Cleveland Clinic Heart Vascular & Thoracic Institute Cardiologists And Surgeons
Choosing a doctor to treat your abnormal heart rhythm depends on where you are in your diagnosis and treatment. The following Heart, Vascular & Thoracic Institute Sections and Departments treat patients with Arrhythmias:
- Section of Electrophysiology and Pacing: cardiology evaluation for medical management or electrophysiology procedures or devices – Call Cardiology Appointments at toll-free 800.223.2273, extension 4-6697 or request an appointment online.
- Department of Thoracic and Cardiovascular Surgery: surgery evaluation for surgical treatment for atrial fibrillation, epicardial lead placement, and in some cases if necessary, lead and device implantation and removal. For more information, please contact us.
What Is Considered A Dangerously High Heart Rate
A normal heart rate in a healthy adult range from 60 to 80 beats per minute at rest, Infants and children has higher heart rates than adults in the normal state. The heart rate can rise during exercise, running, high fever, flu, excitement, consumption of nicotine or caffeine, surgical operations, and treatment procedures. When heart rate in adults exceeds 100 beats per minute at rest, then the condition is called tachycardia which has a pathological reason behind. It becomes extremely dangerous for the patient as it may cause heart failure, cardiac arrest, and even death.
How Are Arrhythmias Treated
Many arrhythmias don’t need treatment. For those that do, these options might be used:
- Medicines. Many types of prescription anti-arrhythmic medicines are available to treat arrhythmia. Sometimes, these can increase symptoms and cause side effects, so the patient will be closely watched by the doctor.
- Pacemakers. A pacemaker is a small battery-operated device implanted into the body through a surgical procedure. Connected to the heart by a wire, a pacemaker can detect if the heart rate is too slow and send electrical signals to speed up the heartbeat.
- Defibrillators. A small battery-operated implantable cardioverter defibrillator is surgically placed near the left collarbone. Wires run from the defibrillator to the heart. The ICD senses if the heart has a dangerously fast or irregular rhythm and sends an electrical signal to restore a normal heartbeat.
- Catheter ablation. A catheter is guided through a vein in the leg to the heart. Arrhythmias often are caused by microscopic defects in the heart muscle. Once the problem area of the heart is pinpointed, the catheter heats or freezes the defective muscle cells and destroys them.
- Surgery. Surgery is usually the treatment recommended only if all other options have failed. In this case, a person is put under anesthesia and a surgeon removes the tissue causing the arrhythmia.
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Start With Resting Heart Rate
You should test your resting heart rate before measuring your training heart rate. The best time to test your resting heart rate is first thing in the morning, before youve gotten out of bed ideally after a good nights sleep.
Using the technique described above, determine your resting heart rate and record this number to share with your doctor. You might try checking your resting heart rate for a few days in a row to confirm that your measurement is accurate.
According to the American Heart Association , the average resting heart rate is between 60 and 100 beats per minute. However, this number may rise with age and is usually lower for people with higher physical fitness levels. The AHA notes that physically active people, such as athletes, may have a resting heart rate as low as 40 beats per minute.
Svt Symptoms Causes And Diagnosis
Some patients with SVT, which generally first arises in people in their teens and 20s, may have no symptoms, going in and out of the arrhythmia quickly. Others have symptoms, such as palpitations, a racing heart, sweating and feeling lightheaded or dizzy. SVT can become a problem requiring treatment if it lasts a long time or causes shortness of breath or chest pain.
Though most episodes of SVT are caused by the hearts electrical system, other causes include certain drugs, health conditions, surgery and familial disorders, such as Wolff-Parkinson-White syndrome.
SVT can be diagnosed by your doctor through a physical exam and questions about what triggers your fast or irregular heart rate. Tests include X-rays or an electrocardiogram to measure the hearts electrical activity and record SVT events. You may have to temporarily wear a portable EKG to pick up events as they occur.
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What’s A Normal Heart Rate
Heart rate is measured by counting the number of beats per minute. Someone’s normal heart rate depends on things like the person’s age and whether he or she leads an active lifestyle.
The resting heart rate decreases as people get older. Typical normal resting heart rate ranges are:
- babies : 100150 beats per minute
- kids 13 years old: 70110 beats per minute
- kids by age 12: 5585 beats per minute
A doctor can determine whether a heart rate is too fast or slow, since the significance of an abnormal heart rate depends on the situation. For example, a teen or adult with a slow heart rate might begin to show symptoms when the heart rate drops below 50 beats per minute. But trained athletes have a lower resting heart rate, so a slow heart rate in them isn’t considered abnormal if it causes no symptoms.
How Is It Treated
If you have tachycardia, your treatment team will work with you to offer appropriate treatment options that can restore your heart to normal rhythm, regulate your heart rate and prevent blood clots.
Your treatment will depend on the specific type of tachycardia you have and may include:
- Medication. Your doctor may prescribe drugs alone or in combination with other treatments. You may need a medicine that slows your heart rate, restores normal rhythm, prevents blood clots or thins your blood.
- Implantable cardioverter defibrillator . If youre diagnosed with ventricular tachycardia, your doctor may recommend an implantable cardioverter defibrillator. This small device monitors your hearts rhythm and delivers bursts of electrical energy to restore a normal heart rhythm.
- Catheter radiofrequency ablation. In cardiac catheter ablation you get a mild sedative and a local anesthetic. Then your doctor threads thin, flexible tubes through your blood vessels. Radiofrequency energy given through the catheter removes abnormal tissue.
- Open-heart maze procedure. If you have atrial fibrillationthe most common kind of tachycardiayour doctor may recommend a maze procedure to regulate your heartbeat.
- Follow-up care. If youre recovering from heart surgery or medical device implantation, your doctor may recommend cardiac rehabilitation. Cardiac rehabilitation consists of monitored exercise sessions during your recovery period.
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What Are The Symptoms Of Arrhythmia
Some patients have no associated symptoms with arrhythmia, while others may notice symptoms but not have a life-threatening arrhythmia. It is important to have regular check-ups with your GP, especially if you are concerned.
Common symptoms of a heart arrhythmia include:
- Fluttering feeling in the chest
- Racing heartbeat
- Alternative medicine including yoga, meditation or relaxation techniques
Treatment for abnormally fast heart rhythms
Generally, patients with abnormally fast heart rhythms can be treated with drugs that slow the heart rate or may be treated with a procedure, known as catheter ablation. This involves passing a catheter up through a vein into the heart and burning away the small regions of the heart that are causing the arrhythmia.
Treatment for abnormally slow heart rhythms
Patients with abnormally slow heart rates are most effectively treated with an electronic pacemaker which sends regular electrical signals to the heart to ensure that it beats at a normal rate.
How To Check Your Heart Rate
You can check your heart rate by counting the pulse. A pulse can be felt at various sites on the body like over the sides of the neck, the wrist, and the top of the foot. To check your pulse on the wrist with the help of your middle finger and index finger, you need to:
- Keep your middle finger and your index finger over the inner part of the wrist and keep pressing gently until you can feel your pulse. The pulse is felt in your radial artery.
- After you have located your pulse, look at the watch, and start counting the beats for 30 seconds. Doubling this count will give you your heart rate. You can even count the beats for 10 seconds and multiply the number by six to get your heart rate.
If you find the rhythm of your heartbeat slightly irregular, you will have to count the beats completely until 60 seconds. You will have to visit your doctor if you keep getting a fast and irregular heart rate consistently.
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Normal Resting Heart Rate For Kids
Childrens heart rates are normally faster than those of adults. According to Cleveland Clinic, the normal resting heart rate for a child aged six to 15 is between 70 to 100 beats per minute.
Many factors can affect your resting heart rate, including your level of physical activity. In fact, highly trained athletes can have a resting heart rate of around 40 beats per minute!
Other factors that can affect resting heart rate include:
- Age. You may find that your resting heart rate decreases as you get older.
- Temperature. Your heart rate may increase slightly when youre exposed to hot temperatures.
- Medication side effects. For example, medications such as beta-blockers can lower your resting heart rate.
- Emotions. If youre anxious or excited, your heart rate may increase.
- Weight. People who are obese may have a higher resting heart rate. This is because the heart has to work harder to supply the body with blood.
- Body positioning. Heart rate can increase temporarily when you move from a sitting to a standing position
- Smoking. Smokers tend to have a higher resting heart rate. Quitting smoking can help bring it back down.
What Causes Ventricular Tachycardia
Your heart rate is controlled by electrical signals that move across the heart muscle. When something goes wrong and signals are sent too quickly, it can cause tachycardia. Most patients with ventricular tachycardia have another heart problem, such as coronary artery disease, high blood pressure, an enlarged heart or heart valve disease. The condition can also develop after a heart attack or heart surgery because of scar tissue that forms on the heart. Other, non-heart-related causes of ventricular tachycardia include some medications, an imbalance in electrolytes , too much caffeine or alcohol, recreational drugs, exercise, and certain genetically transmitted conditions. Sometimes the cause is unknown. You are also more likely to have ventricular tachycardia as you get older or if you have a family history of heart rhythm disorders.
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Tachycardia: Causes Symptoms And Treatment
Tachycardia is the medical term to describe a fast heartbeat. Heart rate varies from person to person and during different activities and times of day. For diagnosing fast and slow heart rates, doctors look at heartbeats while at rest. Any heart rate above 100 BPM at rest is considered faster than normal.
There are several different types of tachycardia, which are categorized and defined by what causes them. Recommended treatment of tachycardia varies based on the root cause.
What Are The Long
The outlook for children with SVT is excellent. The problem is usually not life- threatening and there are safe and effective treatments available. Exercise guidelines: Exercise guidelines are best made by a patient’s doctor so that all relevant factors can be included. Usually no activity restrictions are necessary for children with SVT and the child may participate in all physical activities including competitive athletics. If an episode occurs during competition, the child should remove himself from participation until the arrhythmia is converted. Also, activities that involve climbing or heights should be avoided since an episode may cause dizziness leading to a fall. See the section on Wolff-Parkinson-White syndrome for exercise information specific to this sub-type.
References
Dick M., O’Connor B, Serwer G, LeRoy S, Armstrong B. Use of radiofrequency energy to ablate accessory connections in children. Circulation 1991 84:2318-24. LeRoy S. & Dick M. Supraventricular tachycardia. In Zeigler VL & Gillette P, eds. Practical management of pediatric cardiac arrhythmias. Armonk, NY: Futura Publishing Co. 2001: 53-109. Weindling SN, Saul JP & Walsh EP. Efficacy and risks of medical therapy for supraventricular tachycadia in neonates and infants. Am Heart J 1996 131:66.Written by: S. LeRoy RN, MSN, CPNP. Reviewed by: M. Dick, MD, Peter Fischbach Reviewed September, 2012
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What To Expect At The Doctors
Your doctor may use a variety of diagnostic tools to help diagnose your condition, including:
- Electrocardiogram. Also referred to as an ECG or EKG, this diagnostic tool uses small electrodes to record the electrical activity of your heart. Your doctor can use the information collected to determine if heart abnormalities are contributing to your condition.
- Imaging tests. Imaging can be used to assess if there are any structural abnormalities in your heart that may be contributing to your condition. Possible imaging tests can include echocardiogram, CT scan, and MRI scan.
- Laboratory tests. Your doctor may order blood tests to determine if your condition is caused by something such as an electrolyte imbalance or thyroid disease.
Once a diagnosis is made, your doctor will work with you to develop a plan to treat and manage your condition.
Depending on the findings from the diagnostic tests, your doctor may refer you to a cardiologist. A cardiologist specializes in treating and preventing diseases of the heart and circulatory system.
What Are The Types Of Tachycardia
There are 3 types of tachycardia.
- Supraventricular where problems with the electrical signals in the upper chambers of the heart cause the heart to beat faster. This reduces blood flow to the rest of your body because your heart can’t pump blood as effectively. Two common types of supraventricular tachycardia are atrial flutter and atrial fibrillation.
- Ventricular where problems with the electrical signals in the lower chambers of the heart cause the heart to beat faster. This affects its ability to pump blood to the rest of your body.
- Sinus tachycardia where the natural pacemaker in your heart sends electrical signals faster than normal. This can be in response to a stressor described below, or it can be a sign of anaemia, problems with the thyroid gland or general ill health.
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How Is Paroxysmal Supraventricular Tachycardia Diagnosed
If you have an episode of fast heartbeats during an examination, your doctor will be able to measure your heart rate. If its very high, they may suspect PSVT.
To diagnose PSVT, your doctor will order an electrocardiogram . This is an electrical tracing of the heart. It can help determine which type of rhythm problem is causing your fast heart rate. PSVT is only one of many causes of abnormally fast heartbeats. Your doctor will also likely order an echocardiogram, or ultrasound of the heart, to evaluate the size, movement, and structure of your heart.
If you have an abnormal heart rhythm or rate, your doctor may refer you to a specialist who is an expert in electrical problems of the heart. They are known as electrophysiologists or EP cardiologists. They may perform an electrophysiology study . This will involve threading wires through a vein in your groin and up into your heart. This will allow your doctor to evaluate your hearts rhythm by checking the electrical pathways of your heart.
Your doctor may also monitor your heart rate over a period of time. In this case, you may wear a Holter monitor for 24 hours or longer. During that time, youll have sensors attached to your chest and will wear a small device that records your heart rate. Your doctor will assess the recordings to determine if you have PSVT or some other type of abnormal rhythm.
How The Heart Works
The heart has two upper chambers and two lower chambers .
The atria and ventricles have walls of muscle. A heartbeat happens when this muscle suddenly contracts so that the chambers become smaller and the blood inside is squeezed out.
The control of the heartbeat starts with a small clump of cells in the right atrium, called the sinoatrial node . This sends out electrical impulses through the atrial muscle to another clump of cells called the atrioventricular node, found between the atria and ventricles. The impulse then continues through the AV node down fibres that conduct the impulse into the muscle of the ventricles.
The AV node determines the rate of contraction of the ventricles. The pulse felt at the wrist is due to the contraction of the ventricles.
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What Are The Symptoms Of Ventricular Tachycardia
During an episode of ventricular tachycardia, the heart is beating so fast that the blood pressure drops so the heart cannot pump enough oxygen to every part of the body, and this is what causes symptoms. Although some people with ventricular tachycardia do not experience any symptoms, the most common symptoms are dizziness, lightheadedness, palpitations, shortness of breath or chest pain. When the heart rate is extremely high or the ventricular tachycardia persists for more than a few seconds, it can cause fainting, unconsciousness or cardiac arrest and death. If you experience unexplained fainting, dizziness, lightheadedness, shortness of breath or palpitations, you should be evaluated for possible ventricular tachycardia. Chest pain, difficulty breathing and a rapid pulse are urgent symptoms of a potentially fatal ventricular tachycardia, and you must seek emergency help immediately to avoid the risk of cardiac arrest and death.
What Does Fetal Tachycardia Indicate
Fetal tachyarrhythmia is an abnormally fast fetal heart rate. In some cases the fast heartbeat may also have an irregular rhythm. Tachyarrhythmia is one of several types of fetal cardiac arrhythmias, congenital heart conditions involving an abnormal heartbeat. The condition is also sometimes referred to as tachycardia.
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