What to know about variable heart rhythms and AFib

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A lot of people have abnormal heart rhythms. The electrical system of the heart is a carefully coordinated dance with the natural pacemaker of the heart delivering electrical impulses to different chambers at appropriate time intervals.

Why seek treatment for an abnormal heart rhythm?

Abnormal heart rhythms that’re going to get you in trouble are usually accompanied by significant symptoms such as shortness of breath, fatigue, chest pains and light headedness. It’s important not to ignore those symptoms. Some patients might think the symptoms are due to a blockage, but they might be due to an abnormal heartbeat caused by an electrical problem.
 
Abnormal heart rhythms can cause you to pass out and they can even cause you to die suddenly.

What is atrial fibrillation?

Atrial fibrillation, or AFib, is an abnormal, rapid heart rhythm coming from the upper chambers of the heart. These abnormal rhythms increase your risk of stroke and heart failure. 

What are the symptoms of atrial fibrillation? 

The most common symptom is a rapid heartbeat that feels like fluttering in your chest, often accompanied by shortness of breath. You may have progressive fatigue and swelling in the legs. There are symptoms like passing out that are too obvious to ignore.  
 
With the rapid heart rate of AFib, the upper chambers of the heart beat so rapidly that blood doesn’t move around. This can cause stroke, and the heart can run too fast and result in heart failure.
 

What are other heart rhythm problems? 

Another fairly common diagnosis is bradycardia, which is a slower than normal heart rate. The hearts of adults at rest usually beat between 60 and 100 times a minute. If you have bradycardia, your heart beats fewer than 60 times a minute. Bradycardia can be a serious problem if the heart doesn't pump enough oxygen-rich blood throughout the body. There other abnormal heart rhythms such as ventricular tachycardia that generally have more severe symptoms and can be life threatening.

How is AFib diagnosed? 

A diagnosis of atrial fibrillation can be difficult. The biggest problem we see is that the symptoms are paroxysmal, in other words, they come and go. I compare it to taking your car to a mechanic because you keep hearing a noise and the car stops making the noise when you get to the mechanic. 
 
Sometimes the symptoms are from other causes, which makes diagnosis even more 
elusive. Monitoring is key. We have a variety of excellent monitors that can be worn and even some that are inserted under the skin. The types of monitors are improving, and we continue to use the best available equipment for our patients. 

How are abnormal heart rates managed?

Management of arrhythmia varies depending on the underlying cause and your individual needs. We have a variety of excellent medications to choose from in order to prevent stroke, for example. There are more invasive therapies like surgical ablation that may be appropriate. 
 
Even though a disease process may be similar, each patient requires a unique treatment. We consider every patient individually to determine the best disease treatment. You can’t always live longer, but treating abnormal heart rhythms can improve your quality of life. That’s the most rewarding thing for me as a doctor—the positive impact on my patients’ quality of life.
 
At The Ohio State University Wexner Medical Center, the types of therapies we’ve helped to develop have been expanded to treat people with the most difficult forms of abnormal heart rhythms. We work hand-in-hand with surgeons and heart failure specialists if the needs go beyond cardiac electrophysiology. We perform catheter ablation to fix AFib, ventricular tachycardia, super ventricular tachycardia, and also conduct unique procedures on the outside of the heart instead of just on the inside.  
 
We’ve also pioneered many new therapies that allow us to significantly increase the cure rate when it comes to these abnormal heart rhythms. Many of the newest devices were developed with people here at Ohio State.
 
John Hummel is a cardiac electrophysiologist at The Ohio State University Wexner Medical Center