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Cedars-Sinai Marina del Rey Hospital provides patients suffering from arrhythmia with a wide variety of treatment approaches, depending on the type and severity of the condition. The well-trained doctors and specialists can offer individualized treatment regimens for arrhythmia to suite each patient’s needs and promote a rapid and efficient recovery.
Arrhythmia is a condition in which there is a change in the rate or rhythm of the heartbeat. The heart may beat faster than normal (tachycardia), or too slow (bradycardia), or in an irregular manner. A fast heart rate in adults is more than 100 beats a minute, and a slow heart rate is lesser than 60 beats per minute. Atrial fibrillation is the most common type of arrhythmia that causes the heart to beat fast and irregularly. Arrhythmia occurring for a very brief period, for instance, a premature beat or temporary pause will not affect the overall heart rate or rhythm. If arrhythmia continues for a longer period, the heart starts functioning abnormally. Arrhythmia is usually harmless, but may prove to become serious or even fatal in some cases. During arrhythmia, the heart is unable to pump blood effectively to all parts of the body. This results in damage to the brain, lungs, heart, and other organs due to lack of blood flow.
The cardiovascular surgeons at Cedars-Sinai Marina del Rey Hospital may recommend one of the two surgical procedures as treatment for arrhythmia:
The maze procedure is usually recommended for patients who do not respond well to other conservative means of treatment or for those who are undergoing heart surgery for other reasons such as a heart valve repair. During this procedure, the surgeon makes several surgical cuts in the heart tissue of the upper half (atria) of the heart, in order to give rise to a maze-like pattern of scar tissue. The scars may also be created using radiofrequency energy or extreme cold (cryotherapy). As the scar tissue is unable to conduct electricity, it prevents the spread of the disorganized electrical impulses that cause arrhythmia.
Coronary artery bypass grafting is another procedure, which is recommended in conditions where coronary heart disease is the reason for arrhythmia. This surgery improves blood flow to the heart muscles.
If your arrhythmia turns serious, restoration of normal heart rhythm is attempted through treatments such as intravenous or oral medications, implantation of a short-term cardiac pacemaker, and electrical shock therapy (defibrillation or cardioversion).
These minimally invasive treatment methods are offered before surgical therapy is considered. Surgery is usually recommended when the patient does not respond to these conservative treatment methods.
Most arrhythmias may not have any signs or symptoms. The most common symptoms, when present include:
The other symptoms that may be more serious include:
Our cardiologists diagnose arrhythmias by taking a complete medical and family history, performing a thorough physical examination, and by evaluating the results of certain tests. During a physical examination, the physician listens to the rate and rhythm of your heartbeat, distinguishes heart murmur (the unusual sound between heartbeats), checks the pulse rate, and screens for the signs such as swelling in the legs or feet or other signs of thyroid disease. There are several tests that help the physician diagnose the type of arrhythmia. These include:
Blood tests are done to check the levels of substances such as potassium and thyroid hormone in the blood as abnormal levels increase the chances of arrhythmia.
A chest X-ray can reveal heart enlargement.
An electrocardiography (ECG) is a standard test used to diagnose arrhythmia. This test can detect the relative timing of atrial and ventricular electrical events of the heart. It records the electrical activity of the heart and measures the rate of heartbeat. During this test, small patches or electrodes are stuck on various parts of the body such as one in each of the arms and legs, and several on the chest area. The electrical activity of the heart is then traced onto a paper or in a computer. A standard ECG can record the heartbeat for only a few seconds. In order to diagnose arrhythmias that are transient, portable ECGs such as Holter and event monitors should be worn.
A Holter monitor can record the heart's electrical signals for a period of 24-48 hours. It can be worn during normal daily activities, and as with an ECG, several electrodes are stuck to the chest. The wires are connected to a portable, battery-operated device. The patient needs to note down the activities performed and symptoms experienced during the monitoring period. At the end of the period, the device's memory is analyzed using a computer that quickly recognizes rhythmic disturbances.
An event recorder is recommended for suspected arrhythmias that occur infrequently or when symptoms elapse too quickly. The device is similar to a Holter monitor, but for most event monitors, one has to start the monitor when symptoms are felt. Some monitors can sense abnormal heart rhythm and start recording the electrical activity. The recorded ECG can be sent through the phone to your cardiologist for analysis.
The stress test can provoke arrhythmia and thus helps in its diagnosis and proper treatment. It is an option in patients with exercise-related arrhythmia. During this test, your heart rate and rhythm will be monitored while walking or running on a treadmill.
A tilt-table test may be done to find out the cause of recurrent episodes of fainting (syncope) in some people. This test reveals the relation between altered position and the heart rate and blood pressure. During the test, you are told lie down on a table that is moved from a lying down position to an upright position. The change in position may result in a fainting spell. Your symptoms, heart rate, blood pressure, ECG reading are recorded throughout this test.
This test is used in the assessment of serious arrhythmia. The procedure is carried out under local anesthesia. Using a fluoroscope, temporary electrode catheters are passed through the peripheral veins or arteries into the heart. These catheters are then placed in the atria, ventricles or both. These can record the heart's electrical signals and trace the spread of electrical impulses during each heartbeat, thus detecting the position of the heart block. This test also helps to find out the origin of tachycardia, whether supraventricular or ventricular.
This test is used to diagnose as well as treat certain types of arrhythmia. A thin, flexible tube is inserted into the nostril and passed into the esophagus. As esophagus is in close proximity to the heart's upper chamber or atria, an ECG recording at this position provides more accurate information.
This is a non-invasive test that provides valuable information regarding the heart with an arrhythmia. This uses ultrasound waves to study the heart's size, structure, and motion.
Echocardiography (echo) is done to evaluate the size and shape of your heart and the functions of the heart chambers and valves. This test can also find out areas of decreased blood flow to the heart, heart muscles that do not undergo normal contraction, and areas of past injury to the heart muscle. A stress echo may be done to determine whether there is decreased blood flow to your heart, which is an indicator of coronary heart disease.
The most serious forms of arrhythmia is common among older adults as they are more likely to suffer from heart diseases that lead to arrhythmia. Some types of arrhythmia such as paroxysmal supraventricular tachycardia (PSVT) including Wolff-Parkinson-White syndrome occur more often in children and young adults.
The conditions that can increase the chances of developing arrhythmia or abnormal heart rhythm include:
Other risk factors for arrhythmia include:
Arrhythmia may result if the electrical signals that are involved in controlling the heartbeat are either delayed or blocked. This happens when the specialized nerve cells that give rise to electrical signals do not function normally. It may also occur if these electrical signals do not travel in a normal manner through the heart.
Secondly, arrhythmia may also occur when some other part of the heart starts producing electrical signals. This adds up to the signals produced by the specialized nerve cells and further disturbs the normal heartbeat.
The causative factors of arrhythmia are as follows:
Our patients will be advised to seek alternative treatments before we resort to surgical methods of treatment. These include:
Regular chiropractic care that includes cervical and thoracic spinal adjustments should be considered for treatment of heart palpitations. These are designed for reduction of stress and anxiety. A chiropractic adjustment at the cervical region of the spine lowers blood pressure, which in turn reduces heart rate and occurrence of palpitations. A chiropractic adjustment to the thoracic region of the spine directly reduces palpitations by decreasing the pressure on the nerves surrounding the heart. Depending on your condition, it could require one simple adjustment or sometimes more than one adjustment may become necessary.
As patients with arrhythmia need to reduce the factors that trigger stress, acupuncture is a reliable alternative treatment method that helps reduce the response to mental stress, thereby lowering blood pressure, cholesterol, and heart rate. It also helps prevent abnormal heart rhythms after cardioversion is performed for atrial fibrillation.
Performing aerobic exercises regularly can strengthen your heart. These exercises include walking, jogging, biking, and swimming.
Incorporation of relaxation techniques such as Yoga and meditation as a daily routine can help avoid stressful situations in your lifestyle. These techniques can lower your blood pressure.
It is important to know that individuals who appear healthy, without any heart disease can have abnormal heart rhythms. The patients with heart disease are at a greater risk of developing an arrhythmia. As the cause for arrhythmia is not always clear, it is important to prevent and treat heart problems such as atherosclerosis and high blood pressure in order to lower the risk of arrhythmia. The lifestyle modifications that can be followed to prevent arrhythmia include:
For any questions, information or guidance related to arrhythmia, consult our specialty-trained, skilled cardiologists at Cedars-Sinai Marina del Rey Hospital.