Mohali, June 11, 2015: When Mrs Rita Khanna (name changed to protect privacy), a 62-year-old retired doctor from the United States, experienced a couple of fainting spells and palpitations, she immediately contacted her doctors. On investigation, the doctors did not find anything significant and coupled with lack of cardiac history, they gave her a clean chit. However, during her trip to India in March this year, when the US resident again experienced similar symptoms, she immediately contacted Dr Rajat Sharma, the Cardiac Electrophysiologist at Fortis Hospital Mohali. As the patient had extremely high heart rate, Dr Sharma asked her to use Mobile Cardiac Outpatient Telemetry (MCOT), a hand-held and extremely convenient device that provides continuous patient ECG monitoring for periods ranging up to weeks, if necessary.
“After a week of real time, beat-to-beat analysis, we were able to detect her arrhythmia and treat her for it. If left untreated, this condition can result in stroke, which can sometimes even be fatal,” Dr Sharma said.
Addressing media persons as part of World Heart Rhythm Week 2015, Dr Sharma, who heads the Heart Rhythm Services and Cardiac Pacing Division at the hospital, said, “This week is designed to promote vital awareness for the detection, protection and correction of various rhythm disorders of the heart. Cardiac arrhythmia is a disorder of heart’s electrical system, wherein there is a change in regular heart beating and most often warrants immediate medical attention. The electrical or rhythm disorders of the heart, have claimed the No. 2 killer position globally, and are second only to all cancer related deaths. The idea of the World Heart Rhythm Week is to create awareness about such heart ailments. There has been a great emphasis on preventions and treatment of the common ‘heart attacks’ or coronary artery diseases globally. But, we as a nation still lack the knowledge and awareness regarding these heart rhythm disorders.”
Atrial Fibrillation, which is the most common sustained cardiac arrhythmia and most common cause of stroke, can be so transient that it often goes unnoticed. Studies have shown even 2 minutes of atrial fibrillation are capable of producing a stroke. Dr Sharma said explained that as a result, doctors now use Mobile Cardiac Outpatient Telemetry (MCOT) in high risk patients as it detects any heart rhythm abnormalities and disorders, over a prolonged period of time, typically 7 days to 30 days. It’s a very simple portable device that is attached to the patient’s chest via electrodes for automatic arrhythmia detection and wireless ECG transmission. He can monitor the patient’s heartbeat via an application that is available only with doctors.
For Nirpal Kaur, who is in her 70s, the Event Loop Recorder (another kind of mobile ECG monitoring) proved to be a boon as it helped check the efficacy of her Atrial Fibrillation treatment, which has been ongoing since 2012. “She used the device for 7 days and we could alter and adapt her treatment basis the real-time reading of her cardiac health,” the Fortis doctor said, adding that once Atrial Fibrillation was detected timely it can be managed better and further problems can be avoided.
There are some heart rhythm disorders that a routine clinical assessment and monitoring may not pick up on. Globally, there are many types of MCOT devices available for a greater detection and appropriate treatment of heart rhythms disorders. These are particularly used for patients who have intermittent symptomatic palpitations or fainting spells, or when the cause of a stroke is unknown (cryptogenic), he explained.
1) Heart Rhythm Week
As part of the Week, Fortis Hospital Mohali is organizing awareness talks on ‘Know your pulse’, ‘AF & SCD Talk’ and Community Physician Awareness Programme. Patients can also avail the facility of free heart rhythm clinics.
2) Heart Rhythm Disorders
Today, one of the major causes of a disabling stroke is due to very common heart rhythm disorder known Atrial Fibrillation or AF or A-Fib. Similarly, the most common cause of Sudden Cardiac Death (SCD) is due to a condition called Ventricular Fibrillation or Ventricular Tachycardia (VF/VT), which results from an extremely chaotic electrical activity from lower chamber of heart or the ventricle. The other common heart rhythm disorders are like very fast heartbeats or extremely slow heartbeats.
3) Know your pulse
Being aware of your pulse is important because it may indicate an abnormal heart rate or rhythm. Your pulse in: your heart beat, your heart rate and your heart rhythm. One of the easiest places to check the pulse is on your wrist, just below your thumb. Your pulse rate will change during the day, depending on the activity you are doing. To get your baseline pulse and normal rhythm, take your pulse when you wake up in the morning, and before going to bed. Between 60 and 100 is considered normal – but this can alter due to varied reasons. You need to consult a specialist if your pulse seems to be racing and you’re feeling unwell, it seems to be racing and you’re feeling unwell or if the pulse feels ‘jumpy’.