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Is Treatment For Arrhythmia Adequate? An irregular heartbeat is an arrhythmia, also known as dysrhythmia. Hear rate, a normal one is between 50 and 100 beats per minute, can also be irregular. But irregular heartbeat and abnormal heart rate does not necessarily occur together. Irregular heartbeat can occur with a normal or slow heart rate, also known as bradyarrhythmia (less than 50 beats per minute) or it can occur with rapid heart rate, also called tachyarrhythmia (faster than 100 beats per minute). Irregular heartbeat could be caused by factors such as coronary artery disease, changes in the heart muscle, healing process after heart surgery and injury from a heart attack. Irregular heart rhythms, on the other hand, could occur in normal and healthy hearts, too. There are several types of irregular heartbeat, including atrial fibrillation, premature atrial contractions, ventricular fibrillation and atrial flutter. Being the most common type of irregular heartbeat, atrial fibrillation causes the atria (the upper chambers of the heart) to contract abnormally. It affects about 2.7 million Americans, as reported by the Centers for Disease and Control and Prevention (CDC). Atrial fibrillation has symptoms like shortness of breath, fatigue, heart racing and chest pains. The irregular blood flow arising from atrial fibrillation can lead to clots that raise the risk of stroke.
Researchers from Duke University Medical Center, Durham, NC and other institutions in the United States of America pointed out in their study of treatment practices for atrial fibrillation that many of the Americans who have irregular heartbeat do not receive adequate treatment from their doctors. Their findings were published online February 22, 2013 in the ‘American Heart Journal’. A registry of 10,061 American patients treated for atrial fibrillation between 2010 and 2011 was used to draw conclusion that patients were being under-treated for heart rhythm and stroke. They showed that 2 out of 3 patients received therapies meant to help control their heart rate (6,859 patients or 68 percent). However, just 1 in 3 patients received treatments meant to control their heart rhythm (3,202 patients or 32 percent). Patients with controlled heart rate tended to be older and more likely to have hypertension, heart failure, prior stroke, and gastrointestinal bleeds, according to the findings. Patients who received rhythm control tended to show more symptoms and were treated by an electrophysiologist. An electrophysiologist is one who specializes in cardiac electrophysiology that involves elucidating, diagnosing, and treating the electrical activities of the heart. In most countries, cardiac electrophysiology is considered a subspecialty of cardiology. It usually requires 2 or more years of fellowship training beyond a general cardiology fellowship. It is not difficult to control a patient’s heart rate. Using drugs like beta-blockers can simply do it. However, this might not resolve the irregular heartbeat in the long term. Rhythm control can be very challenging for the doctors because it requires more sophisticated heart monitoring and drugs that can cause severe side effects. Despite the fact that atrial fibrillation can cause stroke, 1 in 4 patients with atrial fibrillation did not receive blood thinners meant to lower the long-term risk of stroke caused by blood clots. There are reasons why patients at risk of stroke do not receive blood thinner. Patients with atrial fibrillation, which can be transient, may not show symptoms during a visit to the doctor's office. Doctors also do not prescribe blood thinners to some patients at risk for falls. Warfarin, a blood thinner that can be affected by certain foods, has been used for decades but doctors need to closely monitor their patients. Fortunately, new blood thinners that do not require so much monitoring have entered into the market over the last 3 years. In researchers’ opinion, the risk of bleeding was generally over-estimated compared to the risk of stroke that is significant.
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