The Power Of Teamwork: Heart Center

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WHAT ARE ARRHYTHMIAS
Cardiac arrhythmias are abnormal heart rhythms that can cause the heart to beat rapidly, slowly or erratically. Arrhythmias may occur at any age and can occur in otherwise perfectly healthy people. Some arrhythmias are dangerous and mandate medical therapy, while others are benign and may cause only trivial symptoms. Your doctor will determine whether or not an arrhythmia requires further evaluation or treatment.

There are a number of factors that may contribute to arrhythmias, including coronary artery disease, heart failure, some congenital and genetic heart diseases, smoking, excessive use of alcohol or caffeine, drug abuse and stress. Occasionally over-the-counter drugs, prescription medications, dietary supplements and herbal remedies can cause arrhythmias in certain people. In some cases an arrhythmia occurs without a known cause.

SYMPTOMS OF ARRHYTHMIAS
During an arrhythmia, people often feel their heart beat rapidly or irregularly, experience fluttering in the chest or have noticed their heart skip a beat. Dizziness, fatigue, fainting, shortness of breath and chest pains may also be symptoms of arrhythmia.

People generally should not panic when they feel a few heart flutters or skipped beats. You should talk with your doctor about your symptoms and any questions you might have about your heart rhythm. If the sensation of heart racing or dizziness occurs repeatedly, or if it ever results in chest pain or fainting, notify your physician immediately.

DIAGNOSING ARRHYTHMIAS
Doctors can diagnose arrhythmias through several tests:

Electrocardiogram – a test that records the electrical activity of the heart over several seconds.
Holter Monitoring – a recording of your heart activity over a 24-hour period.
Echocardiogram – the use of sound waves (ultrasound) to create a 3-D picture of the heart chambers. Through this picture, doctors are able to see if there are any structural abnormalities that may cause arrhythmias.
Event Recorder – when patients feel symptoms, they can start a special recorder that transmits a recording of the heart rhythm over the phone to the physician's office.
Exercise ECG Test – this is also known as a treadmill or stress test. During exercise, your doctor can record your heart rate and rhythm. This test may bring on arrhythmias that would not occur when you are at rest.
Electrophysiology (EP) Study – this test involves placing catheters into the heart chambers (generally through veins in the legs). These specialized catheters allow the heart's electrical activity to be recorded directly. An EP study often also involves the use of IV drugs and electrical pacing of the heart during the study to diagnose arrhythmia.

TREATMENT OF ARRHYTHMIAS
Some cardiac arrhythmias do not require treatment. When treatment is necessary, it may involve the following:

Medication – Medicines can help to both suppress arrhythmias and also to reduce health risks associated with some arrhythmias.
Cardioversion – Application of a brief external electrical stimulation to disrupt an irregular heart rhythm and resume a regular one. Patients are under anesthesia and do not feel any pain from cardioversion.
Catheter ablations – doctors place catheters in the heart and examine the abnormalities in the heart causing an arrhythmia. Heat or cold is then applied by the catheter to permanently interrupt the circuit through which the irregular beats travel. Catheter ablation can cure some types of arrhythmia and generally involves only minimal discomfort during the procedure.
Pacemakers – a small electronic device that is placed under the skin (typically in the left or right upper chest region) to keep your heart beat from being abnormally slow.
Implantable Cardioverter Defibrillators (ICD) – a device similar to a pacemaker (but somewhat larger). In addition to functioning as a pacemaker to treat slow heart rhythms, an ICD can also treat life-threatening fast heart rhythms (typically ventricular tachycardia and ventricular fibrillation) with fast electrical pacing or brief electrical shocks.
Cardiac Resyncrhonization Therapy (Bi-ventricular pacing) – A specialized type of pacemaker or defibrillator which can help to treat certain types of congestive heart failure (CHF).
Tilt Table Test – a non-invasive test which involves being tilted upright on a padded stretcher for between 30 and 60 minutes. This can help to diagnose certain causes of fainting.

PREVENTING ARRHYTHMIAS
A healthy lifestyle may help to prevent some types of arrhythmias. If caffeine or alcohol is worsening your arrhythmia, your doctor may ask you to stop drinking colas, coffee, tea or alcoholic drinks.

Reducing high blood pressure and high cholesterol levels, losing weight, reducing stress and eating right will help you manage arrhythmias. And if you smoke, you should quit.

Exercise can also help to control some types of arrhythmias. Your doctor can help you develop an exercise program that is right for you. If you've been diagnosed with an arrhythmia, be sure to check with your doctor before beginning any exercise program.

MASSACHUSETTS GENERAL HOSPITAL HEART CENTER
The Massachusetts General Hospital Heart Center stands on a long tradition of innovation and excellence, dating as far back as 1914. Our physicians have made significant contributions to advancing the world of cardiac care through trailblazing discoveries in research, and by making unparalleled improvements in the diagnosis and treatment of cardiac diseases.

The Cardiac Arrhythmia Service at Massachusetts General Hospital was the first clinical program focused on cardiac arrhythmias in New England. It has a long history of success in the treatment of all types of cardiac arrhythmias.

We give our patients access to the latest advanced technologies, clinical trials, and promising treatments. People from around the world come to us seeking diagnosis and treatment for the entire spectrum of cardiac disease.

Our team approach to cardiac care allows us to provide the best and most appropriate diagnosis and treatment for our patients. Drawing on the depth and breadth of our cardiac specialists, we are able to treat each patient individually and offer care that is customized to each patient's specific needs.

For more information or to make an appointment, please call us at 866-MGH-8910.

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