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Heart Rhythm Disorders

When to Seek Medical Care for Your Heart Rhythm

Most people have noticed their heart racing, a fluttering in the chest, or a sensation that the heart skipped a beat. If this happens once, or infrequently, with no other symptoms, it is usually not serious. However, any questions or concerns should be discussed with a health care provider. The health care provider should also be notified if a recommended treatment does not alleviate the symptoms.

More serious symptoms should be evaluated immediately at the nearest hospital emergency department. These symptoms include:

  • Any unexplained shortness of breath
  • Light-headedness or feeling faint
  • Feeling that the heart is beating too slowly or too quickly
  • Chest pain with any of these symptoms

People experiencing these symptoms should not drive to the emergency department. They should call 9-1-1 for emergency medical transport.

Heart Rhythm Exams and Tests

Evaluation of heart rhythm disorders requires a discussion of symptoms and a physical exam with a health care provider.

In addition, an electrocardiogram (ECG) is mandatory to establish the exact type of arrhythmia. If the rhythm disturbance is present while the ECG is being recorded, the problem can be identified immediately. Otherwise, more specialized testing may be required. A 24-hour (or longer) recording of the heartbeat is often necessary to detect any rhythm problem that occurs daily but not constantly.

However, if the arrhythmia is even more infrequent, an event recorder may be used. These vary from hand-held machines that are activated by the patient whenever he or she feels symptoms, to some that are placed surgically under the skin and left there for up to one year.

An ultrasound of the heart, called an echocardiogram, is often used for an evaluation of the structure and function of the heart. In more serious cases, a test using electrodes placed inside the heart, called an electrophysiologic study (EPS), may be recommended to determine further management.

Treatment for Heart Rhythm Disorders

The treatment of heart rhythm disorders varies depending on the presence or absence of symptoms, how frequent the arrhythmia occurs, and the seriousness of any underlying heart condition. The treatment may range from medication to more advanced surgical procedures, such as an internal implanted cardiac defibrillator (ICD). Sometimes no treatment is necessary. At times, simple or specialized pacemakers may be required to control arrhythmias.

A detailed discussion of the tests and treatment options should be done with the health care provider.

Medications for Heart Rhythm Disorders

The choice and use of medications depends on the specific type of heart rhythm disorder you have. Detailed discussion about this is beyond the scope of this article.

Follow-Up for Heart Rhythm Disorders

Follow-up for a heart rhythm disorder is usually done with the primary care provider and often with a heart specialist. The patient is monitored for effectiveness of treatment, recurrence of symptoms or arrhythmia, side effects of medication, additional routine testing, and overall condition. For those requiring pacemakers, follow-up on a regular basis is mandatory.

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