Heart arrhythmia

The heartbeat is controlled by electrical impulses that begin in the upper chamber (atria) of your heart. When you have AFib, these electrical impulses are erratic. This causes an irregular heartbeat that affects the heart's ability to pump blood efficiently to the rest of the body.

The three main types of AFib are:

• Paroxysmal — starts and stops suddenly; symptoms last from a few minutes to a few days
• Persistent — starts and does not stop; requires treatment to restore the heart's rhythm
• Permanent — does not stop even after treatment; for this type, controlling the heart rate is critical to prevent stroke

Unfortunately, you may or may not experience symptoms if you have AFib. Regular checkups with your doctor or annual visits to a cardiologist, if you have AFib risk factors, can help diagnose and treat this condition quickly. Risk factors of having AFib include:

• Advancing age
• Being a smoker
• Being under constant or overwhelming stress in your day-to-day life
• Having a family history of heart disease
• Having been diagnosed with:
  • A congenital heart disorder
  • Coronary artery disease
  • Diabetes
• Having had a previous heart attack

The thyroid's hormones aid in regulating the speed and strength of your heartbeat. When you have a thyroid condition that causes your thyroid to be overactive (hyperthyroidism), it can increase your risk of developing AFib.

According to the American Thyroid Association, research suggests underactive thyroid (hypothyroidism) and related conditions can also increase your risk of developing AFib.

If you have a thyroid condition or family history of thyroid issues, we suggest you check with your doctor to see if you should be assessed for arrhythmias.

Early diagnosis is critical to help ensure arrhythmias are treated before long-term or irreparable damages are done. We offer many options to diagnose heart rhythm disorders, including:

• Heart and vascular imaging — We provide advanced technology to look at your heart and veins. This includes 3D arrhythmia mapping, electrocardiograms (EKGs), echocardiograms (ultrasounds) and transesophageal echocardiograms (TEEs).
• Electrophysiology (EP) study — EP is the medical study of the electrical activity of the heart. An EP study is a minimally invasive diagnostic procedure in which a catheter is used to record the heart's electrical signals. It may also be used to medically induce an arrhythmia, which allows us to examine an irregular heartbeat for patients who experience symptoms intermittently.
• Holter monitor — This device continuously records each heartbeat, whether an arrhythmia is detected or not.
• Implantable loop recorder — This recording device is temporarily placed in the chest to record the heart rhythm and can be used for long-term, remote monitoring.
• Tilt table test — This test positions a patient at a tilted angle of 60 to 70 degrees for 30 to 45 minutes while their heart and blood pressure are constantly monitored.

Occasionally, some people with minor arrhythmias find symptom relief in self-care remedies, such as leading heart-healthy lifestyles and practicing breathing exercises or other stress-reduction techniques. However, please talk to your doctor before you assume this is the best way to manage your condition. Although it may seem like a benign issue — especially if you have the type of arrhythmia that comes and goes — there may be something more serious going on. Our cardiologists can help you understand your condition and personalize your treatment plan around your needs.

Some options we may suggest to treat your irregular heartbeat include:

These medications will help slow down or speed up your heart rate, or return your heart rhythm to normal. These medications include blood thinners, beta blockers, calcium channel blockers and digoxin.

Ablation therapy is a technique designed to treat irregular heartbeat patterns and possibly eliminate the need for medication. We offer these therapies via minimally invasive catheters. Our treatments include burning (radiofrequency ablation) or freezing (cryoablation) off abnormal electrical tissue in the heart that triggers erratic rhythms. We also provide an innovative high-intensity focused ultrasound ablation for certain patients.

This involves placing electrodes or paddles on the chest or back. An electrical current is passed through the chest wall to the heart to reset its electrical circuits and attempt to return the heart rhythm to normal. This can be done as a scheduled (elective) procedure or in an emergency.

These may be suggested following a procedure or to aid in the effectiveness of medication. These types of changes may include weight management. This is because, through diet and exercise, you can often help reduce the frequency, duration and/or severity of arrhythmia episodes.

Should you need it, we provide many different heart surgeries to treat arrhythmias by regulating the heartbeat. This includes both traditional and minimally invasive procedures, such as:

• Automated external defibrillator insertion
• Convergent maze procedures
• Left atrial appendage closure (LAAC) device insertion
• Pacemaker and implantable cardioverter defibrillator (ICD) insertion and repair
• Cardiac resynchronization therapy (CRT) (bi-ventricular device insertion)