A bradycardia is an unusually sluggish heart rhythm. An arrhythmia is an irregular heartbeat. An issue with your heart's electrical system leads to arrhythmias.

The normal heart rate ranges from 60 to 100 beats per minute. Your heart rate is less than 60 beats per minute if you have bradycardia. Less blood is pumped to your body by your heart when its beat slower. If your heart beats too slowly, your body might not receive enough blood flow or oxygen to perform at its best.

Bradycardia is also known as bradyarrhythmia.

What is the cause of Bradycardia?

An issue with your heart's electrical system results in bradycardia. The sinoatrial node, your heart's natural pacemaker, might not produce enough electrical signals in some situations. Sometimes an electrical signal does not follow the usual paths. Visit the Heart and Blood Vessel Basics section to discover more about your heart's electrical system.

The underlying cause of bradycardia, however, differs from person to person. There are times when doctors are unable to determine the cause. Sometimes bradycardia is brought on by aging, drugs, or an underlying heart condition.

What are the symptoms?

Bradycardia has no symptoms in most cases. Some individuals might experience:.

• Weakness.
• Breathing difficulties.
• Feeling lightheaded or dizzy.
• Chest ache.
• Unrest during sleep.
• Palpitations (the sensation that your heart is beating rapidly or irregularly).

Even simple tasks like walking to the mailbox or climbing a few stairs can cause symptoms like shortness of breath. Bradycardia typically causes a slow onset of symptoms. Sometimes, instead of a heart condition, people believe the symptoms are caused by aging.

What tests could I have?

Your doctor may recommend one or more of the tests below to determine whether you have bradycardia. Your doctor may select the optimal course of treatment for you based on the test results as well.

You might occasionally be referred to specialists for treatment as well as testing and diagnosis in certain situations. Visit the section on Your Treatment Team to find out more.

1. cardiac echo.

2. Electrocardiogram, also known as an EKG.

Three. Examining electrophysiology (EP).

4. Watch Holter.

5. Test of Stress.

Echocardiogram

What is an echocardiogram?

An echocardiogram, sometimes referred to as an echo, is a moving, three-dimensional picture of your heart. Doppler ultrasonography is employed in an echo. It resembles the ultrasound examination that expectant mothers undergo. People cannot hear the sound waves emitted by the echo machina because of their frequency. Through the heart and over the chest, the waves travel. When the waves "echo" or reflect off the heart, they display:

The dimensions and form of your heart.

The efficiency of the heart valves.

the efficiency of the heart's chamber contractions.

how much blood your heart pumps out with each beat, or the ejection fraction (EF).

What can I expect?

You undress up to your waist for an echocardiogram, don a hospital gown, and lie on a table. To help transmit the sound waves, the technician applies gel to your side and chest. A transducer, which resembles a pen, is then moved around on your side or chest by the technician. The echoes of the sound waves are captured by the transducer. On a special monitor, a moving image of your heart is displayed concurrently. Depending on where you are in the test, you might be instructed to lie on your back or your side. In order for the technician to get a clear picture of your heart, you might also be asked to briefly hold your breath. An echo test is a painless procedure. Only slight pressure is applied to your skin as the transducer oscillates.

Electrocardiogram (ECG or EKG)

What is an ECG?

How well your heart's electrical system is functioning can be seen on an electrocardiogram, or EKG. Your cardiac rhythms, or heartbeats, are detected and recorded by the ECG. A strip of paper bearing the results is printed on. Also useful to your doctor is an ECG.

assess if:

1. It's arrhythmias.

2. It's working, your heart medication.

3. Blood and oxygen are being denied to your heart muscle due to blocked coronary arterias.

4. A heart attack is the result of blocked coronary arteries.

There are three types of tests in total that capture the electrical activity of your heart, each for a distinct amount of time:.

performed in the physician's office: an electrocardiogram (ECG). It captures your heartbeats for a short while.

For a period of 24 to 48 hours, Holter monitoring captures and stores (in its memory) every heartbeat.

Event recorder: continuously captures your heartbeats. However, only when a button is pressed does it store the rhythms (in its memory).

What are the parts of an ECG strip?

Waves are the peaks seen on an electrocardiogram (ECG) strip. When combined, the peaks and valleys provide crucial information to your doctor about the health of your heart.

1. Your heart's upper chambers, or atria, are seen contracting in the P-wave.

2. Your heart's ventricles, or lower chambers, contract as seen by the QRS complex.

Three. The T-wave displays the ventricles in your heart contracting.

What can I expect?

You take off your clothes up to your waist, put on a hospital gown, and lie on a table for an electrocardiogram (ECG). Your chest, neck, arms, and legs may receive as many as 12 electrode patches. The electrodes on the ECG machine sense the electrical signals coming from the heart. The machina then plots the beat of your heart on a strip of graph paper.

Electrophysiology (EP) Study

What is an EP study?

A test of your heart's electrical system is called an electrophysiology (EP) study. The EP study provides a more detailed look at your heart's electrical system than an electrocardiogram (ECG) does. The test aids in the discovery of information regarding arrhythmias, or abnormal heart rhythms. The EP study can show:.

1. If an arrhythmia affects you.

2. the reason for the arrhythmia.

3. where in the heart the arrhythmia first manifests.

4. If you're in danger of suffering a sudden cardiac arrest (SC).

5. An arrhythmia's best course of action.

An EP study begins with the insertion of one or more leads into a blood vessel, typically in the groin. The doctor "steers" the leads gently in the direction of your heart. The leads detect electrical activity in your heart once they are in position. Additionally, a special lead sends electrical impulses to your heart to cause an arrhythmia. This will enable researchers to determine how readily your heart can generate arrhythmias on its own.

Your doctor keeps a close eye on your heartbeat throughout the EP study. If an arrhythmia develops, the physician will:.

1. medications administered via an intravenous (IV) line in your arm or hand.

2. Patches transmit electrical signals to the outside of your chest.

In some circumstances, your EP study and an ablation (a type of treatment) are carried out concurrently. (In the section on medications and procedures, under the heading "Procedures," you can find information on ablation. Or, following the EP study, your doctor might recommend different kinds of therapy.

What can I expect?

A "cath lab" will be used to administer your test. You undress, put on a hospital gown or sheet, and then lie on an examination table. Throughout the test, fluids and medications are given through an intravenous (IV) line that is implanted into your arm. You become sleepy but not unconscious as a result of the medication. On your chest, electrode patches are applied. Throughout the test, the electrodes keep an eye on the electrical signals coming from your heart. Frequently, your blood pressure is also taken using a blood pressure cuff on your arm.

For the catheter, the doctor makes a tiny incision, typically in the groin. Since the groin area will be numb, you shouldn't experience any pain during catheter insertion, but you might feel some pressure. Your heart may race or pound if the doctor sends electrical signals to your heart. Because you won't be sound asleep during the test, your doctor or nurse may quiz you.

The majority of people recover fairly quickly, though you might spend the night in the hospital afterward.

Holter Monitoring

What is Holter monitoring?

A small recording device known as a Holter monitor is used in Holter monitoring. The monitor typically records and tracks the electrical activity of your heart for a period of 24 to 48 hours.

If your doctor suspects that you have arrhythmias, or irregular heart rhythms, Holter monitoring may be able to help. Though they may occur infrequently, arrhythmias are nevertheless something your doctor should be aware of and treat.

All told, there are three types of tests that capture the electrical activity of your heart, each with a distinct time frame:.

• ECG: performed at the physician's office. For a few minutes, it records the rhythms of your heart.
• Holter monitoring captures, logs, and retains (in its memory) every heartbeat for a duration of 24 to 48 hours.
• Your heart rhythms are continuously monitored by the event recorder. However, it only saves the rhythms (in its memory) in response to button pushes.

The heart rhythms obtained from all three tests have the same appearance when printed out: peaks and valleys in the electrical signals. In cases where symptoms occur at least once a day or twice a week, a doctor might advise Holter monitoring.

If you experience any symptoms during the test, your doctor might ask you to record them in writing. Chest fluttering, vertigo, and fainting are possible symptoms. It's important to record the start and duration of the symptoms. You may also be asked to record your exercise, medication intake, and moments of emotional instability by your doctor. This can assist your physician in determining whether your symptoms or activities are related to your cardiac rhythms.

What can I expect?

Your chest may receive as many as seven electrodes, which are 4-7 sticky patches.

The electrodes are connected to the Holter monitor's wires. Your heart's rhythms are detected by the electrodes, and are recorded and stored by the monitor. Showering or taking a bath before starting the Holter monitoring test is advised, and you shouldn't do so at any point while it is being conducted because the electrodes cannot get wet. The actual Holter monitor is about the size of a tiny portable tape recorder. It is simple to wear on a shoulder strap or a belt.

Using the Holter monitor shouldn't interfere with the majority of your daily tasks at home and at work. While the Holter monitor records your heart rhythms, you won't experience any discomfort. You give the monitor back in 24 to 48 hours. Upon reviewing the recordings, a technician compiles a report for your doctor, noting any arrhythmias you may have experienced.

Stress Test

What is a stress test?

One kind of electrocardiogram (ECG or EKG) is a stress test. The resting heart rhythm is measured by routine ECGs. Tests of stress measure your heart's reaction to exertion or stress. Stress tests come in numerous varieties. However, determining whether your heart is receiving enough blood and oxygen is the main goal of most stress tests.

Stress tests are frequently used to simulate symptoms such as dyspnea or chest pain. The exam examines:.

1. pulse rate.

2. the blood pressure.

3. The electrical system in your heart.

The test may real:.

• If you suffer from coronary artery disease (CAD).

• If you think you could have a heart attack.

• The origin of symptoms such as angina, or chest pain.

• If you experience arrhythmias, or abnormal heart rhythms.

• If the course of treatment—drugs or an implanted device—has made your heart and blood vessel function better.

You use a stationary bike or a treadmill for one of the more basic forms of stress tests. You go slowly at first. To make you work harder, the machine is gradually adjusted. You keep working out until you experience symptoms or run out of energy. Another name for a stress test is an exercise test, exercise ECG, or treadmill test.

An intravenous (IV) line is inserted by the technician or nurse during a nuclear stress test, usually in your arm. Through an IV, a tiny quantity of thallium, a radioactive material, is injected into your bloodstream. Since the thallium can provide your doctor with additional information about whether your heart receives enough blood and oxygen, a nuclear stress test is typically performed in conjunction with a standard stress test. Though you can take another medication to force your heart to beat faster, a nuclear stress test can still be performed even if you are unable to exercise.

You lie on a table beneath a special camera after receiving an injection of thallium. Next, your heart is captured on camera. Less thallium is given to any area of your heart that isn't getting enough blood or oxygen. That portion of your heart appears on the picture as a lighter color as a result.

What can I expect?

You undress from the waist up and change into a hospital gown before a stress test. Your arms, legs, chest, and neck may receive up to twelve electrode placements, which are tiny patches. The electrocardiogram's (ECG) wires are connected to the electrodes. From each of the electrodes, the machine then records the electrical activity in your heart. Additionally, a blood pressure cuff is placed on your arm, and regular blood pressure checks are performed. In addition, an IV will be inserted (usually into your arm) if you have a nuclear stress test.

In most cases, a stress test doesn't hurt, but occasionally it can mimic unpleasant symptoms. On the other hand, because you exercise until you're extremely exhausted, the test works your muscles. Throughout the test, a nurse usually speaks with you and gives you instructions. Following your workout, the nurse continues to check on your symptoms, blood pressure, and heart rate for ten to fifteen minutes.

What are the treatment options?

Your treatment depends on your test results. Your doctor may recommend one or more of these medications or procedures.

Medications Antiarrhythmics

Procedures Pacemaker lmplant

MEDICATIONS

Tips for Taking Heart Medications

You might be interested in learning more about one of your medications if you suffer from a heart or blood vessel condition. This section of the website contains information on common heart and blood vessel medications. It also contains advice on how to take your medications as prescribed.

As soon as a new doctor prescribes medication for you, be sure to inform them of all the drugs and supplements you are taking. Then, your doctor can assist in ensuring that you benefit the most from your medication. Informing your doctor of this information also helps to prevent harmful drug interactions.

Every time you start taking a new medication, you might also want to bring up these issues with your doctor or nurse:.

• the rationale behind your medication use, the anticipated advantages, and any potential negative effects.
• When and how to take your medications.
• If you use any other over-the-counter medications, vitamins, supplements, or other medications.

Your heart may occasionally take several months to get used to new medications. Therefore, it's possible that you won't see any progress right away. Additionally, it might take some time for your doctor to determine the ideal dosage.

People who take heart medications occasionally need blood tests. The blood tests assist your doctor in determining the proper dosage, assisting in the prevention of negative side effects.

Never alter the dosage of your medication on your own because you feel better without it, no longer need it, or think it's not working as intended.

If you have:, make sure to speak with your doctor or nurse.

1. Concerns regarding the functioning of your medications.

2. side effects that are unpleasant.

3. difficulty remembering to take your medication.

4. trouble affording your prescription drugs.

5. You may be hindered from taking your medications as prescribed by other factors.

6. Concerns regarding the use of any of your medications.

Furthermore, if you have any concerns about how to take your medications or when to take them, don't be afraid to ask your pharmacist.

Antiarrhyth mics

The cardiac electrical system is impacted by antiarrhythmics. By looking at the term's root words, you can comprehend the goal of antiarrhythmics. Arrhythmia is the abnormal heartbeat or heart rhythm; anti is counter or against.

Sorne generic (and Brand) names: All medications are approved by the Food and Drug Administration (FDA) for a specific patient group or condition. Only your doctor knows which medications are appropriate for you.

• amiodarone (Cordarone, Pacerone)
• disopyramide (Norpace)
• dofetilide (Tikosyn)
• flecainide (Tambocor)
• procainamide (Procanbid)
• propafenone (Rythmol)
• quinidine (Quinaglute)

Sometimes other categories of medications-beta blockers and calcium channel blockers-are used to help prevent arrhythmias.

What they're used for

To avoid and treat arrhythmias, which are irregular heartbeats or rhythms.

How they work

Different antiarrhythmic medications change the electrical activity in your heart in various ways. Because the cause of the arrhythmia can originate from various locations within the heart, various medications are used.

Antiarrhythmic medication use can:.

• Regain a regular heartbeat.
• Avoid rhythms that are abnormally fast.

Pacemaker lmplant

What is a pacemaker?

A pacemaker is a tiny implantable medical device used to treat arrhythmias, which are irregular heartbeats. A pacemaker specifically treats bradycardia, a slow arrhythmia. Typically, a pacemaker can treat bradycardia-related symptoms like shortness of breath, exhaustion, and dizziness.

It's your heart's electrical system that's the cause of arrhythmias. The heart's electrical signals travel along a specific path. Your heart contracts due to the movement of these signals. But too few heart signals are sent out during bradycardia. Visit the Heart and Blood Vessel Basics section to find out more about the electrical system of your heart.

Your heart's rhythm can be corrected with a pacemaker. The pacemaker can also change to suit the demands of your body. This is so that it can be detected: thanks to the device's sensors.

1. During periods of rest when you need a slow heartbeat.

2. when you're working out and your heart rate needs to be higher.

Maybe most of the time, your heart is effective at controlling your heart rhythm. When your heart requires it, a pacemaker is only used as a back-up treatment.

In other instances, a person's heart loses the ability to generate its own electrical signals or direct them along the correct pathways. For instance, certain therapies may be required due to aging or an ablation procedure in specific areas of the heart. In these circumstances, the pacemaker may continue to deliver treatment to trigger each heartbeat.

The heart receives electrical signals from the pacemaker. The system accomplishes this by delivering insignificant electrical energy—too small to feel—to the top, bottom, or both chambers of the heart.

The procedure of implanting a device involves local anesthesia. Usually, there is no need for general anesthesia.

It is important to regularly check an implanted device to review the data it has stored and to monitor settings.

How is the implant procedure done?

A pacemaker comprises two components.

The device can comfortably fit in the palm of your hand due to its small size. It has tiny battery-operated computerized components.

Leads: The thin, insulated wires that link the gadget to your heart are called leads. Electrical signals are transmitted back and forth between your device and your heart through the leads.

Typically, your doctor makes a small incision close to your collarbone to insert the leads. The leads are carefully guided into your heart by your doctor via your blood vessels. With fluoroscopy, a real-time moving x-ray video screen, your doctor can see where the leads are going.

Once the leads are connected to the device, the doctor tests the system to ensure that it will function as a whole to deliver treatment. After that, your doctor sutures the incision closed and inserts the device just beneath your skin.

What can I expect?

A few hours prior to the procedure, you are typically instructed not to eat or drink anything. You undress and change into a sheet or hospital gown. It will be done in a "cath lab" for your procedure. An intravenous (IV) line is inserted into your arm while you lie on an examination table. Throughout the procedure, the IV supplies medications and fluids. You feel sleepy from the medication, but not out cold.

Your doctor inserts the leads through a tiny incision made close to your collarbone. You shouldn't experience any pain because the area will be numbed, but as the leads are inserted, you might feel some pressure. It's possible that you'll spend the night in the hospital and that the area of your incision will hurt. The majority of people recover rather quickly.