Heart ailments worry callers

Atrial fibrillation — the most common of all heart arrhythmias and a potential cause of stroke — dominated the Deseret Morning News/Intermountain Health Care Hotline Saturday.

In two hours, Dr. John D. Day and Dr. J. Peter Weiss, cardiologists in the Utah Heart Clinic Arrythmia Service at LDS Hospital, fielded about 80 questions, half of them about atrial fibrillation and a quarter on undiagnosed heart arrhythmias. Callers also learned about patience, some waiting as long as 20 minutes to ask their question as the phone lines were flooded with calls.

Many of the questions Weiss took were from people who are "basically scared and want to know if what they're feeling is something to be scared about," he said.

Arrhythmias are caused by problems in the heart's electrical system. They are treatable, but first you have to have a diagnosis, Day said. Repeatedly he told callers about some of the diagnosis options, from having an ultrasound of the heart — called an echocardiogram — to wearing an "event monitor" so that when the person feels the flutters or palpitations or arrhythmias he or she can push a button that records the event, allowing the doctor to see exactly what the heart's doing at that time.

Some patients wear the monitor for as long as a month to gather the data needed to make a diagnosis, since arrhythmias sometimes appear then disappear for long periods of time.

One caller has a type of arrythmia that is easily cured by ablation, where the physician uses a catheter to enter the heart and zap or cauterize the electrical problem, basically shorting it out and thus fixing it. Such arrhythmias, Day said, are a welcome rarity in medicine in that they can be simply cured and it's over.

"With most things, we throw pills at it," he said.

People with heart disease, a history of rheumatic fever or heart surgery are all at increased risk of developing arrhythmias.

An especially worrisome type of arrythmia is ventricular fibrillation, for the simple reason that it's lethal if not dealt with fast. People who have the condition, which throws the heartbeat into chaos, suddenly die of cardiac arrest unless they receive prompt defibrillation, which shocks the heart out of the fibrillation into a normal rhythm. If there's no public access defibrillator available, someone must do CPR until the paramedics arrive to shock the heart.