Unlike what popular media portrays, palpitations are not always a result of shock or distress from winning a lottery or seeing your kid’s poor report card. It could be due to a medical condition called arrhythmia of the heart…

Arrhythmia is defined as irregular heart beat which can be either faster or slower than normal. Each year, millions of people are affected by arrhythmias, most of which are treatable and are not life- threatening. However, some arrhythmias can be dangerous and even cause sudden death. Early diagnosis and treatment can help decrease deaths and discomfort from arrhythmias.

What causes Arrhythmia?

The heart has a ‘natural pacemaker’ called the Sinus Node, located in the right upper chamber. This generates the electrical impulses that regulate the heart beat. A normal heart rate for an adult is between 60 to 100 beats per minute. Another area at the centre of heart called Atrio-Ventricular Node (AV) manages the electrical impulse from atrium to ventricles (lower pumping chambers of the heart). Arrhythmia occurs when the AV node fails to conduct the impulse appropriately, causing the heart to beat either too fast or too slowly.

Faster or Slower?

Fast heart rate – of over 100 beats per minute is called Tachycardia. Slow heart rate – of less than 60 beats a minute is called Bradycardia. Either of these will cause you to experience symptoms like palpitations (where you will feel your heart hammering in your chest), palpitations accompanied by chest pain, frequent spells of giddiness and breathlessness.

A Permanent Cure

Tachycardia can be treated with medication. But these rate-lowering drugs control rather than cure and have side effects like low heart rate and excessive fatigue. Recently a new and more effective cure has emerged called Radio Frequency Ablation (RFA).

In this procedure the heart’s electrical activity is mapped by placing a special catheter in the heart through the vein in the leg, to detect the source of an arrhythmia. If a specific area is identified, then radio waves are emitted from the tip of the heart catheter to destroy the tissue causing the arrhythmia. Using latest technology like 3D Mapping, this one-time procedure can be done in 30 minutes to an hour.

Avoiding ‘Sudden Death’

Some arrhythmias like Ventricular Tachycardia are life threatening and can cause sudden death. If detected in time, Automatic implantable defibrillators (AICD) are implanted like pacemakers, which can quickly detect an arrhythmia and convert it to normal rhythm. RFA is also offered in some cases. Pacemaker implantation is also the only treatment recommended for Bradycardia or “slow heart rate” which is usually caused by sinus node dysfunction or AV nodal block.

The ‘Magic’ of RFA.

Much to his embarrassment Sriram, a high school student, found himself fainting frequently. With his Std 12 exams around the corner, his anxious parents took him for a series of tests. He was diagnosed with arrhythmia of the heart and put on rate controlling drug. For a while he seemed better and began preparing for his exams with gusto.

Unfortunately one day, right after his Physics paper, Sriram blacked out again. The search of a solution finally brought him to MIOT. When the Electro Physiologists at MIOT saw Sriram’s ECG they understood why the medication did not work. His was no ordinary arrhythmia but the deadly ventricular tachycardia that could cause sudden death!

Luckily the hospital has a sophisticated Electro Physiology Lab, where with 3D Mapping they isolated the area causing Sriram’s arrhythmia.

Sriram was offered the latest treatment

  • Radio Frequency Ablation. Under sedation a catheter was inserted through a vein in his groin and threaded to the chambers in his heart. Using radio waves the tissue causing the arrhythmia was destroyed. Just to make sure, the doctors tried provoking the arrhythmia again but he remained stable.

Within a few hours, with a one-time, non-invasive procedure Sriram went from being under threat of sudden death to a carefree student, cured for life!

Dr. K. J. Prem Kumar,
M.D.D.M. FIEP.,
Interventional Cardiologist & Electro Physiologist

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