Heart Arrhythmia – Diagnosis and Treatment
Diagnosis
Doctors begin by asking about your medical history and any symptoms you have. They also perform a physical exam.
After this, doctors may use specific tests to check for changes in your heart’s rhythm or how your heart beats. Here are common tests that help spot and understand heart rhythm problems:
| Test Name | How It Works | What It Shows |
|---|---|---|
| Electrocardiogram (ECG or EKG) | Doctors stick small sensors to your chest, arms, or legs and connect them to a computer. | Measures and records your heart’s electrical signals and speed. |
| Holter Monitor | You wear a portable device for 24 hours or longer to track heart activity continuously. | Records your heart rhythm during daily routines. |
| Event Recorder | You wear a portable tracker for weeks and press a button if you feel unusual heartbeats. | Captures unusual heartbeats that happen less often. |
| Echocardiogram | Doctors use sound waves to create pictures of your moving heart. | Shows heart size, structure, and how well heart valves work. |
| Implantable Loop Recorder | Doctors place a small device under the skin in your chest area. It records for months or years. | Detects rare or hard-to-catch arrhythmias. |
If the first tests do not find the problem, doctors may try more advanced tests to bring out the arrhythmia.
| Additional Test | Main Use |
|---|---|
| Stress (Exercise) Test | Finds arrhythmias brought on by physical activity. |
| Tilt Table Test | Checks passing out or fainting episodes. |
| EP Study | Locates exact spot of abnormal signaling in heart. |
Exercise Heart Test: You walk on a treadmill or pedal a machine. If needed, doctors give special medicine instead of exercise. This test checks if exercise brings on arrhythmias.
Table Tilt Test: Doctors use this test if you faint often. You lie flat on a table, which then tilts up so your body is upright. Doctors watch how your blood pressure and heartbeat change.
Electrophysiology Study (EPS): In a hospital, doctors guide thin tubes through a blood vessel to your heart. Sensors on the tubes check how electrical signals move inside the heart. This test helps doctors find exactly where the abnormal rhythm starts.
Treatment
Medications for Heart Rhythm Problems
Medicines can help manage heart rhythm problems. The treatment depends on the type of arrhythmia and possible risks.
Doctors may use medications to control a heartbeat that is too fast. For atrial fibrillation, blood-thinning medicines help lower the risk of blood clots and prevent strokes.
Doctors choose one or more types of medication to match your needs. The most common include:
- Beta-blockers: Slow the heartbeat.
- Calcium channel blockers: Help regulate heart rhythm.
- Antiarrhythmic drugs: Correct irregular rhythms.
- Anticoagulants: Prevent blood clots.
Doctors explain how to take your medicines and review any side effects. Regular follow-up visits help check how the medicines are working.
Common Non-Surgical Treatments
Some treatments do not need surgery. These therapies help control or stop irregular heartbeats. The best approach depends on the type of arrhythmia and how severe the symptoms are.
Simple Actions (Vagal Maneuvers)
Simple actions can slow down a very fast heartbeat. Coughing, holding your breath and bearing down, or putting a cold object on your face can all stimulate a nerve that calms the heart.
Doctors usually try these for certain fast heart rhythms.
Electrical Shock to the Heart (Cardioversion)
Doctors use patches or paddles placed on your chest to send a quick, controlled electric shock to your heart. The shock resets the heartbeat to a normal pattern.
Doctors may use cardioversion if other methods do not work, especially with atrial fibrillation or similar rhythms.
Here is a quick comparison of non-surgical treatments:
| Therapy | Description | When It’s Used |
|---|---|---|
| Vagal Maneuvers | Physical actions to slow fast heartbeats | Certain rapid rhythms |
| Cardioversion | Electric shock to restore normal heart rhythm | Irregular rhythms like atrial fibrillation |
Surgical Procedures and Medical Devices
If medicines and other therapies are not enough, doctors may recommend surgery or special devices.
Catheter Ablation
Doctors thread a thin tube through blood vessels to your heart. They send energy, either heat or cold, to small spots in the heart muscle. This creates tiny scars that block faulty electrical signals. Catheter ablation treats different types of arrhythmias.
Pacemaker
For slow heart rhythms, doctors place a pacemaker in your chest. This small device sends electrical signals to help your heart keep a steady beat.
Implantable Cardioverter-Defibrillator (ICD)
Doctors put an ICD under the skin near your collarbone. The device checks your heart’s rhythm all the time.
If it senses a dangerously fast or irregular heartbeat, it delivers a shock to restore a normal rhythm. ICDs are for people at high risk for life-threatening rhythms.
Maze Surgery
A surgeon makes tiny cuts in the upper part of your heart to form a pattern. These cuts create scar tissue that blocks irregular signals and guides the heart’s electrical signals the right way.
Maze surgery is an option when other treatments do not work or when you need surgery for other heart problems.
Coronary Artery Bypass Surgery
If blocked arteries cause arrhythmias, a surgeon creates new pathways for blood to move around the blockages. This helps fix both the blood flow problem and irregular heart rhythms.
Device and Surgery Comparison Table:
| Procedure/Device | Purpose | Main Use |
|---|---|---|
| Catheter Ablation | Block abnormal signals | Many arrhythmias |
| Pacemaker | Keep heartbeat steady | Slow heart rhythms |
| ICD | Shock heart during dangerous rhythms | Prevent sudden cardiac events |
| Maze Procedure | Create scar tissue to correct rhythm | When other treatments fail |
| Coronary Artery Bypass | Improve blood flow in heart arteries | When arrhythmia is linked to blocked arteries |
Regular doctor visits and following instructions are important after these treatments.
Tips for Daily Habits and Home Care
Healthy routines can support heart health and help manage symptoms from heart rhythm problems. Smart choices each day can lower risk factors and improve wellness.
Healthy Eating
- Choose foods low in salt and solid fats.
- Add more fruits, vegetables, and whole grains to your meals.
Physical Activity
- Aim to be active for at least 30 minutes most days.
- Walking, cycling, or swimming can help.
No Tobacco Use
- Do not smoke or use tobacco products.
- If quitting is hard, get help from a health provider or support group.
Weight Management
- Work towards a healthy body weight and body mass index (BMI).
- Set realistic weight goals with your healthcare team.
Blood Pressure and Cholesterol Control
- Keep blood pressure and cholesterol within recommended levels.
- Take prescribed medicines and make healthy lifestyle choices.
Alcohol Use
- Drink alcohol only in moderation, if at all.
- Suggested limits:
- Up to one drink per day for women and men over 65
- Up to two drinks per day for men under 65
Sleep Habits
- Try for 7 to 9 hours of sleep each night.
- Keep a steady sleep schedule, even on weekends.
Stress Management
- Manage stress through exercise and relaxation methods like deep breathing or mindfulness.
- Get support from friends, family, or groups to help reduce stress.
Getting Ready for Your Visit
Steps to Take Before Your Appointment
Being prepared can help you get the most from your healthcare visit. Here are some tips:
- Check for Instructions: Ask if there are any special rules before the appointment, such as not eating or drinking before certain tests.
- Note Your Symptoms: Write down all your symptoms, even those that seem unrelated.
- Gather Medical Information: List any family history of heart problems, high blood pressure, diabetes, or stroke. Include major stresses or life changes.
- List Medications: Make a list of all medicines, vitamins, and supplements you take, with how much and how often.
- Bring a Companion: Ask a friend or family member to come with you. They can help remember what is discussed.
- Prepare Questions: Write down anything you want to ask the healthcare team.
Here are sample questions to ask during your visit:
| Question Type | Sample Question |
|---|---|
| Cause of symptoms | What could be causing my symptoms? |
| Alternative causes | Are there other reasons for what I’m feeling? |
| Necessary tests | What tests will I need? How should I get ready for them? |
| Treatment options | What is the best treatment plan for me? |
| Diet and activity | Should I change anything I eat or how active I am? |
| Disease management | How can I manage other health conditions along with this? |
| Medication options | Is there a generic medicine I can use? |
Put your questions in order of importance in case you run out of time.
What Your Healthcare Provider Will Want to Know
Your healthcare provider will ask questions to better understand your issue. Common questions include:
- When did the symptoms start?
- Do the symptoms happen all the time, or do they come and go?
- How strong are the symptoms?
- Is there anything that makes the symptoms better?
- What seems to make the symptoms worse?
- Does anyone else in your family have issues with irregular heartbeats?
Giving clear and honest answers helps your healthcare team plan the next steps.
