Rhythm of My Heart: Heart Rhythm Disorders
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Rhythm of My Heart: Heart Rhythm Disorders

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The heart is like an intricate machine—controlled by electrical impulses that must occur at regular intervals to work properly. When that doesn’t happen, the result is a rhythm disorder, also ...

The heart is like an intricate machine—controlled by electrical impulses that must occur at regular intervals to work properly. When that doesn’t happen, the result is a rhythm disorder, also known as an arrhythmia. These abnormalities can range from common and harmless rhythms to serious and potentially life-threatening rhythms. Dr. Eric Mak, specialist in cardiac electrophysiology, discusses these conditions and their treatment methods.

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Rhythm of My Heart: Heart Rhythm Disorders Rhythm of My Heart: Heart Rhythm Disorders Presentation Transcript

  • CardiacElectrophysiologyEric C. Mak, MDCardiology
  • www.SpringfieldClinic.com
  • Heart Rhythm Disorders • An introduction to the normal electrical system of the heart, i.e. Sinus Rhythm • Ectopy (extra beats) • Bradycardias (slow heart rhythms) • Tachycardias (fast heart rhythms) • Q/A
  • Heart Rhythm Disorders • An introduction to the normal electrical system of the heart, i.e. Sinus Rhythm • Ectopy (extra beats) • Bradycardias (slow heart rhythms) • Tachycardias (fast heart rhythms) • Q/A
  • Sinus Rhythm
  • Sinus Rhythm
  • Heart Rhythm Disorders • Arrhythmias are abnormal heart rhythms, i.e. rhythms that are not sinus – They can be fast or slow – They can be symptomatic or asymptomatic – They can benign or serious
  • Heart Rhythm Disorders • Common Questions – Are arrhythmias bad? – What can I do if I have an arrhythmia? – Do I have to do anything if I have an arrhythmia? – How do I know if I have an arrhythmia?
  • Heart Rhythm Disorders • Common Questions – Are arrhythmias bad? – What can I do if I have an arrhythmia? – Do I have to do anything if I have an arrhythmia? – How do I know if I have an arrhythmia?
  • Heart Rhythm Disorders • Not all arrhythmias cause palpitations • Not all palpitations are caused by arrhythmias
  • How do I know if I have anarrhythmia?
  • Heart Rhythm Disorders • EKG: 10 sec “snapshot” • Holter monitor: 24-48 hr • Event monitor: 1-4 weeks • Implantable loop recorder: 3 years
  • Heart Rhythm Disorders • An introduction to the normal electrical system of the heart, i.e. Sinus Rhythm • Ectopy (extra beats) • Bradycardias (slow heart rhythms) • Tachycardias (fast heart rhythms) • Q/A
  • Ectopy, aka extra beats PVCs / VPDs PACs / APDs
  • Ectopy, aka extra beats • Symptoms • Prognosis • Treatment
  • Ectopy, aka extra beats • Symptoms – “skipped beats” – Tired / fatigue
  • Ectopy, aka extra beats • Prognosis – VERY common; everyone has a few PACs and PVCs – Generally benign, though very frequent PVCs (when PVCs are over 20-25% of total beats) can cause weakening of the heart
  • Ectopy, aka extra beats • Treatment – Do nothing – Medicines – Procedures
  • Ectopy, aka extra beats • Treatment – Do nothing – Medicines: beta blockers and calcium channel blockers, though the side effects can sometimes be as bad or worse than the ectopy – Procedures: very effective if the ectopic beats can be located; the more ectopic beats, the easier to locate them
  • Heart Rhythm Disorders • An introduction to the normal electrical system of the heart, i.e. Sinus Rhythm • Ectopy (extra beats) • Bradycardias (slow heart rhythms) • Tachycardias (fast heart rhythms) • Q/A
  • Bradycardia, aka slow heartrhythms Sinus node dysfunction Sick sinus Heart block
  • Bradycardia, aka slow heartrhythms • Symptoms • Prognosis • Treatment
  • Bradycardia, aka slow heartrhythms • Symptoms – Tired / fatigue (worse with exercise) – Shortness of breath (worse with exercise) – Fainting / passing out
  • Bradycardia, aka slow heartrhythms • Prognosis • Treatment – Do nothing – Medicines – Procedures
  • Bradycardia, aka slow heartrhythms • Treatment – Do nothing – Medicines: stop medications that slow the heart rate – Procedures: pacemaker
  • Bradycardia, aka slow heartrhythms • Prognosis – Sinus node dysfunction: pacing improves symptoms, but does not prolong life – Heart block: pacing improves symptoms and prolongs life
  • Bradycardia, aka slow heartrhythms
  • Heart Rhythm Disorders • An introduction to the normal electrical system of the heart, i.e. Sinus Rhythm • Ectopy (extra beats) • Bradycardias (slow heart rhythms) • Tachycardias (fast heart rhythms) • Q/A
  • Tachycardia, aka fast heartrhythmsAtrial FibrillationAtrial FlutterAVNRTAVRTAtrial Tachycardia Ventricular Tachycardia Ventricular Fibrillation
  • SVTs (SupraventricularTachycardias)Atrial FibrillationAtrial FlutterAVNRTAVRTAtrial Tachycardia Ventricular Tachycardia Ventricular Fibrillation
  • SVTs (SupraventricularTachycardias) • Symptoms • Prognosis • Treatment
  • SVTs (SupraventricularTachycardias) • Symptoms – Palpitations, usually starts and stops abruptly – Sometimes with chest pain, shortness of breath, and lightheadedness – Fainting and passing out is rare
  • SVTs (SupraventricularTachycardias) • Prognosis – Generally very symptomatic, but benign
  • SVTs (SupraventricularTachycardias) • Treatment – Do nothing: sometimes coughing, Valsalva maneuvers can stop episodes – Medicines: adenosine given in the hospital can often stop episodes; beta blockers and calcium channel blockers to prevent episodes at home – Procedures: EP study and ablation
  • Tachycardia, aka fast heartrhythmsAtrial FibrillationAtrial FlutterAVNRTAVRTAtrial Tachycardia Ventricular Tachycardia Ventricular Fibrillation
  • Tachycardia, aka fast heartrhythmsAtrial FibrillationAtrial FlutterAVNRTAVRTAtrial Tachycardia Ventricular Tachycardia Ventricular Fibrillation
  • Atrial Fibrillation and Flutter • Symptoms • Prognosis • Treatment
  • Atrial Fibrillation and Flutter • Symptoms – Palpitations – Tired / fatigue – Shortness of breath
  • Atrial Fibrillation and Flutter • Prognosis – Increased risk of stroke in patients with other medical problems • Congestive heart failure • High blood pressure • Older patients • Diabetes • Prior strokes • Patients with previous heart stents • Women
  • Atrial Fibrillation and Flutter • Treatment – Blood thinners / aspirin to reduce risk of stroke – Rate Control • Beta blockers and calcium channel blockers to control heart rate • Ablate AV node and implant pacemaker – Rhythm Control • Antiarrhythmic drugs • Catheter Ablation
  • Atrial Fibrillation and Flutter • Catheter ablation success rates – Atrial flutter: 90% – Paroxysmal atrial fibrillation: 70-80% – Long persistent atrial fibrillation: <50% with most patients requiring multiple procedures • Ablation of atrial fibrillation has not been proven to reduce stroke risk, so generally need to continue blood thinners
  • Tachycardia, aka fast heartrhythmsAtrial FibrillationAtrial FlutterAVNRTAVRTAtrial Tachycardia Ventricular Tachycardia Ventricular Fibrillation
  • Sudden Cardiac DeathAtrial FibrillationAtrial FlutterAVNRTAVRTAtrial Tachycardia Ventricular Tachycardia Ventricular Fibrillation
  • Sudden Cardiac Death • Symptoms • Prognosis • Treatment
  • Sudden Cardiac Death • Symptoms – Cardiac arrest – Passing out without warning – But most people have no symptoms
  • Sudden Cardiac Death • Symptoms • Risk Factors • Prognosis • Treatment
  • Sudden Cardiac Death • Risk Factors – Cardiomyopathy – Ejection Fraction of 35% or less
  • Sudden Cardiac Death • Treatment – Do nothing – Medicines: heart failure medicines (beta blockers, ace inhibitors, statins) – Procedures: implantable defibrillator
  • Sudden Cardiac Death
  • Sudden Cardiac Death • Symptoms • Risk Factors • Prognosis • Treatment
  • Sudden Cardiac Death • Prognosis – One third of patients that meet criteria for ICD will die within 5 years – ICDs reduce the risk of death by over half
  • Hearth Rhythm Disorders • An introduction to the normal electrical system of the heart, i.e. Sinus Rhythm • Ectopy (extra beats) • Bradycardias (slow heart rhythms) • Tachycardias (fast heart rhythms) • Q/A
  • More Resources Find videos, handouts and more resources atwww.SpringfieldClinic.com/DoctorIsIn