The electrical system of the heart creates signals that trigger the heart to pump. These electrical signals control the heart rate and rhythm. Normally, the heart beats in a regular rhythm and at an appropriate rate for the exertion level. In other cases, a problem may occur that makes the heart beat abnormally causing an arrhythmia. Things that can cause the heart to beat abnormally include heavy smoking, alcohol use, excess caffeine or other stimulants, stress, thyroid disease, and fever.
Symptoms of an Abnormal Heart Rhythm
Many people don't realize they have an arrhythmia or abnormal heart rhythm disorder. They either ignore the symptoms or don't notice they have symptoms. Other patients notice a difference as soon as it occurs. Symptoms can be different for each person, depending on age, the cause of the abnormal heart rhythm disorder, and how much it affects the pumping efficiency of the heart muscle.
The most common symptoms patients may experience include:
- Weakness or fatigue
- Irregular or rapid pulse
- Shortness of breath
- Racing or pounding heart, or fluttering in the chest
- Difficulty performing everyday activities
- Pain, pressure or tightness in the chest
- Lightheadedness – dizziness or feeling like you could pass out
Often, patients diagnosed with an abnormal heart rhythm condition also have high rates of other serious health conditions, including:
- High blood pressure
- High cholesterol
- Heart failure
- Coronary artery disease
Abnormal Heart Rhythm Treatment
When diagnosed with an arrhythmia or abnormal heart rhythm disorder, it is normal to experience feelings of anxiety. The specialists at Summa Health Heart and Vascular Institute can explain treatment options and plot the best course of treatment for your specific case. Without treatment, an arrhythmia or abnormal heart rhythm disorder can cause the heart muscle to weaken. This condition, cardiomyopathy, can lead to heart failure and result in long-term disability and/or death. Treatment options may include medication, as well as:
Ablation
Cardiac ablation is used to treat many heart rhythm disturbances, including:
- Atrial fibrillation (AFib)
- Atrial flutter
- Atrioventricular nodal reentrant tachycardia (AVNRT)
- Wolff-Parkinson-White syndrome
- Atrial tachycardia
- Ventricular tachycardia
The procedure involves a Summa Health cardiothoracic surgeon placing a specialized catheter (a long, flexible plastic tube) containing a wire and electrode into a vein in the groin and is carefully threaded through blood vessels and into the heart. Once in the heart, it emits heat/cold to scar or destroy the tissue responsible for causing the abnormal heart rhythm.
Cardiac ablation can take from 3 to 6 hours, and is usually done in an electrophysiology lab or operating suite. You will be given medications to help you relax. In some complex cases, you may be put to sleep by anesthesiologist.
After the procedure, you’ll need to lie still for 4 to 6 hours to decrease the risk of bleeding. Some patients are discharged the same day as the ablation, while others may need to stay in the hospital for observation one or more nights. In the days following the procedure, you may experience mild symptoms such as an achy chest and discomfort or bruising in the area where the catheter was inserted. You might also notice skipped heartbeats or irregular heart rhythms. Most people can return to their normal activities within a few days.
Cardioversion
Most elective (non-emergency) cardioversions are performed to treat atrial fibrillation or atrial flutter, which are heart rhythm disturbances originating in the upper chambers (atria) of the heart.
A cardioversion is a brief procedure where an electrical shock is delivered to the heart, converting an abnormal heart rhythm into a normal rhythm. For most people, cardioversion can quickly restore a regular heartbeat. However, you may need repeat procedures to keep a normal heart rhythm.
Cardioversion is different from defibrillation, an emergency procedure that's performed when your heart stops. Defibrillation delivers more powerful shocks to the heart to correct its rhythm.
Electrophysiology
A cardiac electrophysiology (EP) study can help you physician pinpoint the location and type of an abnormal heart rhythm disturbance (arrhythmia) by showing how electrical impulses move through the heart. Your cardiologist may conduct an EP study to:
- Evaluate symptoms such as dizziness, fainting, weakness, palpitation, or others for a rhythm problem when other noninvasive tests have been inconclusive
- Locate the source of a heart rhythm problem
- Assess the effectiveness of medication(s) given to treat a heart rhythm problem
- Treat a heart rhythm problem
During an EP study, small, thin wire electrodes are inserted through a vein in your groin or neck. The wire electrodes are threaded into the heart, using a special type of X-ray (fluoroscopy). Once in the heart, electrical signals are sent through the catheter to stimulate your heart tissue to try to trigger abnormal heart rhythm disturbances for evaluation. If the source of the arrhythmia or abnormal heart beat is found, an ablation (elimination of the area of heart tissue causing the abnormality) may be done.
The results of the study may help your doctor determine further therapeutic measures. For example, while an arrhythmia can sometimes be corrected with medication, an arrhythmia caused by an abnormal electrical pathway in the heart, our specialists offer several additional procedures to correct the problem, including implantable cardiac defibrillators (ICDs) and pacemakers.
Anticoagulation Therapy
Anticoagulation therapy is a course of drug therapy in which medications are administered to a patient to slow the rate at which the patient's blood clots. Anticoagulants are often referred to as “blood thinners,” which is misleading because these drugs do not “thin” the blood. Anticoagulants inhibit the formation of clotting agents so that the blood cannot clot as easily.
Patients taking anticoagulant medications need information about these drugs so they can work with their physician and pharmacist to reduce the risk of complications. It is important to learn how these drugs should be used, their possible side effects and when to seek medical attention should an episode of excessive bleeding occur. In fact, recent studies show that patients who participate in an anticoagulation management program:
- Have fewer complications due to bleeding or clotting
- Need fewer emergency department visits
- Require fewer blood tests
The Summa Health Anticoagulation Management Service (SAMS) is a nationally recognized Center of Excellence in Anticoagulation. SAMS strives to improve patient outcomes by partnering with physicians to offer patients additional support and assistance during their course of anticoagulation therapy. This care is not meant to replace the care offered by your physician. It supplements the care you already receive.
Our program is designed to:
- Provide comprehensive patient education about anticoagulation therapy
- Improve adherence to treatment regimens, including medications, dietary restrictions and keeping follow-up appointments
- Increase awareness of the signs of a potential problem – and know when to seek help
- Reduce emergency room visits and hospital readmissions as a result of bleeding or clotting complications
If you have been prescribed an anticoagulation medication (such as Coumadin®/Warfarin or newer agents, such as Xarelto®/Rivaroxaban or Eliquis®/Apixaban), talk to your physician about getting a referral to the Summa Health Anticoagulation Management Service Program located at Summa Health System – Akron Campus, 95 Arch, Suite G50.