Care for Arrhythmia

Premature (extra) beats

Premature beats are a common, but usually harmless, kind of arrthythmia. Most of the time they need no treatment, especially in healthy people.

Supraventricular Arrhythmias

These arrhythmias are "tachycardias" (fast heart rates). They include the following types:

• Atrial fibrillation (AF)
• Atrial flutter
• Paroxysmal supraventricular tachycardia (PSVT)
• Wolff-Parkinson-White (WPW) syndrome

Tachycardias can affect the heart's ability to pump blood. They should be analyzed by a heart specialist.

Ventricular Arrhythmias

As the name suggests, these arrhythmias start in the ventricles, and are potentially dangerous. They often need prompt medical attention. They include:

• Ventricular tachycardia
• Ventricular fibrillation

Bradyarrythmias

These arrhythmias are characterized by slower than normal heart rates, usually below 60 beats per minute. Slow heart rates can mean that not enough blood is pumped to the brain, causing a loss of consciousness.

Arrhythmia Specialists

Cardiac electrophysiologist - a doctor who specializes in diagnosing and treating irregular heart rhythms caused by problems with the heart’s electrical system.

Cardiac electrophysiology fellow - a doctor whose training emphasizes teaching and research and who is receiving clinical training in cardiac electrophysiology.

Other Arrhythmia Staff

Nurse practitioner - a registered nurse who has completed advanced education and training in the diagnosis and management of common medical conditions, including chronic illnesses.

Cardiac electrophysiology nurse - a registered nurse who has completed education and training in the diagnosis and management of electrophysiological conditions.

It is important for your doctor to know where the arrhythmia starts in your heart and whether it is abnormal. One or more of the following tests are commonly used to detect arrhythmias:

Electrocardiogram (ECG or EKG)

This test determines the rate and regularity of the heartbeat. The ECG is administered with wires that are painlessly attached to your body and removed once the test is finished. The wires detect electrical signals from the heart, which are recorded on a machine for the doctor’s review.

Holter monitors, or portable ECG units

Worn by an arrhythmia patient to monitor the heart 24 hours a day.

Tilt table

This test evaluates your response (changes in heart rate and blood pressure) to moving from lying down to sitting up.

Electrophysiologic (EP) study

Maps the electrical signals generated by the heart. The EP study requires the insertion of a thin tube (catheter) through a vein.

Lifestyle changes

Beneficial lifestyle changes include quitting smoking and limiting alcohol and caffeine.

Medicine

Your doctor may prescribe medicines to prevent and control arrhythmias and to treat related conditions such as high blood pressure, coronary artery disease (CAD) and heart failure.

Anticoagulants

Anticoagulants (blood thinners) may be prescribed to reduce your risk of blood clots and stroke.

Pacemaker

A pacemaker helps your heart beat regularly. A pacemaker is a small generator, implanted under the skin, that produces the electrical impulses that stimulate the heart to contract and pump blood to the rest of the body.

• In a 7News story, Ryan Aleong, MD, an assistant professor of medicine at University of Colorado Hospital, discusses how the Revo MRI SureScan pacemaker allows patients to undergo MRI procedures. UCH was the first hospital in Colorado, and the region, to offer the MRI-compatible pacemaker.

Cardiac Defibrillation

Cardiac defibrillation and implanted cardiovertor defibrillators (ICD). Defibrillation is a way of returning a heartbeat to normal with a very brief electrical shock. Internal defibrillators can be placed under the skin in the upper chest.

Cardiac ablation

A doctor performs this procedure by putting a catheter in a vein and guiding it to the heart. The tip of the catheter delivers small bursts of energy that destroy very small areas of heart tissue that cause arrhythmias.

Studies on arrhythmia currently conducted at University of Colorado Hospital include:

• Heart electrical signal processing to determine the patient's risk for ventricular fibrillation (fluttering or twitching in the muscles of the lower chamber of the heart, which can lead to sudden cardiac death).
• Studies of electrical signals in patients with congenital (dating from birth) heart disease to determine their risk of sudden cardiac death.
• Right ventricle electrical signal mapping in patients with nodes on the heart to determine the risk of sudden cardiac death.

Living With Arrhythmia

One important way to manage arrhythmias is to reduce stress:

• Exercise
• Meditate
• Get plenty of rest and sleep
• Talk about issues with loved ones and friends

Getting a Second Opinion about Arrhythmia

The doctors and staff of University of Colorado Hospital are happy to provide second opinions for patients who have symptoms of or a diagnosis of arrhythmia. For inquiries, call (720) 848-5300.