics 2012 Update.
7. Christine M. Albert, Claudia U. Chae, Francine Grodstein, Lynda M. Rose, Kathryn M. Rexrode, Jeremy N. Ruskin, Meir J. Stampfer, and JoAnn E. Manson. Prospective Study of Sudden Cardiac Death Among Women in the United States. Circulation, Apr 2003; 107: 2096 – 2101.

Symptoms and Causes

Symptoms of Irregular Heart Rhythms

An arrhythmia may be “silent” and not cause any symptoms. A doctor can detect an irregular heartbeat during an examination by taking your pulse, listening to your heart or performing diagnostic tests.

If symptoms occur, they may include:

• Palpitations – a feeling of skipped heart beats, fluttering, “flip-flops” or feeling that the heart is “running away”
• Pounding in the chest
• Dizziness or feeling light-headed
• Shortness of breath
• Chest discomfort
• Weakness or fatigue (feeling very tired)

Symptoms of palpitations represent 15-25 percent of all the symptoms reported by female heart patients. They are associated with:

• Premenstrual syndrome
• Pregnancy
• Perimenopausal period

When palpitations are present, the doctor begins his or her evaluation by looking for underlying heart disease. The importance of palpitations and the need for treatment is determined by the presence of underlying heart disease, the type of irregular heart beats that are occurring and other symptoms that are present.

Hormones and Irregular Heart Beats

Estrogen and progesterone levels rise and fall in women with a normal menstrual cycle during the days of the month. The rise of progesterone and the fall of estrogen correspond with:

• More frequent episodes of supraventricular tachycardia (SVT)
• More symptoms associated with SVT
• SVT of longer duration¹

During perimenopause (the time period before menopause), there is a marked decrease in ovarian estrogen production. This is associated with an increase in heart rate (sinus tachycardia) and an increased frequency in palpitations and non-threatening arrhythmias, such as premature ventricular contractions or PVCs.

Menopause causes a further decline in estrogen as the menstrual cycle stops. This time period is associated with irregular heart beats, palpitations, spasmodic chest pain and nightmares in women 40 -64 years old².

The Heart and Estrogen/Progestin Replacement Study (HERS) found no benefit in the use of hormone replacement therapy to reduce cardiovascular events, and hormone replacement therapy may even increase the risk of thromboembolism (blood clot) during the first year³. HRT is also associated with lengthening the QT interval [link to the explanation above], although the relevance of this finding is not known⁴. On the other hand, HRT may decrease palpitations and other symptoms such as hot flashes, insomnia, and sweating. Therefore, it may be considered a treatment option in low risk female patients to relieve symptoms of palpitations.

1. Rosano GM, Leonardo F, Sarrel PM, Beale CM, De Luca F, Collins P. Cyclical variation in paroxysmal supraventricular tachycardia in women. Lancet. 1996 Mar 23;347(9004):786-8.
2. Asplund R, Aberg HE Nightmares, cardiac symptoms and the menopause. *Climacteric*. 2003 Dec;6(4):314-20.
3. Grady D, Herrington D, Bittner V, Blumenthal R, Davidson M, Hlatky M, Hsia J, Hulley S, Herd A, Khan S, Newby LK, Waters D, Vittinghoff E, Wenger N; HERS Research Group. Cardiovascular disease outcomes during 6.8 years of hormone therapy: Heart and Estrogen/progestin Replacement Study follow-up (HERS II). *JAMA*. 2002;288:49-57.
4. Gokce M, Karahan B, Yilmaz R, Orem C, Erdol C, Ozdemir S. Long term effects of hormone replacement therapy on heart rate variability, QT interval, QT dispersion and frequencies of arrhythmia. *Int J Cardiol*. 2005 Mar 30;99(3):373-9.

Arrhythmias & Pregnancy

Premature atrial beats occur in about 50 percent of women during pregnancy, although most are harmless and do not last¹. While sustained arrhythmia is somewhat rare, for those who have supraventricular tachycardia or paroxysmal SVT, the symptoms are worsened in 20 percent of cases¹. Symptoms of SVT may include shortness of breath, palpitations, and dizziness². Arrhythmias may occur more frequently during pregnancy due to changes in hormones, changes in associated hemodynamic, hormonal and autonomic changes and changes in circulating blood volume, sleep, and emotion during pregnancy.

Women who have had congenital heart defects repaired have an increased risk of arrhythmias during pregnancy. In 27 women who had repaired congenital heart defects and 29 pregnancies, SVT occurred in 15, ventricular tachycardia in nine, high </ grade heart block in four and sick sinus syndrome in three women³.

Arrhythmias in pregnancy are treated conservatively. After determining the type of arrhythmia, the physician will evaluate for underlying causes. If symptoms are minimal, rest and vagal maneuvers may be used to help slow the heart rate. Vagal maneuvers include carotid massage applying ice to the face, and the Valsalva maneuver, which is the most successful in stopping tachycardias⁴. The Valsalva maneuver involves a person exhaling forcibly with a closed glottis (the windpipe) so that no air exits through the mouth or nose as, for example, in strenuous coughing, straining during a bowel movement or lifting a heavy weight.

When the arrhythmia causes symptoms or a drop in blood pressure, antiarrhythmic medications may be used. No anti-arrhythmic medication is completely safe during pregnancy; therefore medications are avoided during the first trimester if possible to limit risk to the fetus. Drugs with the longest safety record should be tried first. Propranolol, metoprolol, digoxin, and adenosine have been tested and shown to be well tolerated and safe during the second and third trimester⁵.

Cardioversion is safe during all trimesters of pregnancy and can be used if necessary¹. In addition, women who have an ICD who become pregnant do not have an increased risk for ICD discharges or ICD complications. A woman who has an ICD can safely become pregnant unless she has an underlying heart condition that would increase health risks during pregnancy⁶.

1. Blomstrom-Lundqvist C, Scheinman MM, et. al. ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias – executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Supraventricular Arrhythmias). Circulation. 2003 Oct 14;108(15):1871-909.
2. K. Robins\ and G. Lyons. Supraventricular tachycardia in pregnancy. _British Journal of Anaesthesia*, 2004, Vol. 92, No. 1 140-143._
3. Tateno S, Niwa K, Nakazawa M, Akagi T, Shinohara T, Usda T; A Study Group for Arrhythmia Late after Surgery for Congenital Heart Disease (ALTAS-CHD). Circ J. 2003 Dec;67(12):992-7.
4. Zu-Chi Wen, MD; Shih-Ann Chen, MD; Ching-Tai Tai, MD; Chern-En Chiang, MD; Chuen-Wang Chiou, MD; Mau-Song Chang, MD. Electrophysiological Mechanisms and Determinants of Vagal Maneuvers for Termination of Paroxysmal Supraventricular Tachycardia Circulation. 1998;98:2716-2723.
5. Ferrero S, Colombo BM, Ragni N Maternal arrhythmias during pregnancy. Arch Gynecol Obstet. 2004 May;269(4):244-53.
6. Natale A, Davidson T, Geiger MJ, Newby K. Implantable cardioverter-defibrillators and pregnancy: a safe combination? Circulation. 1997 Nov 4;96(9):2808-12.

Diagnosis and Tests

How are arrhythmias diagnosed?

If you have symptoms of an arrhythmia, you should make an appointment with a cardiologist. You may want to choose an electrophysiologist, a cardiologist who has received additional specialized training in the diagnosis and treatment of heart rhythm disorders.

After evaluating your medical history and discussing your symptoms, a physical exam will be performed. The cardiologist also may perform a variety of diagnostic tests to help confirm the presence of an arrhythmia and determine its causes.

Some tests that may be done to confirm the presence of an irregular heart rhythm include:

Management and Treatment

Management of Irregular Heart Rhythms in Women

Treatment options include:

Medications – antiarrhythmic drugs are medications used to convert the arrhythmia to normal sinus rhythm or to prevent arrhythmia. Other medications may include heart-rate control drugs; anticoagulant or antiplatelet drugs such as warfarin (a “blood thinner”) or aspirin, which reduce the risk of blood clots or stroke.

Concerns for women: Because women have a longer QT interval than men. some medications that are used in men to treat irregular heart rhythms prolong the QT interval even more. These medications include Quinidine, Sotalol, Dofetilide, and Amiodarone. These medications may increase a woman’s risk of developing a life-threatening arrhythmia (torsades de pointes) more than in men who take these medications. Women who take these medications should follow their’ doctor’s and dietitian’s dietary guidelines for potassium and avoid becoming low in potassium, which enhances the arrhythmia affect¹.

The biggest concern for all patients with atrial fibrillation is preventing blood clots or stroke. Warfarin (also called Coumadin) is most often used to prevent strokes in patients. According to The Canadian Registry of Atrial Fibrillation (CARAF), women were half as likely to be prescribed warfarin as compared to men, although they would benefit from it as much².

Lifestyle changes– arrhythmias may be related to certain lifestyle factors. Here are some ways to change these factors:

• If you smoke, stop. Learn More
• Limit your intake of alcohol. Learn More
• Limit or stop using caffeine. Some people are sensitive to caffeine and may notice more symptoms when using caffeinated products (such as tea, coffee, colas, chocolate and some over-the-counter medications).
• Avoid certain stimulants. Beware of stimulants used in cough and cold medications and herbal or nutritional supplements. Some of these substances contain ingredients that cause irregular heart rhythms. Read the label and ask your doctor or pharmacist what medication would be best for you.

Invasive Therapies – the following invasive therapies may be used to treat or eliminate irregular heart rhythms. Your doctor will discuss the benefits and risks of these therapies and whether they are appropriate treatments for your condition.

• Electrical cardioversion – in patients with persistent arrhythmias (such as atrial fibrillation), a normal rhythm may not be achieved with drug therapy alone. After administering a short-acting anesthesia, an electrical shock is delivered to your chest wall that synchronizes the heart and allows the normal rhythm to restart.
• Catheter ablation – during ablation, energy is delivered through a catheter to tiny areas of the heart muscle. This energy can either “disconnect” the pathway of the abnormal rhythm; block the abnormal pulses and promote normal conduction of impulses; or disconnect the electrical pathway between the atria and the ventricles.
• Pulmonary vein antrum isolation (PVI) – This procedure is used to treat atrial fibrillation. During PVI, special catheters are inserted into the heart (catheters are inserted into the right atrium and into the left atrium). Intracardiac echocardiography is used to visualize the left atrium during the procedure. One catheter in the left atrium is used to map or locate the abnormal impulses coming from the pulmonary veins. The other catheter is used to deliver the radiofrequency energy to ablate or create lesions outside the pulmonary veins. The procedure is repeated for all four pulmonary veins. The lesions form a circumferential scar around the pulmonary veins. The scar blocks any impulses firing from within the pulmonary veins, thereby “disconnecting” the pathway of the abnormal rhythm and potentially curing atrial fibrillation.

Electrical devices – a small device may be implanted under the skin that can detect an irregular heart rhythm and/or treat it. Your doctor will discuss the benefits and risks of implantable devices and whether they are an appropriate treatment for your condition.

• Permanent pacemaker – a device that sends small electrical impulses to the heart muscle to maintain a normal heart rate. The pacemaker has a pulse generator (which houses a battery and a tiny computer) and leads (wires) that send impulses from the pulse generator to the heart muscle, as well as sense the heart’s electrical activity. Pacemakers are mostly used to prevent the heart from beating too slowly. Newer pacemakers have many sophisticated features that are designed to help with the management of arrhythmias, optimize heart-rate-related functions and improve synchronization.
• Implantable cardioverter-defibrillator (ICD) – a sophisticated electronic device used primarily to treat ventricular tachycardia and ventricular fibrillation, two life-threatening abnormal heart rhythms. The ICD constantly monitors the heart rhythm. When it detects a very fast, abnormal heart rhythm, it delivers energy to the heart muscle to cause the heart to beat in a normal rhythm again.

Heart surgery – The Maze, modified Maze, and minimally invasive ablation surgeries are used to correct atrial fibrillation that is not controlled with medications or non-surgical treatment methods. Arrhythmia surgery also may be recommended if you need surgery to correct other forms of heart disease (such as valve disease or coronary artery disease).

Treatment also includes regular follow-up with a physician. While women have specific concerns related to irregular heart rhythms, communication with your physician will ensure safe and effective treatment.

1. Wolbrette D. Differences in the Proarrhythmic Potential of QT-prolonging Drugs. Current Women’s Health Reports 2002, 2:105-109.
2. Karin H. Humphries, Charles R. Kerr, Stuart J. Connolly, George Klein, John A. Boone, Martin Green, Robert Sheldon, Mario Talajic, Paul Dorian, and David Newman. New-Onset Atrial Fibrillation : Sex Differences in Presentation, Treatment, and Outcome. Circulation 2001 103: 2365 – 2370.
3. Bailey MS, Curtis AB. The Effects of Hormones on Arrhythmias in Women. Current Women’s Health Reports 2002, 2:83-88.
4. Blacks, Women Less Likely to Get Implantable Defibrillators, www.dukenews.duke.edu/2000/11/blackwomenheartn17.html.

Resources

Doctors vary in quality due to differences in training and experience; hospitals differ in the number of services available. The more complex your medical problem, the greater these differences in quality become and the more they matter.

Clearly, the doctor and hospital that you choose for complex, specialized medical care will have a direct impact on how well you do. To help you make this choice, please review our Miller Family Heart, Vascular & Thoracic Institute Outcomes.

Cleveland Clinic Heart, Vascular & Thoracic Institute Cardiologists and Surgeons

Choosing a doctor to treat your abnormal heart rhythm depends on where you are in your diagnosis and treatment. The following Heart, Vascular & Thoracic Institute Sections and Departments treat patients with Arrhythmias:

The Heart, Vascular & Thoracic Institute has specialized centers to treat certain populations of patients:

Learn more about experts who specialize in the diagnosis and treatment of arrhythmias

For younger patients with abnormal heart rhythms:

See About Us to learn more about the Sydell and Arnold Miller Family Heart, Vascular & Thoracic Institute.

Contact

If you need more information, click here to contact us, chat online with a nurse or call the Miller Family Heart, Vascular & Thoracic Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.

Becoming a Patient

Treatment Options

Treatment Guides

Diagnostic Tests

Diagnostic tests are used to diagnose your abnormal heartbeat and the most effective treatment method.

Anatomy

Webchats

Our webchats and video chats give patients and visitors another opportunity to ask questions and interact with our physicians.

Videos

Interactive Tools

Resource Links

References

Why choose Cleveland Clinic for your care?

Our outcomes speak for themselves. Please review our facts and figures and if you have any questions don’t hesitate to ask.

90,000 Why irregular heartbeat is good

Depending on external or internal stimuli, the heart rate will change
Photo: pixabay.com

Scientists have disproved the heart rate myth and recommended optimal breathing techniques.

Many people worry about their heart beating at an irregular rhythm, but a recent study has shown that this is a mistake. The portal “MedicForum” writes about it.

A team of Austrian scientists led by Andreas Schwerdtgefer investigated how various processes in the body affect the heartbeat. They came to the conclusion that a healthy heart does not beat regularly, but has a certain variability of rhythm.This rhythm is influenced by many factors: breathing, stress, brain function, and so on. This is why heart rate variability (HRV) is an indicator that your body is flexible and able to adapt to different conditions.

Scientists have also found that a too fast heartbeat may indicate an insufficient supply of blood to the brain, especially in people with depression and other mental disorders.

Based on their observations, the team developed an optimal breathing technique that helps to lower the heart rate and maximize oxygenation of the brain, which means it will improve memory and concentration.To do this, you need to take exactly six breaths per minute: ten seconds per breath.

As Kubanskie Novosti reported, scientists have created an environmentally friendly detergent from agricultural waste.

90,000 Arrhythmia. How to detect and prevent disease

Recommendations of the Head of the Department of Surgical Treatment of Complex Cardiac Arrhythmias and Electrocardiostimulation Research Institute-KKB No. 1, Ph.m. n. Maxim Kandinsky

Arrhythmia is a violation of the rhythm of the heart. It occurs due to any disease or malfunction of the body. Arrhythmia can also occur in healthy people as a result of colds, overwork, as well as excessive drinking, smoking or drug use.

Types and symptoms of the disease:

Bradycardia is a decrease in the heart rate of less than 60 beats per minute at rest.

Symptoms:

• general weakness and fatigue,

• dizziness,

• dyspnea,

• darkening in the eyes.

• sometimes – a light-headed state, as well as a feeling of a “rush of heat to the head” and short bouts of loss of consciousness.

Tachycardia is an increase in heart rate up to 100 beats per minute at rest.

Symptoms:

• shortness of breath (a sign of life-threatening arrhythmia),

• feeling of a rapid heartbeat,

• fast fatiguability,

• general weakness.

Irregular heartbeat

Symptoms:

• palpable accelerated heartbeat, which alternates with barely audible beats of the heart, and the nature of the beat rhythm can be called chaotic.

In order to avoid heart problems, pay attention to the indicated symptoms in time and be examined by a therapist and cardiologist.

What is the danger of arrhythmia?

1. Heart failure.Due to a rare or very frequent rhythm, a malfunction in the circulatory system can occur, as a result of which blood will not flow to the heart.

2. Heart attack. If a person already has heart diseases, then arrhythmia can aggravate their course and lead to the death of part of the heart muscle.

3. Stroke. Violation of the rhythm of the heartbeat can lead to the formation of blood clots, which tend to break off and enter the brain.Active preventive actions in this direction can save a person.

Diagnostics and treatment

The initial diagnosis of arrhythmia is carried out by a therapist or cardiologist. Then comes the turn of instrumental research methods, which include:

• Electrocardiography (ECG)

• Echocardiography, additionally echocardiography is performed with stress

• Holter ECG 24-hour monitoring

• Transoesophageal pacing (CPES)

• Passive orthostatic test

The choice of a method for treating arrhythmias depends on the causes of the disease, the type of rhythm disturbance, the general condition of the patient, etc.e. In some cases, medical supervision is sufficient. In others, medical or surgical treatment may be required.

How can arrhythmia be prevented?

Moderation in life is the basis of the foundations! Treat your health with respect! Any excesses overload our body, they are extremely harmful to it. Start with your bad habits: get rid of them!

Learn to develop and maintain a positive attitude.Control your emotional state.

Regular exercise is extremely beneficial for the prevention of heart disease. Walk in the fresh air every day: walk at least five kilometers. Go swimming and avoid many health problems!

Review your diet:

• Avoid or limit your intake of fatty, fried, very salty and spicy foods.

• Include as many herbal ingredients as possible on the menu.

• Eat potatoes, bananas, currants, and sunflower seeds. They contain potassium, one of the most important components that affect the rhythmic contraction of the heart.

• Include buckwheat porridge, legumes, nuts in the diet. These foods contain magnesium, calcium and zinc. An additional course of vitamins with magnesium and calcium will not harm (consult with your doctor first).

• As for calcium, these are, first of all, dairy products – kefir, cottage cheese, milk, sour cream.

• Beets and corn are another essential part of a healthy diet for normalizing your heart rate.

• Eat 3-4 hours before bedtime.

• Do not overuse alcohol and coffee.

Remember: healthy sleep is one of your most important vital needs! It is essential for health, wellness and performance.

Cardiac arrhythmias: how to recognize and treat?

The human heart has a conductive system that transmits
electrical impulses throughout the organ, causing it to contract in
a certain rhythm. Electrical signals originate in a group of cells in the right
an atrium called a sinus node.Normally, the heart is at rest during
minutes makes from 60 to 100 contractions, which are uniform and rhythmic
character.

Arrhythmia – violation
rhythm of the heart, which occurs when electrical impulses initiating
heartbeat, not functioning properly, causing the heart to beat
too fast, or too slow, or irregularly, irregularly.

The most common causes of arrhythmia are
cardiovascular disease, high blood pressure, sugar
diabetes, smoking, excessive alcohol and caffeine consumption, abuse
drugs, stress.

Atrial fibrillation

The most common form of arrhythmia is atrial fibrillation . Atrial fibrillation
about 1% of the world’s population is affected. In Russia it is about one and a half million
human. This disease is characterized by an irregular contraction
atria, which are chaotically transmitted to the ventricles of the heart and cause
the following symptoms:

• Feeling of rapid irregular heartbeat;
• shortness of breath;
• general weakness and increased fatigue;
• poor tolerance to physical activity;
• chest pain and discomfort in the area
  hearts.

Also, atrial fibrillation may be asymptomatic.

Types of treatment
diseases

Radiofrequency ablation – minimally invasive
surgical treatment of atrial fibrillation. The procedure begins with building
electrical model of the left atrium and determination of the localization of the pulmonary veins,
which are the main source of atrial fibrillation. During the intervention
a catheter is inserted through the patient’s femoral vein into the left atrial cavity.Then
perform electrical isolation of the pulmonary veins using a catheter
radio frequency damage. The procedure is performed under local anesthesia and
takes about two hours.

Drug therapy – appointment of special
drugs for arresting arrhythmia attacks and preventing their occurrence.

In some cases, atrial fibrillation can cause
permanent, when the doctor decides not to restore the rhythm in
due to certain reasons.In this situation, therapy is selected to control
heart rate.

Bradyarrhythmia

Bradyarrhythmia – heart rhythm disturbance characterized by the frequency
contractions less than 60 per minute. The main cause of bradyarrhythmia
is inflammatory or degenerative damage to the sinus node (syndrome
weakness of the sinus node). Sick sinus syndrome mainly
elderly patients (over 60-70 years old) suffer, this is due to myocardial damage
in the aging process.Severe bradycardia affects blood supply
the brain and other human organs.

Symptoms of bradyarrhythmia:

• feeling of slowing down of the heart;
• dizziness;
• loss of consciousness;
• weakness and decreased physical activity;
• pulse less than 30-40 beats per minute.

Treatment of bradyarrhythmia

Patient suffering from bradyarrhythmia is indicated for implantation of a pacemaker
– an artificial pacemaker.In case of violations of the functioning of the heart, the device
sends an electrical discharge that stimulates the contraction of the heart muscle. Implantation
The pacemaker is performed in the left subclavian region. Carry out
electrodes through a puncture in the subclavian vein to the chambers of the heart and fix to
surrounding tissues. Pacemaker replacement is required every 7-8 years due to
discharging the battery.

Ventricular fibrillation

Fibrillation
ventricles – a life-threatening form of heart rhythm disturbance,
characterized by uncoordinated, arrhythmic, scattered contractions
in certain groups of muscle fibers of the heart ventricles.The frequency of such
ventricular contractions reaches 300 per minute and leads to circulatory failure and
even cardiac arrest – sudden cardiac death. Most often occurs in
people who have had a heart attack or myocardial infarction.

Fibrillation symptoms
ventricles:

• loss of consciousness;
• chest pain;
• strong heartbeat;
• seizure;
• involuntary urination;
• characteristic picture of clinical death.

Treatment of fibrillation
ventricles

In case of an attack of ventricular fibrillation, it is necessary to
immediately start cardiopulmonary resuscitation. The most important part of resuscitation
measures – ventricular defibrillation, which is carried out using special
devices – electrical defibrillators. Prevent deadly
the condition may be implantation of a cardioverter-defibrillator. When an attack occurs
ventricular fibrillation, the device recognizes the situation and delivers a defibrillation shock,
allowing to restore normal heartbeats.

At the Meshalkin Center, a patient can be diagnosed
heart rhythm disturbances using high-end equipment and get
professional advice from a specialist cardiologist-arrhythmologist. The center has
a full range of competencies in the treatment of patients with cardiac arrhythmias:
highly professional staff of specialists, modern equipment,
practical and scientific base that meet European standards that
provides the maximum result of diagnostic and surgical procedures.

symptoms and treatment. Causes, signs, diagnostics, prevention

Cardiac arrhythmia occurs when the electrical impulses that cause the heart to beat occur at an irregular rhythm, causing an irregular, fast, or slow heartbeat. Sometimes it is not dangerous to health, but in some cases it causes unpleasant symptoms or begins to threaten a person’s life. The specialists of the clinic on Barclay will make the correct diagnosis in case of cardiac arrhythmias and prescribe modern therapy.

Arrhythmia – causes and symptoms of the disease

Cardiac arrhythmia can occur for various reasons, in particular:

• an attack of angina pectoris or myocardial infarction;
• postinfarction cardiosclerosis;
• cardiomyopathy and myocardial dystrophy;
• hypertension.

Often, the causes of arrhythmias lie in high or low levels of thyroid hormones. The risk of developing pathology is increased by smoking, drinking large amounts of alcohol or caffeine, stress, taking medications for colds and allergies, obstructive sleep apnea syndrome, diabetes.

There is also a physiological respiratory arrhythmia – an irregular heartbeat depending on the phases of breathing. It is most pronounced in children and young adults and is not a disease. Respiratory or sinus arrhythmias do not require treatment.

Abnormal heart rhythm may not be accompanied by any symptoms. In these cases, the signs of arrhythmia are determined by the doctor during the examination.

Possible arrhythmia symptoms:

• unpleasant sensations of overturning, heart sinking;
• too fast or slow heart rate;
• chest pain;

90,035 shortness of breath;

• dizziness and fainting;
• excessive sweating.

Main types of arrhythmia

The classification of arrhythmias is based on the site of its occurrence, the rate and regularity of the heart. The main types of rhythm disturbances:

• tachycardia – acceleration of the heartbeat more than 100 per minute;
• bradycardia – slowing it down to less than 60 per minute;
• extrasystole – single, paired or group premature contractions of the heart.

Tachycardia is normal with exertion.During sleep, there is a physiological slowdown in the heartbeat.

Atrial tachycardia includes atrial fibrillation (atrial fibrillation), atrial flutter, paroxysmal supraventricular tachycardia. In the ventricles, ventricular tachycardia, flutter and fibrillation of the ventricles are formed, which are life-threatening.

Persistent bradycardia is usually associated with sick sinus syndrome or grade II – III atrioventricular block.

All these forms of pathology have a different mechanism of occurrence.Their treatment requires supervision by a qualified cardiologist.

Complications and diagnosis of arrhythmia

Although not all arrhythmias are hazardous to health, some of them can cause complications:

With an irregular heartbeat, the risk of blood clots forming in the vessels, which usually enter the arteries of the brain and clog them, increases. To prevent this complication, antiplatelet agents and anticoagulants are prescribed.

• Heart failure

An irregular heartbeat leads to impaired blood circulation in the body.This is accompanied by shortness of breath, weakness, in severe cases, edema and enlargement of the liver occur.

• Cardiac arrest

An attack of arrhythmia can result in a violation of cardiac contractions and cardiac arrest. In this case, emergency medical assistance is needed.

The clinic on Barclay uses all the necessary methods for diagnosing rhythm disturbances:

• blood and hormonal tests;
• ECG;
• daily ECG monitoring;
• Ultrasound of the heart (echocardiography).

If necessary, the doctor recommends a more in-depth examination: monitoring of cardiac events, ECG tests with exercise, transesophageal electrophysiological examination.

Arrhythmia – treatment and predictions of recovery

Often, treatment of arrhythmias is required only when it is accompanied by unpleasant symptoms or threatens a person’s life.

In case of bradycardia, if it is not possible to find the non-cardiac cause of the slow heartbeat and to eliminate it, implantation of a pacemaker is necessary.

For palpitations, various treatments are used:

• during an attack of tachycardia, you can take a deep breath and hold your breath or lower your face into a basin of cold water, but such actions do not always help;
• it is often necessary to take antiarrhythmics and blood thinners;
• In some cases, cardioversion helps to relieve an attack – the use of special medications or an electric discharge.

In case of ineffectiveness of drug treatment, the doctor decides on a surgical intervention – radiofrequency ablation, Maze operation (or “labyrinth”), coronary artery bypass grafting, implantation of a pacemaker or cardioverter-defibrillator.

If arrhythmia is detected, home treatment is supplemented by the following measures:

• Healthy foods that are low in salt and dense fats, and high in fruits, vegetables, and whole grains;
• regular physical training for 30 minutes daily;

90,035 quitting smoking and drinking alcohol;

• weight normalization;
• control of cholesterol and blood pressure
• continuous intake of prescribed drugs.

Treatment of arrhythmia with folk remedies (herbal medicine) usually does not lead to a positive result. With this disease, you must entrust your health to professionals. The effectiveness of drug treatment reaches 75 – 80%, with surgical intervention, depending on its type, recovery occurs in 80 – 100% of cases.

Skilled Arrhythmia Treatment on Barclay

Benefits of treatment in our medical center:

• The clinic on Barclay, located in Moscow, offers medical services for the diagnosis of arrhythmias, identifying their causes, the selection of medicines, and monitoring the effectiveness of treatment.
• Careful attention to each patient increases the likelihood of a good therapy effect.
• The medical center is equipped with modern equipment that makes it possible to accurately determine the diagnosis.
• We offer affordable prices for services, convenience and comfort for the patient.

Make an appointment by phone at a convenient time for you.

Atrial fibrillation: treatment, symptoms

Atrial fibrillation is diagnosed in patients suffering from hypertension, as well as thyroid, kidney and lung diseases.

Treatment of atrial fibrillation

The method of treatment of atrial fibrillation is selected by the doctor for each patient individually and will largely depend on the form of the disease. Sometimes medication is enough for effective treatment. Correctly selected therapy gives good results. If drug treatment is ineffective, catheter treatment of arrhythmia (radiofrequency or cryoablation) is considered.

Symptoms of atrial fibrillation

Atrial fibrillation is accompanied by pain in the heart, shortness of breath, high blood pressure, weakness, and excessive sweating.

Unpleasant sensations can increase with physical exertion and prolonged activity. Atrial fibrillation is accompanied by a rapid heartbeat (tachycardia) or slow heartbeat (bradycardia).

In a mild form, atrial fibrillation does not have pronounced symptoms. A person may not be aware of the disease for many years.

All patients with attacks of irregular heart rhythm, sudden heart palpitations, syncope (fainting) conditions, suffered ischemic stroke (especially atherothrombotic type OM), with congenital and acquired heart defects are shown a diagnostic search for arrhythmia.

Methods for diagnosing atrial fibrillation

To accurately determine the nature and type of arrhythmia, the doctor assesses the general condition of the patient and prescribes additional examinations. To diagnose atrial fibrillation, an electrocardiogram (ECG), 24-hour monitoring, an ECG-holter for 24 or 48 hours, and echocardiography are used. Further, the diagnostic search consists in identifying the cause of atrial fibrillation.

With arrhythmias, the heart rate does not match the pulse rate, the pulse is chaotic, and abnormal noises are present.

After carrying out the diagnosis and obtaining the results of all studies, the specialist will determine the further tactics of treating atrial fibrillation.

Prevention of atrial fibrillation

For the prevention of diseases of the cardiovascular system, it is recommended to give up bad habits, monitor nutrition, lead an active lifestyle, and also undergo an annual medical examination to identify and treat chronic diseases.

In no case should you exhaust yourself with training, the load should be uniform.Outdoor walks, Nordic walking, skiing and just morning exercises (push-ups, squats, stretching, etc.) are perfect.

It is important to exclude fatty and very salty, smoked foods. Replace fatty meat with dietary (chicken, turkey, rabbit) and fish. Limit the use of easily digestible carbohydrates (baked goods, confectionery). Preference should be given to fresh vegetables and fruits, whole grain cereals. It is useful to include in the diet foods rich in trace elements necessary for the heart – potassium and magnesium.

If symptoms appear, you should consult a cardiologist and follow his recommendations. The specialists of the Scandinavian Health Center are ready to provide qualified assistance. If the diagnosis of atrial fibrillation is made on time, the treatment will be successful and effective.

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90,000 Tonometer for arrhythmia – how to identify and what to do?

One of the main human organs, our fiery motor, which provides all other organs of the body with oxygen and nutrients – the heart.The well-being of a person largely depends on the health of the heart, therefore it is very important to control the state of one’s own cardiovascular system.

There are many diseases of the cardiovascular system. In this article, we will consider such a violation of the work of the heart as arrhythmia.

What is arrhythmia?

Arrhythmia is a failure in the rhythm of the heart. The frequency of contractions in arrhythmias can be too fast, too slow, irregular.Any arrhythmia can be dangerous and indicate a number of possible diseases.

What diseases can arrhythmia indicate?

Frequent, palpable arrhythmias may indicate:

• diseases of the heart and blood vessels, including coronary heart disease and arterial hypertension;

90,035 disorders of the thyroid gland;

• diabetes mellitus;
• stress, depression and many others.

Arrhythmias can be accompanied by symptoms such as shortness of breath, dizziness and chest pain, and the patient clearly feels too fast or slow heartbeat, interruptions in the rhythm of the heartbeat. It is important to note that even arrhythmias that are hazardous to health may not appear and can only be detected during a medical examination. How not to miss an important moment and notice a dangerous condition in time?

How to recognize arrhythmia?

The most reliable way to detect arrhythmias and other heart problems is to see your doctor regularly.However, not everyone has the opportunity to spend time on regular visits to the clinic. In addition, if a person feels well, then he will not go to a doctor.

A simple and quick way to monitor important body parameters is a home blood pressure monitor.

Tonometer for arrhythmia

Modern OMRON blood pressure monitors not only measure blood pressure. In addition, all new OMRON blood pressure monitors have an arrhythmia indicator.

The irregular heartbeat function detects irregularities in the rhythm of the heart and displays a special icon on the tonometer display.

It should be recalled that arrhythmia is a phenomenon that occurs quite often and in most cases is not felt. Therefore, if the tonometer detected an arrhythmia and displayed an icon on the screen, then you need to repeat the measurement. But in the case when the arrhythmia icon lights up regularly, you should consult a doctor. Any arrhythmia is dangerous!

All OMRON blood pressure monitors with clinically proven Intellisense algorithm detect all types of cardiac arrhythmias, not only missing hypertension, but also providing early arrhythmia diagnosis.And the versatile fan-shaped cuff provides added precision and comfort.

A healthy heart is an important step towards a long, fulfilling life. Keep your heart readings under control with modern high-precision OMRON blood pressure monitors.

If the heart beats out of time. How to get rid of arrhythmia?

nina andreeva-ross

Health

03 June 2020

Arrhythmia, that is, a violation of the rhythm of the heart, suffers from every third inhabitant of the planet.Many do not consider this a disease at all and do not get any treatment – until they suddenly lose consciousness on the street, and this often happens with young people. Moreover, 25% of ischemic strokes are associated with arrhythmia. If the heart is not beating to the beat, how to restore its rhythm? The director of the National Medical Research Center for Surgery named after V.I. AV Vishnevsky, President of the Russian Society of Arrhythmologists, Academician of the Russian Academy of Sciences Amiran REVISHVILI.

Photo: Pixabay / Pexels

– Amiran Shotaevich, what are the causes of arrhythmia? Why does the heart, for the time being beating a clear rhythm, suddenly start to go astray from it?

– This may be due to many circumstances: heart disease, disorders in the autonomic nervous system, arterial hypertension, changes in hormonal status (in women in menopause, the risk increases), thyroid diseases, bad habits (smoking, alcohol), hypothermia and much more…

Including the same stresses. Their constant “presence” triggers inflammatory processes in the body that destroy the heart tissue and cause disturbances in the heart rhythm. Or burnout syndrome. That is, a feeling of dissatisfaction with life, combined with overwork and irritability – the heart rate can also suffer from it …

Therefore, I advise everyone to try to be optimists, to lead an active lifestyle, to walk at least 45 minutes in the fresh air every day.Do not smoke and be sure to monitor your blood pressure.

– People are mostly familiar with three types of arrhythmias: tachyarrhythmia (with a heart rate of up to 120 – 150 beats per minute), bradyarrhythmia (with a heart rate of less than 55 beats per minute) and atrial fibrillation. But cardiologists say that there are many more varieties and each type is treated in its own way.

– This is true! In addition to tachycardia and bradycardia, arrhythmias are divided into supraventricular and ventricular, depending on which part of the heart they originated in.According to another classification, arrhythmia is paroxysmal (paroxysmal) and constant (chronic).

There are also many arrhythmias in which the heart beats unevenly. The most common of them are extrasystolic (premature contraction of the whole heart or only the ventricles) and atrial (chaotic contraction of individual groups of muscle fibers, the pulse reaches 100-150 beats per minute).

Atrial fibrillation is one of those sudden cardiac arrhythmias in which an ambulance must be called immediately.However, she is already one of the most frequent reasons for her arrival.

– How dangerous is this or that arrhythmia?

– With the same atrial fibrillation, there is a high risk of blood clots, which can move through the vessels and clog them, creating a threat of heart attack or stroke. If rhythm disturbances are associated with a rare pulse, then there is a threat of short-term cardiac arrest, which cuts off blood circulation and leads to loss of consciousness.

But there are types of arrhythmias that are completely harmless, which do not lead to significant consequences.The insidiousness of this disease is that arrhythmia can be asymptomatic. Therefore, even with good health, an irregular rhythm caught by a home tonometer is a reason to consult a cardiologist.

It is worth consulting with him, even if no treatment is required later. For example, sometimes patients complain of cardiac interruptions, fading followed by a sharp jolt. This condition often occurs during physical exertion or from excitement, quite often at rest.With such extrasystole, it is useful to take a sedative.

And, for example, during magnetic storms it sometimes happens like this: arrhythmia occurs, and after a while it passes safely. But you need to know that at this time there was a slowdown in blood flow, which worsened the nutrition of vital organs, and even the blood became thicker. This means that you need to keep drugs against the formation of clots in the vessels on hand. But a doctor must prescribe them.

There are also some very simple tips to somehow calm the suddenly arising strong heartbeat.In case a person is simply very worried or frightened of something. Sit in a chair or lie on a bed, breathe slowly, deeply, measured – this will quickly normalize a rapid heart rate. And another thing: take a deep breath, pinch your nose, tighten your stomach strongly – the pulse will quickly return to normal.

You can adopt such a psychological technique. Feeling the approach of an attack, a person usually intuitively grabs the heart, as if trying to block the pain – he kind of calms the heart, gives it the command to beat slower.Give the same command to your heart: “Beat slower … Even slower …”.

– Atrial fibrillation, as you said, is one of the most common causes of strokes. Is it possible to somehow get rid of it?

– It is necessary to start getting rid of the elimination of the underlying disease, which led to arrhythmias (for example, high blood pressure). There is also medical treatment. If the doctor has already accurately diagnosed atrial fibrillation, then he will prescribe it.If therapy does not help, then it is worth considering surgery – it is called ablation.

Until recently, arrhythmias were treated by open surgery with the connection of a heart-lung machine. Although the focus of the disease is tiny, only a few millimeters, it is difficult to find it. We have developed a new method for finding this very focus – an original procedure for computer surface mapping.

Electrodes are placed on the patient’s body, they simultaneously remove electrocardiograms.Many – up to 240 cardiograms. Then the patient undergoes an MRI of the chest. After processing the tomography results, the doctor receives a 3D model of the heart, on which the source of the arrhythmia is indicated with maximum accuracy. Today our technology is used in many countries around the world.

Once the source of the arrhythmia is established, it is eliminated using a catheter procedure. Catheters are inserted through the femoral artery or vein, which, moving through the vessels, reach the heart and “cauterize” the arrhythmogenic zone.The treatment is carried out under X-ray control. Moreover, with the help of X-ray surgery, diagnosis and treatment are easier and faster. The procedure is performed under local anesthesia and takes no more than an hour and a half.

Today in Russia the technology of electrocardiographic mapping of the heart is used in many clinics. Tens of thousands of procedures are performed, but the need is one and a half times greater.

In the same way, another procedure has been worked out – the installation of a pacemaker.It is required for patients with bradycardia. More than 40 thousand operations are performed in the country annually, which is fifteen times more than they performed ten years ago, but three times less than necessary.

– What prevents all those in need from carrying out procedures? Are there not enough medical centers?

– There are not enough highly qualified specialists! Each patient has his own type of arrhythmia, so there cannot be one standard operation for everyone.

In general, an arrhythmologist is a rather rare specialty.This is a multidisciplinary doctor. He must be equally proficient in all methods of treatment (electrophysical diagnostics, catheter, thoracoscopic and surgical methods) in order to choose the method of treatment that best suits the patient. To work independently, he needs to study for at least ten years and complete at least a thousand procedures during this period.

BTW

Experts give such advice on the prevention of arrhythmias:

– for the heart to work without interruptions, include oranges, pears, raspberries, currants in your diet.In winter, let it be frozen berries, it’s still good. The diet should also contain red bell peppers, tomatoes, beets, parsley, apples, corn;

– a mixture of honey, walnuts, lemon, dried apricots and raisins is very useful. These foods contain a lot of potassium, magnesium, calcium, which are needed for the normal functioning of the heart;

– with arrhythmias and cardiovascular diseases, it is better to use tea with mint. Mint relieves irritability, soothes.In this case, you should keep the liquid in your mouth longer and drink it in small sips. You can also suck on mints before bed;

– the infusion of viburnum berries is also useful. It contains a large amount of vitamin K, which has a beneficial effect on the heart and blood vessels, and normalizes cardiac activity. Viburnum is also rich in vitamin C, which strengthens the immune system, and vitamin P, which is necessary for the body to assimilate ascorbic acid. That is why viburnum is indispensable for high blood pressure.The recipe is simple:

Pour 1 glass of fruit with 1 liter of hot water, put on a low heat and let it boil for about 10 minutes. Then strain and cool. Drink half a glass three times a day;

– what about coffee? Scientists have come to the following conclusion: if a strong coffee overdose can lead to arrhythmias, then a couple of cups of good grain coffee a day, as it turned out, somehow stabilize the heart rhythm. This mainly concerns atrial fibrillation.

The material was published in the newspaper “St. Petersburg Vedomosti” No. 094 (6692) from 03.06.2020 under the heading “If the heart beats out of time”.

Materials of the rubric

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