Listen To The Beat

Heart rhythm abnormalities are a growing cause for concern, but a little caution and timely tracking of early warning signs should help.

By E Kumar Sharma  
Tuesday, February 5, 2019

In today's fast-paced world, professionals have to cope with unhealthy lifestyles as well as stress. The outcome: Cases where people notice a momentary flutter in the chest or experience slight dizziness for no apparent reason or even have a blackout for a second or two are on the rise. But such symptoms are so transient that one may attribute them to overwork or inadequate food/water intake. Medical practitioners, however, are concerned.

"Do not ignore such symptoms as these could be early signs of heart rhythm abnormalities - be it a minor condition such as missed heartbeats or a pounding heart or a serious disorder like ventricular tachycardia, where lower chambers of the heart beat very fast, or atrial fibrillation (AFib), marked by irregular and rapid heart rate," says Dr Deepak Padmanabhan. An electrophysiologist (a specialist who assesses heart rhythms to track anomalies) at Narayana Health in Bengaluru, he advises people not to make light of these syndromes as they could lead to heart failure, stroke or sudden death. According to him, the number of cases involving abnormal heart rates has doubled over the past five years in tune with work-life imbalance and a global epidemic of lifestyle diseases such as hypertension and diabetes. Consequently, young professionals are increasingly suffering from these conditions. For instance, AFib is the most frequent cause of undiagnosed strokes. Around 8-10 per cent of stroke cases fall under this category and people may not even feel any palpitation.

So, who all are at high risk? People who have undergone heart surgeries in their childhood or those suffering from a rheumatic heart where a heart valve is damaged or those with a hole in the heart. You can undergo a Holter monitor test to check if you have any heart rhythm abnormality. The Holter monitor is a small battery-operated device that continuously records the heart's rhythm - from 24 hours to as long as 30 days - but you need not be admitted to a hospital. In this test, sticky dots or electrodes connected to the monitor are put on the chest. You will get a better diagnosis as standard electrocardiograms may not always capture irregular heart rates. Its cost depends on the time span of the test and could range between Rs 5,000 and Rs 14,000. Therefore, consult your doctor first to find out if you need to undergo the test. "In case of AFib, a person may or may not require blood thinners for the rest of his/her life depending on age and other illnesses," says Dr Padmanabhan. "But instead of routine aspirins, some stronger medication will be required."

From AI to Implantable Recorders

the Need for innovation to ensure fast and efficient processes has led to the use of artificial intelligence (AI) to identify abnormalities in heart rhythm. Although it is being done abroad, in the US, for instance, the protocol is yet to take off in India. As AI ensures rapid patient screening, it is critical in the Indian context where there are too few specialists. Implantable loop recorders are also used abroad for long-term remote monitoring, but very few medical facilities use them here as each device costs around Rs 80,000 for three years. Now research is on to use remote monitoring in a non-invasive manner so that no implants are required, says Dr Padmanabhan.

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