Managing Fast Heartbeats: Insights on Monitoring and Emergency Responses

Tachycardia

Hello Dr.
He: Thank you for your response.
I have some additional questions to ask.
I have undergone three 24-hour Holter monitors, but none have captured the episodes of supraventricular tachycardia.
The doctors have not mentioned the possibility of a week-long monitoring.
Is there such a device available? If the episodes occur infrequently and a week-long rhythm recording still does not provide evidence, what should I do? Also, is there a risk to my life when these symptoms occur? Should I follow the doctor's advice to seek a clinic or hospital with an ECG machine immediately during an episode to see if it can capture the ECG in real-time for the doctor to interpret? However, during an episode, I may not be in an urban area, and by the time I find a clinic, my heart rate may have already slowed down, and the readings may show no abnormalities.
This is really distressing, and I am unsure what to do.
Is it truly a matter of hoping that a hospital is nearby when an episode occurs, or do you have better suggestions? I would greatly appreciate your help in answering these questions.
Thank you, Dr.
He.

Mr. Wang, 40~49 year old female. Ask Date: 2016/05/13

Dr. He Dongjin reply Cardiology

Hello, there is basically no life-threatening situation, so there is no need to be anxious.
The Holter monitor for a week is only available in a few hospitals, and such occurrences are infrequent.
The likelihood of capturing evidence of your heart rhythm over a week is quite low.
The current medical practice is to seek a nearby clinic or hospital with an ECG machine immediately during an episode to see if it can be recorded in real-time.
If you are still very concerned, there is another type of ECG recorder that can be implanted surgically, which can monitor your heart for three years, but it requires out-of-pocket expenses, which I believe could be several tens of thousands.
It is advisable to observe your condition for now.
Changhua Hospital cares about you.

Reply Date: 2016/05/13

More Info

Managing fast heartbeats, or tachycardia, can be a complex issue, especially when episodes occur unpredictably and without clear documentation through standard testing methods like a 24-hour Holter monitor. Your concerns about the frequency and nature of your symptoms are valid, and it's essential to approach this situation with a comprehensive understanding of both the physiological and psychological aspects involved.

First, it's important to recognize that the normal resting heart rate for adults ranges from 60 to 100 beats per minute (bpm). When heart rates exceed this range, especially if they reach 150 bpm or higher, it can lead to symptoms such as dizziness, shortness of breath, or even chest discomfort. These symptoms can be alarming and may prompt concerns about underlying heart conditions.

In your case, you mentioned having undergone three 24-hour Holter monitors without capturing any episodes of supraventricular tachycardia (SVT). This can be frustrating, especially if your symptoms are sporadic. It's worth noting that some arrhythmias can be infrequent and may not present during the monitoring period. Continuous monitoring devices, such as an event monitor or a mobile cardiac telemetry device, can be beneficial in these situations. These devices can be worn for extended periods (up to 30 days) and are designed to capture heart rhythms during episodes, providing more comprehensive data for your healthcare provider.

Regarding your question about the potential dangers of your symptoms, while many cases of tachycardia are benign, certain types can pose risks, particularly if they are associated with underlying heart disease or structural abnormalities. If you experience significant symptoms, such as prolonged dizziness, chest pain, or fainting, it is crucial to seek immediate medical attention. These could be signs of a more serious condition that requires prompt evaluation.

In terms of emergency responses, if you experience an episode of rapid heartbeat, the first step is to remain calm. Anxiety can exacerbate symptoms, so practicing deep breathing or relaxation techniques may help. If you have a portable heart rate monitor, use it to check your pulse. If your heart rate is significantly elevated and accompanied by severe symptoms, seek medical help immediately.
Additionally, it is advisable to keep a detailed diary of your symptoms, noting the time, duration, and any associated activities or stressors. This information can be invaluable for your healthcare provider in determining the best course of action. If episodes occur while you are away from medical facilities, consider discussing with your doctor the possibility of using a smartphone app or wearable technology that can monitor your heart rate and rhythm.

Lastly, addressing any underlying anxiety or panic disorders is crucial, as these can contribute to the perception of rapid heartbeats and may lead to a cycle of fear and avoidance. Cognitive-behavioral therapy (CBT) and other forms of psychological support can be beneficial in managing anxiety related to health concerns.

In summary, while your symptoms may not currently indicate a life-threatening condition, ongoing monitoring and communication with your healthcare provider are essential. Exploring options for extended heart rhythm monitoring, maintaining a symptom diary, and addressing any anxiety can help you manage your condition more effectively. Always prioritize seeking medical attention if you feel that your symptoms are severe or worsening.

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