Dealing with arrhythmia? Here are your treatment options at MedPark

Operating on a complex electrical system, the heart tirelessly pumps blood to sustain our lives. It coordinates every heartbeat with precision. However, disruptions to this rhythmic pattern can happen, and it’s called arrhythmia – an abnormal heartbeat. During an arrhythmia, the heartbeat can be too slow, too fast, or just irregular. While most arrhythmias are harmless, some can really impact your quality of life and even lead to life-threatening conditions. So, what should you do if you experience symptoms of arrhythmia? Can it be cured? We talked to Dr Sanisara, a cardiologist at MedPark Hospital Bangkok, to understand the most common types of arrhythmias, diagnostic techniques, and personalised treatment plans.

Common types of arrhythmias

Arrhythmias in the elderly

According to Dr Sanisara, the prevalence and type of arrhythmias often vary with age. “In the elderly population [people over 65 years old], the most common arrhythmia is atrial fibrillation (AF or afib),” she stated. Afib happens because the upper chambers of the heart beat extremely fast or irregularly. It can lead to poor blood flow. This condition is of particular concern because it increases the risk of stroke and heart failure. Dr Sanisara explained, “AF is associated with the formation of blood clots in the left atrial appendage, which can travel to the brain and cause a stroke.”

Other common types of arrhythmias in the elderly include different types of bradycardia and tachycardia. Bradycardia occurs because the heart beats too slowly, leading to insufficient blood supply to vital organs. In contrast, tachycardia is a type of arrhythmia where the heart beats too fast.

Arrhythmias in the young

Arrhythmias are less common in younger populations, but they can still occur and cause significant distress. Dr Sanisara noted that premature ventricular contractions (PVCs) and supraventricular tachycardia (SVT) are more prevalent among younger people.

PVCs are extra heartbeats that originate in the ventricles and disrupt the heart’s normal rhythm. If it happens frequently, itcan potentially lead to heart failure. SVT, on the other hand, involves a rapid heart rate originating above the heart’s ventricles and can occur suddenly, affecting daily activities and sleep. Though not typically life-threatening, SVT can significantly impact your quality of life.

How MedPark Hospital diagnose arrhythmias

MedPark Hospital uses various diagnostic methods to accurately identify and assess arrhythmias. Since arrhythmia doesn’t always cause symptoms, the diagnostic process starts with a thorough patient history and physical examination. Then, depending on the suspected type of arrhythmia, they utilise different diagnostic tools and techniques.

Electrocardiogram (ECG) and Holter monitoring

For many arrhythmias, an electrocardiogram (ECG) is the first-line diagnostic tool. An ECG records the electrical activity of the heart and can detect irregularities in heart rhythm. However, since some arrhythmias are intermittent, a single ECG might not capture them. In such cases, doctors at MedPark would recommend continuous monitoring using a Holter monitor.

A Holter monitor is a small device that patients wear for 24 hours or longer to record their heartbeat. This allows continuous monitoring of heart activity over an extended period. It provides insights into heart activity that may go undetected during a traditional ECG examination.

Advanced cardiac imaging and stress tests

In addition to ECG and Holter monitor, advanced cardiac imaging and stress tests are often used to provide further insights. Stress echocardiograms, which involve ultrasound imaging of the heart while the patient exercises, can help identify arrhythmias that occur during physical activity. These tests also evaluate the heart’s overall function and can detect underlying conditions such as coronary artery disease.

Electrophysiological studies

For more complex cases, electrophysiological (EP) studies are conducted. These invasive tests involve threading catheters through blood vessels into the heart to map its electrical activity. EP studies can pinpoint the exact location of abnormal electrical signals causing the arrhythmia. Dr. Sanisara explained that this detailed mapping is crucial for planning targeted treatments such as ablation.

Treatment options at MedPark Hospital

MedPark Hospital tailors treatment plans to each patient’s specific condition, symptoms, and overall health. Below are the available treatment options at the hospital.

Medications

Medications are often the first line of treatment for many arrhythmias. Antiarrhythmic drugs can help control heart rate and rhythm, while anticoagulants are prescribed to reduce the risk of stroke in patients with Afib.

Medications are also used in special cases. For example, Dr Sanisara had a 28-year-old pregnant patient who had SVT. This case is particularly challenging because pregnant patients require special consideration to ensure both the mother’s and the baby’s safety. Therefore, they used non-invasive monitoring and carefully selected medication that was safe during pregnancy to control her heart rate. The patient responded well to the treatment, and both she and the baby remained healthy throughout the pregnancy.

Electrical cardioversion and ablation

For patients with persistent or severe arrhythmias, electrical cardioversion may be recommended. This medical procedureuses low-energy shocks to restore a normal heart rhythm.

Another treatment is catheter ablation, which involves using radiofrequency energy (heat energy) or cryotherapy (cold energy) to destroy small areas of heart tissue that are causing the abnormal rhythm. The procedure requires inserting tools into the pulmonary vein, which connects to the left upper chamber of the heart, with the goal of disrupting abnormal electrical signals originating from this area. Dr. Sanisara explained, “Catheter ablation is particularly effective for treating AF and SVT, with a high success rate and low risk of complications.”

Implantable devices

In cases of bradycardia or heart block, implantable devices such as pacemakers or defibrillators are used. Pacemakers help maintain a regular heart rate by sending electrical impulses to the heart. Implantable cardioverter-defibrillators (ICDs) are devices that monitor heart rhythms and deliver shocks if a life-threatening arrhythmia is detected.

Recent advances and breakthroughs

Aside from the traditional treatment options, MedPark Hospital has also been implementing recent advancements. One notable innovation is the leadless pacemaker, a small device implanted directly into the heart without the need for wires (leads). This technology reduces the risk of complications associated with traditional pacemakers, such as infections and lead dislodgement. “The leadless pacemaker is especially beneficial for elderly patients or those with limited access points for traditional pacemaker leads,” she noted.

MedPark Hospital provides the highest standard of care using the latest technologies and personalised treatment plans tailored to each patient’s unique needs. This approach improves patients’ outcomes and enhances their quality of life.

If you or someone you know is dealing with arrhythmia, visit MedPark Hospital’s website today for further details and to book an appointment.

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