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WHEN YOUR HEART BEATS TOO FAST …
Have you ever felt that your heart beats too fast , skipped a beat or having irregular heartbeats ? Very often your doctor may tell you that you have anxiety or “ it ’ s all in your head ”. They might be right , or you may have a cardiac condition called arrhythmias .
The term " arrhythmias " basically means heart rhythm disorders . When the heart doesn ' t beat properly in a synchronised manner , it can ' t pump blood effectively . When the heart doesn ' t pump blood effectively , the lack of blood flow to the brain and the heart itself can cause various associated symptoms like giddiness , fainting spells , chest pain and shortness of breath , on top of the most common symptom which is palpitation ( perception of fast or racing heartbeat ). Arrhythmias that are associated with fast heartbeat are called tachyarrhythmias .
Most patients with tachyarrhythmias can present with merely bothersome symptoms without any adverse consequences . On the other end , they may present with heart failure , stroke or even sudden death . Hence , anyone with symptoms of palpitation or its associated symptoms like giddiness , fainting spells or shortness of breath should get himself / herself a full cardiac assessment by cardiologists or electrophysiologists .
When someone is suspected to have tachyarrhythmias , the doctor will perform a comprehensive physical examination after a thorough history taking . Basic tests such as blood tests , electrocardiogram ( ECG ), echocardiogram ( ultrasound of the heart ) and exercise treadmill test ( stress test ) will be conducted . These tests can find out the possible cause of the tachyarrhythmias and also rule out the presence of structural heart disease which generally carries poorer prognosis to the patients . To capture the actual diagnosis of arrhythmias can be challenging . The ECG is able to capture the ongoing arrhythmias on the spot , but unable to do so for those that
Dr Koh Kok Wei Consultant Cardiologist
comes intermittently ( paroxysmal ). Portable or adhesive monitor devices can be used to detect these paroxysmal tachyarrhythmias over a period of days to weeks . In some circumstances , the electrophysiologists may perform a minimally invasive cardiac rhythm testing called cardiac electrophysiological study ( EP study ) to induce certain tachyarrhythmias so that curative therapy can be delivered effectively . Most of the EP study procedures are conducted in awake condition with no or mild sedation .
Common examples of tachyarrhythmias are supraventricular tachycardia ( SVT ), atrial tachycardia , atrial flutter , atrial fibrillation and ventricular tachycardia . The good news is , all of these can be controlled with medications . Majority of the common tachyarrhythmias can even be cured by catheter ablation . With the current technologies , catheter ablative therapy can be performed with high success rate and low potential side effects / risks .