By FRANCESCO SANTONI-RUGIU, MD
For Montclair Local
Editor’s note: This series will be written by practitioners in Summit Medical Group (SMG) on health-related topics. This one is by Francesco Santoni-Rugiu, MD, cardiac electrophysiologist at Summit Medical Group in Montclair, NJ. Born in Italy, Dr. Santoni-Rugiu converses in several languages with his patients including Spanish, Italian, Portuguese, and Russian.
Have you ever felt like your heart was racing or skipping a beat? Chances are, sometime in your life, it was. Most of the time, heart palpitations — which cause fluttering or pounding feeling in the chest — are meaningless, caused by stress or too much caffeine. But they can also be a sign that your heart has an abnormal rhythm, a potentially serious medical condition called an arrhythmia.
The heart is a complex organ. Various structures, chambers, and blood vessels work together to oxygenate the blood and pump it throughout the body. But there is also an electrical system — a mastermind that oversees this vast network — telling the heart when and how to beat. When parts of the normal electrical system or “rogue” heart muscle elements misfire, an arrhythmia occurs and the heart beats too fast, too slow, or erratically. In some cases, arrhythmias can weaken the heart muscle over time and lead to life-threatening problems like stroke and heart failure.
As a cardiac electrophysiologist, it is my job to diagnose these arrhythmias. We are different from other branches of cardiology because we specialize specifically in the electrical activity of the heart. Patients are often surprised to hear how common it is to have an irregular heartbeat. More than half of adults in the U.S. will develop an arrhythmia in their lifetime — and one in four adults will be impacted by a serious arrhythmia condition at some point, typically later in life.
Being a detective is a big part of my work. Arrhythmias are tough to diagnose. They can affect everyone from young healthy adults to sick elderly patients. While some people experience obvious clues like fainting or palpitations, about half of my patients notice only very vague signs or nothing at all.
A 24-year-old male in good health who suddenly faints or has an unexplained episode of dizziness at the gym needs an evaluation immediately. However, as you age, the signs of arrhythmia become less obvious. Last week, I saw a 75-year-old woman who only presented with high blood pressure and fatigue — signs of many potential conditions. Discuss any unusual symptoms, such as a lack of energy, breathing intolerance, or a change in exercise stamina with your physician immediately.
There is a spectrum of arrhythmias. Some are benign while others can lead to very serious complications. As we grow older, the risk of developing a dangerous irregular heart rhythm known as atrial fibrillation (AFib), which can lead to blood clots, stroke, and heart failure, increases dramatically. Depending on the severity of the arrhythmia, there are numerous treatment options that range from lifestyle modifications to medications, procedures and implantable devices like pacemakers.
Thankfully, there are several tests that can confirm an arrhythmia. And more often than not, when I meet a new patient, I am happily ruling out the condition. Diagnosing an arrhythmia involves monitoring the electrical activity of the heart for a period of time, maybe 24 hours, a month, or even a year. Today, there are also many wearable over-the-counter heart monitoring devices approved by the Food and Drug Administration. However, I caution patients that this technology can be unreliable and should never be used as a substitute for a doctor’s advice.
Finding arrhythmias, particularly AFib, at an earlier age when they are still treatable can help reduce this risk dramatically. So if you feel something unusual, tell your doctor right away. Together we can make sure your heart does not miss a beat!