If your heartbeat seems to have an unusual rhythm during an impromptu dance party in the kitchen with your spouse and kids, something might be up.
It’s best to schedule an appointment with your primary care provider or a local heart specialist as soon as possible. If your provider discovers an irregular heartbeat, your next appointment will be with an electrophysiologist — a cardiologist with a specialty in heart rhythm.
What Is an Irregular Heartbeat?
Your heartbeat is the result of rhythmed electrical currents that flow throughout the heart. When an electrical current gets “off,” the result is an abnormal heartbeat, also known as an arrhythmia. Perhaps your heart races randomly, is beating unusually slow, skips beats, or the rests and thumps seem unevenly spaced.
Rhythm disturbances can be caused by cardiac or noncardiac sources:
- High blood pressure
- Coronary artery disease
- Illness of the heart muscle
- Trauma, such as from a car accident
- Electrolyte disturbances
- Inherited genetic risk or developmental issue
- Obstructive sleep apnea
- Age-related changes
- Sometimes other unknown causes
“Many people actually feel the difference,” said Riyad Mohama, MD, FACC, electrophysiologist at North Central Heart, a division of Avera Heart Hospital. “About 20% don’t feel the abnormality and it’s discovered under the stethoscope.
When your heart rate is out of rhythm, symptoms might include:
- Sensations of a racing heart
- Chest pain
- Lightheadedness or dizziness
- Shortness of breath
Don’t play around when it comes to your heart. If you’re concerned with any hint of these symptoms, go to the Emergency Department immediately.
Types of Arrhythmias
- Palpitation – a fast or irregular heartbeat
- Ventricular tachycardia – a fast heartbeat that starts in the two lower chambers of the heart (ventricles)
- Atrial flutter – a fast, uneven heartbeat that starts in the two upper chambers of the heart (atria)
- Atrial fibrillation – the most common arrhythmia of the top chamber, AFib is a faster, more uneven version of atrial flutter
What Is Electrophysiology?
“Electrophysiology studies the rhythm your heart’s electrical system,” said Mohama. “It’s a specialized branch of cardiology dedicated solely to your heartbeat.”
If you’re referred with an arrhythmia, your electrophysiologist needs to find out where there is a problem with the heart’s electrical currents. This might include an exercise stress test or an echocardiogram (EKG) — unsedated tests that check your heart’s performance.
However, a more involved test is the electrophysiological (EP) study. Under sedation, wire electrodes are inserted and threaded through the veins until it reaches your heart. These tiny wires enter the heart’s chambers and ventricles to begin the study.
X-ray images and heart activity are displayed on a screen where your doctor can measure and examine the electrical signals pulsing throughout your heart.
The wire electrodes also dispense small electrical currents to the heart. In this controlled effort to recreate the irregularity, the electrophysiologist can find where the heart’s electrical currents are being interrupted.
Treatment for Irregular Heartbeat
When an irregular heartbeat goes untreated, you put yourself at risk for stroke, cardiac arrest or death. Possible treatments include:
- Medication – Prescribed by your physician, medication can regulate your heart rate.
- Pacemaker – If your heart beats too slowly sometimes, an inserted pacemaker delivers electrical currents at the right moments to increase its speed.
- Radiofrequency ablation – An inserted catheter delivers a burn directly to the abnormal heart tissue. The created scar redirects rogue electrical currents so the heart beats normally.
- Defibrillator – When you have a dangerously high heart rate, an implanted defibrillator delivers an electrical shock to help it return to normal.
“If the patient is young, ablation is the more preferred treatment as it reduces the need to take lifelong medications,” said Mohama.
Though many arrhythmia issues can be traced to genetics, you still have the power to improve your heart health through a healthy lifestyle.
“Treating your health and heart is a team approach,” said Mohama. “We encourage you to do your part and we are here to help with preventive screenings, detecting problems and offering treatment.”
