A healthy living blog from Marshfield Clinic Health System

Lost your beat? Get it back

animated heartbeat on EKG machineIf you’ve been feeling a bit out of rhythm lately, it could be due to an arrhythmia, or change in the rhythm of your heartbeat.

These changes in heartbeats can be too fast, called tachycardia;  too slow, called bradycardia; or fast and irregular, atrial fibrillation.

We’ve all experienced a skipped heart beat or the temporary sensation that our hearts are racing. These symptoms are usually not a cause for alarm.

Arrhythmias that occur more often or cause other symptoms – dizziness, loss of consciousness, chest pain or shortness of breath –  may be more serious and need to be discussed with your doctor. You may be referred to an electrophysiologist, a cardiologist with additional training and experience in heart rhythm disorders.

Arrhythmia treatment – begins with medicine

Dr. Sanjay Kumar is a Marshfield Clinic electrophysiologist and physician who sees patients ranging from youth to older adults. He offers a variety of treatment options that usually begin most therapies with prescription medications.

“When we don’t know the cause of arrhythmia, beta blocker like medications are the safest thing,” he said. If medications don’t work, the next step is usually to have the patient wear a recording device at home that keeps track of rhythm disturbances for 24 hours or so.

Procedures sometimes necessary, effective

If these tests reveal rhythmic problems, Dr. Kumar performs a catheter-based test called an electrophysiology study.

“We can move the catheter inside the heart into areas of interest and we induce tachycardia. It will show us right where the problem’s coming from,” he said.

He can also employ mapping technology to help find the problem.

“That’s a wonderful thing. I like to tell people this is the 21st century,” he said.

Arrhythmia cure rate high

Armed with all that information, he can precisely inactivate the area causing the arrhythmia, either with radiofrequency (RF) or cryotherapy or freezing. Both techniques are more than 94 percent effective and have very low recurrence rates, typically just 3-6 percent.

Do we cure cases of arrhythmias? Absolutely,” Kumar said. “I can’t guarantee it every time, but I do tell people there is a good chance we can cure arrhythmia in most cases. My standard phrase is that ‘cure’ is a good four-letter word.”

In the case of atrial fibrillation, which is most disorganized abnormal rhythm of upper chamber of the heart, we would like to restore normal rhythm sooner than later, Dr. Kumar added.

“We have learned that success rate in resolving atrial fibrillation is very high when we act early in the disease course. Therefore, education and engagement of patient as well as providers are very important.”

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