Cardiac Arrhythmia : a ticking time bomb

By employing new technologies like the cutting-edge Loop Recorder, medical professionals at Sukumvit Hospital can now accurately monitor patients suffering from irregular heartbeat.

An invisible threat
Many patients who suffer from cardiac arrhythmia (irregular heartbeat) are unaware of the dangers that the condition may pose on their health because there are often no identifiable symptoms. By definition, the group of conditions that fall under ‘arrhythmias’ describe heart rates that are too fast (tachycardia), too slow (bradycardia), or fluctuates between both states (flutter or fibrillation). These abnormalities can affect patients of any age, however the most at-risk patients are individuals between 60 to 70 year olds who develop problems once the heart begins to deteriorate. Other at-risk
patients are those who have been diagnosed with a rapid heart rate and have opted to use medication to treat the condition. However, the situation becomes complicated when the prescribed medication causes the heart to fluctuate between beating too slow and too fast.

Initial examinations
Dr Apichai Phokawattana is a cardiac physician who specialises in arrhythmia cases. He explains that it is of utmost importance for patients to visit a hospital for an examination if they have any suspicion that they are suffering from an irregular heartbeat. At the hospital, an initial test is carried out using an electrocardiogram (ECG) that records the heart’s electrical activity using electrodes placed on the skin. As the test compares voltage to time, doctors can then evaluate the fluctuations in the heart’s rhythm in order to identify the kind of arrhythmia affecting the patient. However, as this test only records the heart rate over a short period of time, it can be difficult to detect irregularities in certain cases. Dr Apichai estimates that over 80% of arrhythmia patients will arrive at the hospital and will no longer experience the symptoms or abnormalities they were feeling earlier, as certain arrhythmias can become symptomatic for one to three minutes and then subside.

Treating complex cases
For more complex cases, professionals at Sukumvit Hospital will employ more developed technologies to help doctors accurately diagnose patients suffering from an irregular heartbeat, regardless of whether they are exhibiting physical symptoms when they meet a specialist. An example of a machine used is called a Holter Monitor – a device worn by the patient which continuously records the heart’s rhythm over a 24 hour period, during which the patient can go about their day-to-day life, but must refrain from showering, as the device cannot get wet. After 24 hours the patient must return to the hospital where doctors will evaluate the results and attempt to make a diagnosis. This is helpful for certain individuals, but Dr Apichai explains that for some the time between each symptomatic episode can be weeks or even months, which results in an impossible diagnosis using this approach.

This is when medical professionals will implement the newly developed Loop Recorder. This implantable heart- monitoring device is approximately the size of a paperclip and is inserted via a small incision so that it sits under the chest’s skin. The device then begins to record an individual’s heart rhythm and sends the data to doctors through a wireless transmission signal, allowing them to monitor the information remotely, and identify when the heart rate accelerates, slows down or exhibits abnormal behaviour. The information is of equally high quality when compared to data collected by an ECG or Holter Monitor, but because the device can stay in place for up to three years, it allows doctors a much larger window of time to evaluate data, and therefore, come to a conclusion about the cause of the irregularity.

Dr Apichai explains that this is particularly helpful when trying to avoid the complications of an irregular heartbeat. For example, atrial flutter or atrial fibrillation (AF) is categorised by rapid and irregular beating of the atria (the heart’s upper chamber). This can lead to risk of thrombosis, as blood is not pumped out of the heart efficiently and has the potential to pool and form a dangerous clot. This clot can then travel and block the blood flow in the brain, which can result in a life-threatening stroke. Other serious complications include heart failure and cardiac arrest.

Consequently, doctors recommend arrhythmia patients to use the Loop Recorder to monitor their hearts consistently so that these risks are minimised. The procedure itself is advantageous as it only takes five minutes to complete, and requires a small incision about four to five millimetres wide. This wound will heal in no longer than a week and the patient can live, bathe and exercise normally. Patients can also benefit from routine check-ups, where doctors can offer advice on living with the condition and address any additional concerns. The overarching group of arrhythmias affect a large subset of the population. Therefore, it is crucial to implement this new technology in order to offer these patients a better chance at a healthy life.

Sukumvit Hospital began operations in 1977, recently completed a major makeover. Not only have they built a new building, but the entire team of doctors, specialists, nurses and assistants have all been trained with the singular aim of helping their patients maintain optimum health. Then there is the equipment, state-of-the-art MRIs, Cath labs and myriad of others, so that their specialists have the best available tools for diagnosis and treatment. Conveniently located on Sukumvit Road with English speaking staff, Sukumvit Hospital is now ready for any emergencies or treatments.

Sukumvit Hospital 1411 Sukhumvit Road (Ekkamai BTS) Prakanong Nua, Wattana, Bangkok, Thailand 10110, Tel: 02 391 0011, www.sukumvithospital.com, Facebook: @sukumvithospital