Rapid Heartbeat: Causes, Risks, and Treatment Options

Tachycardia with a heart rate exceeding 160 beats per minute?

Hello, Doctor! A few years ago, I experienced episodes of rapid heartbeat once a year.
Last year, it occurred every six months, and this August, the episode lasted for 5 hours.
While I was in Japan, my brother-in-law found some emergency methods online, and I ended up with my heart rate dropping to 58.
I managed to return to Taiwan the next day.
Upon returning, I went to Mackay Memorial Hospital, where the doctor said they couldn't determine the cause since I wasn't experiencing an episode at that time.
One option is to be hospitalized and use a provocation method to identify the type of arrhythmia.
What does the provocation method entail? Is it dangerous? If the examination reveals an additional conduction pathway, the doctor mentioned that catheter ablation could be performed.
However, I saw on your website that doctors advised patients that medication treatment could be considered first.
Is that correct?

Xiao Mao, 60~69 year old female. Ask Date: 2015/12/05

Dr. He Dongjin reply Cardiology

Hello, based on your description, it seems you may be experiencing paroxysmal supraventricular tachycardia (PSVT), which is characterized by an additional electrical pathway in the heart.
Given the frequency of your episodes over the past year, I recommend proactive management, specifically catheter ablation.
Medications may not provide a permanent solution, and while there are risks involved, they are very low.
The procedure involves using catheter techniques to induce arrhythmias through electrical stimulation for treatment, which also carries minimal risk, similar to the risk of choking while drinking water.
Worrying about episodes and potential dangers can negatively impact your quality of life.
This condition is treatable, and there is no need for excessive concern.
Changhua Hospital is here to support you.

Reply Date: 2015/12/05

More Info

Understanding rapid heartbeat, or tachycardia, is crucial for identifying potential underlying health issues and determining appropriate treatment options. Tachycardia can manifest in various forms, including paroxysmal supraventricular tachycardia (PSVT), atrial fibrillation, and ventricular tachycardia, among others. Each type has different causes, risks, and treatment strategies.

Causes of Rapid Heartbeat
1. Physiological Factors: Stress, anxiety, and panic attacks can trigger episodes of rapid heartbeat. These emotional states can lead to the release of adrenaline, which increases heart rate.

2. Medical Conditions: Conditions such as hyperthyroidism, anemia, or heart diseases can also cause tachycardia. In your case, the episodes of rapid heartbeat occurring over the years could suggest an underlying arrhythmia or another cardiac condition.

3. Lifestyle Factors: Caffeine, nicotine, and certain medications can lead to increased heart rates. Additionally, dehydration and electrolyte imbalances can also contribute.

4. Structural Heart Issues: Sometimes, structural abnormalities in the heart, such as additional electrical pathways (as you mentioned), can lead to tachycardia. This is often seen in conditions like Wolff-Parkinson-White syndrome.

Risks Associated with Rapid Heartbeat
The risks associated with tachycardia depend on its underlying cause and duration. If the heart beats too quickly for an extended period, it can lead to complications such as:
- Heart Failure: The heart may not pump effectively, leading to fluid buildup and other symptoms.

- Stroke: Certain types of arrhythmias, like atrial fibrillation, can increase the risk of blood clots forming in the heart, which can lead to a stroke.

- Sudden Cardiac Arrest: In severe cases, especially with ventricular tachycardia, there is a risk of sudden cardiac arrest.

Diagnostic Procedures
To determine the specific type of tachycardia you are experiencing, doctors may recommend various diagnostic tests. One common method is the induction study, which involves using electrical stimulation to provoke an arrhythmia in a controlled setting. This can help identify the type of arrhythmia and its triggers. While this procedure is generally safe, it does carry some risks, such as the potential for inducing a more serious arrhythmia during the test.

Treatment Options
1. Medications: Initially, doctors may prescribe antiarrhythmic medications to manage episodes of tachycardia. These can help regulate heart rhythm and prevent future episodes.

2. Catheter Ablation: If medication is ineffective or if there is a specific abnormal electrical pathway (as you mentioned), catheter ablation may be recommended. This minimally invasive procedure involves threading a catheter through the blood vessels to the heart, where it can destroy the abnormal tissue causing the arrhythmia. While it is generally safe, like any procedure, it carries some risks, including bleeding, infection, or damage to the heart.

3. Lifestyle Modifications: Reducing caffeine intake, managing stress, and maintaining a healthy lifestyle can also help manage symptoms.

4. Monitoring: Continuous monitoring through devices like Holter monitors can help track heart rhythms over time and provide valuable data to your healthcare provider.

Conclusion
In summary, understanding the causes, risks, and treatment options for rapid heartbeat is essential for effective management. Given your history of episodes and the recent increase in frequency, it is advisable to follow up with your healthcare provider for a thorough evaluation. They can help determine the best course of action, whether it involves medication, further diagnostic testing, or potential procedures like catheter ablation. Remember, timely intervention can significantly improve outcomes and quality of life.

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