Ask an Expert: My heart’s all a-flutter (but not in a good way). Do I have cardiac arrhythmia?

As Heart Health month comes to a close, clinician scientist Dr. Andrew Krahn at the Centre for Heart and Lung Health shares why cardiac arrhythmia is cause for concern and what it takes to keep your heart healthy.

Q: What are your top three tips for a healthy heart?
First, I’m a big believer in getting a regular amount of moderate physical activity. You don’t need to run marathons, but some form of regular physical activity is a must.

Second, I encourage people to be very aware of their health and to own it. People say things like, “my entire family has diabetes” or “my dad had high cholesterol” as though they’re destined to suffer from the same condition and they can’t do anything to change it–but that’s almost never the case, particularly when it comes to heart health. People should instead say, “heart disease runs in my family but I’m taking charge of my health so I don’t develop it.”

Finally, I believe that many health solutions involve creating habits that allow you to be and stay healthy—such as parking further away from your destination to add walking time to your day. People often say that they don’t have time for physical activity, but I would recommend developing small daily habits that can help keep them active and healthy.

Q: What is cardiac arrhythmia and why might a person suspect they have the condition?
Cardiac arrhythmia describes an irregular heart rate that is either too fast or too slow. We all occasionally have skipped heartbeats and most of them are of no concern. However, people with cardiac arrhythmia feel unwell and have symptoms such as palpitations or light-headedness, which usually prompts them to seek medical attention. However, sometimes cardiac arrhythmias are discovered tragically when an otherwise healthy person dies suddenly or experiences cardiac arrest.

Cardiac arrhythmia can be inherited, so when one person is diagnosed, we know to look for family members who may also be affected. Luckily, there are ways to identify a problem before tragedy strikes. Fainting, a dizzy spell, seizures or routine heart testing can suggest cardiac arrhythmia that needs to be examined closely to prevent serious heart problems.

Q: How is cardiac arrhythmia treated?
It depends on the rhythm problem. Some rhythm problems are incidental and don’t need treatment. However, other problems are suited to treatment with medications that affect the heart’s rhythm, or implantable devices and/or surgery.

Q: How have clinical and research approaches to heart rhythm problems changed over time?
On the research side of things, we now focus on both traditional questions like finding the best test or treatment as well as exploring the experience of patients and families as they journey through our care and come to grips with their condition. In the past we’ve been a bit more focused on finding the right test or treatment, but we’re now asking questions in the context of the patient and their family’s experience: e.g. Am I at risk? How do I feel?  Am I allowed to play sports? Etc. These are often more important to the patient than what their EKG shows.

Q: Is more awareness needed about heart rhythm problems? 
There are two population-level heart rhythm problems for the public to be more aware of: cardiac arrest and atrial fibrillation. I’m glad to see growing awareness about cardiac arrests and we’re reminded of the condition as more automated external defibrillators (AEDs) can be found in public places and are highly visible. It would be great to also see more individuals learn basic cardiopulmonary resuscitation (CPR). The unfortunate reality is that most people don’t know how to perform CPR.

If you can learn to ride a bike or drive a car, you can learn to do CPR. We all should.

Atrial fibrillation (AFib) is usually a fast, irregular heartbeat coming from the upper chamber of the heart. It’s an extraordinarily common heart rhythm problem—by the time we’re 80 years old, one out of 10 of us will have it. Approximately 50,000 people in B.C. have AFib. The condition causes people to feel palpitations that some describe as a fish flopping around in their chest. AFib can make people feel tired and breathless, as well as cause strokes, heart failure, and a general feeling of unwellness. 

The most common risk factors for AFib are advancing age and high blood pressure, followed by diabetes and heart failure.

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