Common Heart Rhythm Issues

Premature Ventricular Contractions (PVC’s)

Patients often describe to me their heart feels like it thumps, or skips a beat. When we use telemetry and monitor the heart

rhythm we often see PVC’s. Almost everyone will have these on occasion. When the heart is

recovering from an event they are also very common. We don’t worry about isolated PVC’s unless a person is having symptoms such as chest discomfort, fatigue, profuse sweating, feeling faint or other heart related symptoms.A PVC may be perceived as a “skipped beat” or felt as palpitations in the chest. In a normal heartbeat, the ventricles contract after the atria have helped to fill them by contracting; in this way the ventricles can pump a maximized amount of blood both to the lungs and to the rest of the body. In a PVC, the ventricles contract first, which means that circulation is inefficient. However, single beat PVC  do not usually pose a danger and can be asymptomatic in healthy individuals. A PVC may be perceived as a skipped heart beat, a strong beat, or a feeling of suction in the chest. They may also cause chest pain, a faint feeling, fatigue, after exercise. Several PVCs in a row 3 or more becomes a form of ventricular tachycardia (VT), which is a dangerous rapid heartbeat.

What Is Atrial Fibrillation?

Atrial fibrillation, is the most common type of irregular heart rhythm or arrhythmia. It occurs frequently following open heart surgery. Often patients will describe feeling slightly out of breath, or more weak. When they check their pulse they find it irregular, and often difficult to count the beats per minute as it speeds up and slows down.

AF occurs if rapid, disorganized electrical signals cause the heart’s two upper chambers—called the atria —to fibrillate. The term “fibrillate” means to contract very fast and irregularly.

In AF, blood pools in the atria. It isn’t pumped completely into the heart’s two lower chambers, called the ventricles. This pooled blood often can stick together and form clots, placing the person at a much higher risk of stroke.  People who have AF may not feel symptoms. However, even when AF isn’t noticed, it can increase the risk of stroke. In some people, AF can cause chest pain or heart failure, especially if the heart rhythm is very rapid As a result, the heart’s upper and lower chambers don’t work together as they should.

AF may happen rarely or every now and then, or it may become an ongoing or long-term heart problem that lasts for years.

The link below is from the National Heart Lung and Blood Institute which has a nice visual of what occurs with atrial fibrillation.

http://www.nhlbi.nih.gov/health/health-topics/topics/af/

If you suspect you are in atrial fibrillation it is very important you contact your doctor immediately. The first goal is to make sure the heart rate is not too fast. A resting heart rate in the 120’s or higher is too fast. The second goal of treatment is to make sure the blood is thin enough to prevent formation of clots, and lastly the physician will determine if the rhythm can be converted back to normal sinus rhythm.