Arrhythmia: Keeping Pace With What To Do

June 25, 2020
Not only keeping pace but at the forefront as a cardiac hub is Bumrungrad International Hospital, a leading light in this field. The Arrhythmia Centre combines pioneering tech advancements in medicine, ground-breaking research and world-class specialist expertise.
While millions experience abnormal heart rhythms, the positive news is that once diagnosed, and with the right management plan, most people can carry on with their normal lives. However, undetected, arrhythmia can be life-threatening, causing cardiac arrest and increasing the risk of stroke, in some cases, by five times.

Innovative Insights

One innovative diagnostic tool is the CardioInsight, the only non-invasive ECG-based technology in the world. It was introduced to The Arrhythmia Centre by the hospital’s world-renowned electrophysiologist, Prof. Dr. Koonlawee Nadamanee in 2017. Bumrungrad International Hospital was one of the first hospitals in the world to adopt this incredible cardiac mapping tool, and certainly the first hospital in Asia.
FDA-approved, CardioInsight provides physicians with information about the cause and behavior of cardiac arrhythmia. The high-tech vest provides 3-D maps of heart-cell issues, without any invasive procedure, offering a greater advantage than traditional EKG’s which cannot create the same level of anatomical data. It also means potentially avoiding having to undergo a traditional electrophysiology study (EPS) which utilizes a catheter.

Diagnosing Arrhythmia

Arrhythmias fall into several types, including heart block and bradycardia which manifest as lower than normal heartbeats, while supraventricular tachycardia entails an abnormally fast heart rate. Resulting in a faster than normal and irregular beat, atrial fibrillation (AF) is the most common type of arrhythmia. An ECG is often the first go-to when diagnosing a condition, with more in-depth tools available such as an echocardiogram which involves taking an ultrasound scan of the heart.
An EPS involves locating electrical activity problems via diagnostic catheters inserted into a vein in the groin and in some cases stimulating a reaction. This aims to determine the cause and discover the most appropriate treatment, including identifying those patients with an increased risk of cardiac attack. The procedure is usually carried out with a mild sedative and local anesthetic in a hospital lab setting.
Meanwhile, a Holter Monitor is a portable ECG device that records the electrical system over a 24 hour or longer period. For sporadic arrhythmia, an event recorder or an implantable loop recorder can be used to capture abnormalities as they occur. Creating stress, such as exercising the body or mimicking this through drugs with a Dobutamine Stress Echocardiogram (DSE), speeds up the heart rate. This potentially helps monitor whether a condition is linked to coronary artery disease. Meanwhile, a tilt table test can also reveal how the heart reacts to different postures from lying down to a standing up position.
An abnormal heartbeat can lead to palpitations, shortness of breath and fainting fits, as well as dizziness. However these symptoms are not exclusive to this condition, further highlighting the need for conclusive investigation and a strong treatment and management strategy.

Treatment Options

Bumrungrad International Hospital’s advanced CardioInsight mapping is noteworthy as successful diagnostic details are key to identifying the best treatment and management. For example, in AF cases cardiac ablations involve destroying tissue, through heat and cold sources, that is causing the heart to beat abnormally. However, being able to accurately pinpoint those problematic cells is the crucial factor, with a non-invasive, cutting-edge tech tool able to offer that solution.
Other treatments range from medication through to surgery, as well as fitting pacemakers to regulate the heartbeat through electrical impulses. Another option might be an ICD, an implantable device that defibrillates and paces the heart to correct the arrhythmia. Meanwhile, cardioversion uses electricity to create a shock that results in the heart being jolted into a normal rhythm and is carried out under sedation or anesthesia.

Successful Management

Managing a manageable condition such as arrhythmia is really about understanding the root cause as well as any exacerbating factors. An unhealthy lifestyle, such as high alcohol intake and a diet that leads to weight gain can contribute to the development of AF, as can using tobacco, low exercise levels and consuming caffeinated drinks.
While it is more common in older people, AF can impact all ages and can also be caused by damage to the heart tissue through illnesses ranging from viruses to heart failure. Certain medications and drug abuse can also play a role in the development of arrhythmia. While it may be difficult to prevent this condition, preventing triggers is part of successful management when looking at reducing future abnormality events.

Blood-thinning medication may be prescribed for AF, while some prescriptions are focused on controlling the heart rate. Individuals with fast heartbeats may be advised by their consultant on how to take control through actions such as coughing, breath-holding and dunking their face in iced-water.

The Arrhythmia Centre at Bumrungrad International Hospital’s has an outstanding reputation on a global scale. Experts work with patients across a multi-disciplinary level, focused on creating sustainable, manageable solutions that put patient-care at heart.

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