Diagnosis And Prognosis Of Abnormal Heart Rhythms (Heart arrhythmia)

Arrhythmia can often be diagnosed from the symptoms described by the patients. Doctors try to determine the type of arrhythmia from these observations:

  • whether palpitations are felt by the patient,
  • whether the rhythm is slow, fast, or irregular,
  • whether they last for a long time or resolve in a short period,
  • whether they precipitate symptoms or worsen the symptoms of heart failure,
  • whether they are felt only during exertion or even at rest,
  • whether they appear and disappear suddenly or over a period of time

In spite of the fairly good picture doctors can obtain from these facts, certain tests are required to identify the exact causes and effects.

Since, faulty electrical activity is the main cause of arrhythmias; Electrocardiography (ECG) is an ideal diagnostic test for this condition. The electrical current involved in each heartbeat is graphically recorded during this procedure so that cardiologists can easily observe abnormal patterns in the heartbeats and correlate them to the abnormalities they indicate.

Since the duration of an electrocardiography test is limited, it may not be possible to assess arrhythmias that appear and disappear intermittently and the result of a single ECG may be misleading. To overcome this possibility, a compact, portable, ECG machine called Holter monitor can be used to monitor and record the electrical activity over an extended period of time. Usually, for a 24-hour observation period the device would be worn, as the patients go about performing their day to day activities keeping a record of the time of each activity as well as the symptoms they felt while doing it. The incidence of arrhythmia can be compared with the activity performed at that time, to arrive at conclusions.

To observe arrhythmias that are infrequent, a small device, to record the electrical activity over a longer period of time, is implanted in the chest. This device can keep transmitting the recorded data across the skin, which doctors can use to make the correct diagnosis.

Hospitalization for continuous monitoring and recording of the heart rhythm is often the only option for critically ill people with potentially fatal arrhythmias, as prompt identification of any sudden development of a serious nature can be immediately recognized and attended to.

Exercise stress testing (ECG) and measuring blood pressure while doing the exercise is also a diagnostic procedure often employed. Another useful diagnostic method is electrophysiologic testing with a minimally invasive catheterization procedure which can determine the type of arrhythmia and its treatment options. In this test, electrodes are attached to the tip of the catheters introduced into the heart, to deliver electric impulses to stimulate the heart so that the response of the heart to such stimuli can be studied.

Prognosis

Arrhythmias are often a cause of great anxiety when awareness of heart beats or palpitations are felt. Unless arrhythmia interferes with and impairs the pumping action of the heart; reducing blood flow, it is often considered harmless. However, in some cases, harmless arrhythmias may lead to serious arrhythmias. The origin of the irregularity is an important factor in determining the seriousness of the condition. Arrhythmias starting in the natural pacemaker of the heart (sinoatrial node) are less serious than those having their origin at a lower point in the electrical pathway. Arrhythmias that start in the ventricles of the heart are the most critical.

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Yasser Elnahas

MD, PHD, Professor Of CardioVascular Surgery
Dr. Yasser Elnahas, Is an associate Professor of Cardiovascular Surgery. Dr. Elnahas was trained as a fellow At Texas Heart Institute And Mayo Clinic Foundation.Dr. Elnahas is dedicated to educating the general public about different disease conditions and simplifying the medical knowledge in an easy to understand terminology.

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