Matters of the Heart

Although dancing yields many heart-healthy benefits of aerobic exercise, the heart itself performs rhythmic contractions that pump blood throughout your body. The normal heart is a beating muscle controlled by a well-choreographed electrical conduction system that determines your heart rate and rhythm.

Cardiac Electrophysiology is the study of the rhythm of the heart, both normal and abnormal. The human heart is designed to beat in an organized and synchronized fashion with both upper atria chambers beating before the lower ventricle chambers. This allows the blood to come back from the body to the upper, right chamber and return from the lungs to the upper, left chamber. The blood then moves to the ventricles where it is pumped out of the heart. This systematic contraction of the heart muscle occurs through coordinated activity of the cardiac conduction “electrical” system.

Abnormalities in the heart’s electrical system may lea conditions that can cause illness; some might even be life threatening. You do not routinely notice your heart beating until it that beat becomes too slow, or too fast, or irregular. Then you experience symptoms such as palpitations, dizziness or syncope, which is loss of consciousness. If you experience any of these symptoms, you should see a doctor as soon as possible for diagnosis and treatment.

Conditions such as wear and tear or loss of function of the heart’s natural pacemaker, which is located in the upper right chamber and called the sinus node, can usually be treated—with a pacemaker. The pacemaker is required to send out an electrical impulse when it does not detect one coming from your own heart. Some pacemakers are designed to detect heartbeats that are too fast and they take over to slow down the rate. Implanting these safety devices is a common procedure so most likely you know someone who has one.

Sometimes, when the sinus node doesn’t perform properly, other cells take over. When that happens the impulse does not typically follow the normal pathway from the upper chamber to and through a tissue bundle at the bottom of the atria known as the atrioventricular node. This causes a faster or slower heart rate or multiple cells can take over creating an irregular heartbeat.

The most common, chaotic, disorganized heartbeats coming from the atria are known as a condition called atrial fibrillation. An abnormal rate or irregular rhythm can impact blood flow to the brain and other parts of the body. Based on what is actually occurring, there are a variety of treatments ranging from medications to use of a guided catheter into the heart to track down actual pathways that are causing the problems. Once the pathway is mapped in an electrophysiology study, performed by a specially-trained cardiologist called an electrophysiologist, this rhythm can then be interrupted or ablated by using a radiofrequency or cold (cryo) signal to targeted cells. Once the abnormal pathway is disrupted, the appropriate cells can take over. Ablating targeted cells results in a cure most of the time.

Heart conditions that lead to inadequate pumping of the ventricles can have dangerous heart rhythms that start from cells in the ventricle instead of from the atria. These need to be controlled through small electrical shocks provided by placement of an implantable cardioverter defibrillator (ICD). These work by shocking the rhythm back to normal. Some people with advanced heart failure, who meet certain indications, might need protection from heart rhythm disturbances in both ventricles. Placing an ICD designed for both ventricles (bi-ventricular ICD) can provide additional benefits for improvement of symptoms. In some cases, a person might need a pacemaker and an ICD. While all ICDs are also pacemakers, pacemakers can only pace and do not have ICD functions. Once any of these devices are implanted, you need to follow-up with your cardiologist or your cardiac electrophysiologist on a regular basis.

Today, the field of electrophysiology provides advanced options for the diagnosis and treatment of rhythm disorders. Device therapies provide key responses and support for underlying rhythm conditions. Precisely targeted ablation therapies such as the use of radiofrequency or cryotherapy are generally safe, can be curative and have no long- term adverse consequences.

So, if you are having symptoms, seek a medical diagnosis and treatment. Then, with your doctor’s approval, you are ready to rock and roll, or salsa or two-step. Anyway, if you want to dance the night away, at least your heart’s got rhythm!