Arrhythmias range from harmless to fatal Whether they’re called “palpitations” or “skipped beats,” occasional, brief bouts of arrhythmia are fairly common. Should you worry?

By MARY JACOBS

Special Contributor

The Dallas Morning News
Feb. 1, 2011

It’s that time of year, when love is in the air, and the heart flutters every time special someone draws near.

But sometimes the diagnosis isn’t love. A fluttering heart — the medical term is “arrhythmia” — can signal something more serious than lovesickness.

Whether they’re called “palpitations” or “skipped beats,” occasional, brief bouts of arrhythmia are fairly common. Many are relatively benign, but some types can be fatal or signal an increased risk of stroke.

Only an electrocardiogram (ECG) can say for sure.

“Making an initial diagnosis from an individual’s subjective description is nearly impossible,” says Dr. Adam Shapira, a cardiac electrophysiologist at the Heart Hospital Baylor Plano. (An electrophysiologist is a cardiologist who specializes in rhythm abnormalities.)

Mellanie True Hills knew something was very wrong when, while walking her dog one day, her heart suddenly started to race. She watched in horror as the reading on her exercise heart rate monitor climbed to 300 beats per minute.

“I was alone on the road, and I thought I was going to pass out, alone,” says Hills, who lives in Greenwood.

The cause: atrial fibrillation (“afib” for short), the most common type of heart rhythm abnormality, which affects about 3 million people nationwide.

In afib, the two upper chambers of the heart (atria) are in a state of electrical chaos, and the heart beats too fast and irregularly. Patients also often experience fatigue, lightheadedness, chest pain or shortness of breath.

While scary, an episode of afib itself isn’t typically life-threatening, but it can lead to stroke.

“About one-fifth of all strokes occurring in the U.S. are related to atrial fibrillation, and they tend to be more devastating and lethal,” says Dr. Peter Ott, an electrophysiologist at the University of Arizona Medical Center.

Expect to hear more about afib as the oldest Baby Boomers turn 65 this year — and as new and better ways to treat it become available. In October, the FDA approved Pradaxa, a new drug that helps prevent stroke in afib patients. In the next 5 to 10 years, Shapira expects significant improvements in catheter ablation, a procedure that involves inserting a catheter into the heart to eliminate the triggers for afib.

Benign, or worrisome?

So, if your heart flutters from time to time, how do you know whether it’s afib or some other cause for concern?

As always, it’s wise to report any symptom to your doctor. Tell him or her soon if you’re also experiencing light-headedness, dizziness, fatigue or shortness of breath, or if you have a history of heart attack, coronary artery disease or heart failure, either in your own medical history or in your family. (Seek immediate medical attention for a rapid heart rate that does not stop, or with symptoms of a possible stroke.)

If your symptoms warrant further investigation, your doctor will probably recommend an ECG. Because it’s critical to get a reading of an arrhythmia while it’s occurring, patients typically wear a ECG monitor until a good reading is obtained, usually for 24 hours but sometimes as long as 3 to 4 weeks.

“The ECG gives the doctor useful information into the nature and cause of the arrhythmia,” says Dr. Lawrence Kanner, director of electrophysiology and arrhythmia services at South Nassau Communities Hospital’s Center for Cardiovascular Health in New York. If the arrhythmia does prove serious, treatment options range from drugs — either to correct the arrhythmia itself or blood thinners to prevent stroke — or surgery or other procedures such as catheter ablation.

(And if it turns out your palpitations are romantic in origin, Shapira can’t offer a medical explanation. “I don’t know the cause,” he says. “I’ve never seen someone fall in love while getting an ECG.”)

After her afib episode, Hills studied all her options,and created a website, www.stopafib.org , to help other patients wade through their choices, too. Ultimately she opted for a surgical procedure called Mini-Maze, and now considers her afib cured.

Would she do it again?

“In a heartbeat,” she likes to say.

 

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