Each day, your heart pumps about 2,000 gallons of blood. Your heartbeat is the steady drum that drives this process. We may not give our heartbeat much thought until we feel a heart flutter (palpitation). Then, the worries may start — could it be something serious?
For many people, the answer is no. For others, an irregular heartbeat may signal an arrhythmia.
“Most people who experience arrhythmia-like symptoms, such as their heart rate running fast or skipping beats, will end up having something that is not dangerous,” says Demetrio Castillo, MD, an electrophysiologist (EP) at Memorial Cardiac and Vascular Institute. “But, some patients have arrhythmias that require treatment.”
Heartbeat changes can be tricky to diagnose. Think of your irregular heart rate like a noise your car makes – but only sometimes. Your mechanic might not hear the noise during a test drive. Likewise, your heart rhythm won’t always change while your doctor is listening to it.
Fortunately, electrophysiologists have various tools and techniques they can use to detect and identify irregular heart rhythms. Here are some questions our doctors often get about diagnosing and treating arrhythmias:
Should I see my doctor right away if I have an irregular heartbeat?
Any new symptom should prompt an evaluation. If palpitations occur more often or last longer than usual, talk to your doctor. They may schedule tests to learn more about what’s happening during heart rate changes.
Seek emergency medical care if you have heart palpitations and you also have:
- Chest pain
- Shortness of breath
Are there different types of arrhythmias?
Arrhythmias may cause your heart to beat faster (tachycardia) or slower (bradycardia). Some arrhythmias cause an extra beat or make your heart beat too early. Heartbeat changes can occur in the heart’s upper chambers (atria) or lower chambers (ventricles).
Arrhythmia types include:
- Atrial fibrillation (AFIB): An irregular beat in the atria. You’re at higher risk for developing AFIB as you get older.
- Cardiac channelopathies: Heartbeat changes caused by inherited conditions that change the heart’s signals. These are rare conditions that include Long QT Syndrome and Brugada Syndrome.
- Supraventricular tachycardia (SVT): A fast heartbeat in the atria. SVT may occur for just a few minutes or last for a few days. SVT is not dangerous, but can cause frequent symptoms.
- Ventricular tachycardia (VT): A fast heartbeat in the ventricles that can sometimes keep the heart from pumping enough oxygenated blood to your body. VT may cause fainting and ventricular fibrillation, a dangerous arrhythmia.
- Wolff-Parkinson-White syndrome: A heart condition you’re born with. You have extra pathways in your heart that electrical signals may follow, causing SVT.
What tests will I have to check for arrhythmia?
Your doctor will ask you how often you have heart palpitations and what you’re usually doing when you have them. You may have an electrocardiogram (EKG), a painless test that measures your heart’s electrical signals.
If your EKG results are normal, your doctor may ask you to:
- Wear a Holter monitor for a few days. This device records your heartbeat throughout the day and while you’re sleeping. Your doctor may also ask you to share heart rate data recorded by any wearable devices you use.
- Have an echocardiogram (heart ultrasound). Specialists move a device (transducer) over your skin that records sound waves and turns them into images. This test shows your doctor how blood flows through your heart.
- Have more heart imaging tests. Cardiac CT scans, MRIs, and cardiac catheterization help your doctor learn more about your heart’s structure and what causes the arrhythmia.
- Get an implantable device. An implantable loop recorder, can provide continuous data about your heartbeat for up to three years. Doctors implant this battery-powered device under your skin. It records your heart rhythm and sends information to your doctor. This is useful when other tests do not make a diagnosis.
Will I need treatment if I have an arrhythmia?
Not all arrhythmias need treatment. Talk to your doctor about palpitations and how often they occur. Your doctor may recommend lifestyle changes or prescribe medication to control heart flutters.
“For some arrhythmias, we do procedures to control symptoms, especially when medications aren’t effective,” says Dr. Castillo. For example, electrophysiologists use a minimally invasive procedure called cardiac ablation to eliminate some arrhythmias.
How do implantable devices treat arrhythmia?
For dangerous arrhythmias, your electrophysiologist may implant a battery-powered device under your skin. They connect it to your heart with wires to change your heartbeat. These include:
- Implantable cardioverter defibrillator (ICD): An ICD detects dangerous heart rhythms in patients who are at risk and delivers an electric shock to your heart to restore its normal rhythm.
- Pacemaker: A pacemaker sends an electrical signal to your heart to regulate your heart rate if it becomes too slow.
Do arrhythmias ever go away on their own?
Heart flutters may occur only once or just a few times and then never happen again. You may have occasional irregular heartbeats with no other symptoms. Talk to your doctor if you’re having more — or stronger — palpitations than usual, especially if you’re feeling very tired.
Schedule an Appointment for Heart and Vascular Services
Learn more about heart and vascular services at Memorial Cardiac and Vascular Institute. To schedule an appointment with a cardiologist, electrophysiologist or vascular specialist at Memorial, call 855-400-6284.