Westside Regional Medical Center – Why does the heart skip a beat?

– Normally the heart rate at rest is about 60 – 100 beats per minute, and it’s sinus rhythm. Meaning it comes from the sinus node, the pacemaker we were all born with. However, if someone has an arrhythmia they may feel skipped beats, extra beats, or a sense that their heart is racing; and in that situation if we have a surface electrocardiogram or some form of non-invasive monitoring like a holter monitor,
or an event recorder, we can actually see what
those skipped beats, extra beats, or fast beating represents. Then, once we’ve put the
catheters inside the heart during electrophysiology study, we can hone down as to exactly where in the heart these things come from. I would say a surface
EKG is a 10,000 foot view of what’s going on in the heart. When we put the catheters
up we’re looking real time, at a few millimeters apart, from where these extra signals come from. So the electrical problems
can either come from the top chamber of the heart, called supraventricular arrhythmias, or from the bottom chamber of the heart, ventricular arrhythmias. Supraventricular arrhythmias are broken up into different types. There’s the big one, atrial fibrillation, then there’s atrial flutter, and then the reentry circuits: AV nodal reentry tachycardia,
av reentry tachycardia, also known as Wolff-Parkinson-White, and atrial tachycardia. The supraventricular tachycardia
are typically dealt with primarily by medication or ablation, the ventricular arrhythmias may
be dealt with with ablation, and sometimes we have to put in devices called defibrillators
for these arrhythmias if they’re felt to be
dangerous or life threatening.

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