Ever Felt your Heart Skipping a beat?

Ever felt your heart skipping a beat? A missing beat by itself 

might not be significant but if you notice other symptoms 

like fatigue, weakness, fainting spells, and an inability to 

cope with the normal routine then you need to see your 

cardiologist for a complete assessment of your heart’s 

functions.

A lady  in her sixties, an active woman who could multi-task 

with ease. But episodes of irregular heartbeats was taking 

an toll of her life. Her cardiologist put her on a holter, which 

records one’s ECG for 24 hours during normal activity and 

the pulse as well. To her horror, the doctor told her that she 

needed a pacemaker. Apart from irregular heartbeats, she 

also bradycardia (slow heartbeat), which could be 

dangerous, with her pulse dipping to 35 at night when she 

was asleep. She was traumatised and terrified but felt better 

after her doctor explained what was happening.

When the heart’s two upper chambers, the atria, contract, 

blood is pumped into the two lower chambers, the ventricles. 

The ventricles then contract and pump blood to the rest of 

the body. The combined contraction of the atria and 

ventricles is a heartbeat. The heart has its own internal 

electrical system to control the rate and rhythm of 

heartbeats. With each heartbeat, an electrical signal spreads 

from the top of the heart to the bottom.

Each electrical signal normally begins in a group of cells 

called the sinus node or sinoatrial (SA) node. As the signal 

spreads from the top of the heart to the bottom, it 

coordinates the timing of heart cell activity. Faulty electrical 

signal in the heart causes arrhythmias.

Pacemakers use low-energy electrical pulses to overcome 

this faulty electrical signalling.

A pacemaker is a small device that is placed in the chest or 

abdomen to help control abnormal heart rhythms. This 

device uses electrical pulses to prompt the heart to beat at a 

normal rate. Pacemakers are used to treat arrhythmias. A 

fast heartbeat is called tachycardia A slow heartbeat is 

called bradycardia. During an arrhythmia, the heart may 

not be able to pump enough blood to the body. This can 

cause symptoms such as fatigue (tiredness), shortness of 

breath, or fainting. Severe arrhythmias can damage the 

body's vital organs and may even cause loss of 

consciousness or death.

Pacemakers can be temporary or permanent. Temporary 

pacemakers are used to treat short-term heart problems, 

such as a slow heartbeat that is caused by heart attacks, 

surgery or an overdose of medicine. They are also used 

during emergencies. They might be used until your doctor 

can implant a permanent pacemaker or until the temporary 

condition goes away.

When is a pacemaker recommended? “Due to an atrio-

ventricular block the heart rate may be low or absent 

resulting in momentary block or loss of consciousness, 

occasionally even seizures. Then pacemaker implantation is 

mandatory. A pacemaker is also useful when the pumping 

efficacy of heart is low,” says a Dr. 

Ageing or heart disease damages your sinus node’s ability to 

set the correct pace for your heartbeat. This can cause 

slower than normal heartbeats or long pauses between 

heartbeats. This condition is called sick sinus syndrome and 

also warrants implantation of a pacemaker. 

What precautions are advised post-surgery?

“Since we keep our patients for a week following the 

procedure, we make sure the wound is healing well, and 

dressed regularly,” says  the Dr. “The patient is advised not 

to shower for the first two or three days, and not lift the arm 

above the head or carry even small weights, or stretch the 

arm for about six weeks. After a month, if there is any 

discomfort it should be reported.”

Regular check ups once in 4-6 months are advised. The 

patient is advised to get into mainstream activity gradually 

like travelling, driving the car, swimming, resuming the job, 

golfing, and walking which will make you return to normal. 

Even sex is not barred. But there are some things to be 

avoided like entering an electromagnetic field. One should 

keep away from transformers, electric arc welding 

equipment and airport screening devices. The pacemaker 

identification card helps. MRIs are definitely to be avoided.

“Generally, we tell patients to avoid induction cooking, but 

the risks I believe are fairly small,” says Dr. , “but you can 

check with the manufacturer of the device.”

“You should use the mobile phone on the opposite ear, and at 

least six inches away from the implant,” says the Dr. 

 “Other household appliances like microwave oven, electrical 

appliances, computers can be safely used.”

Pacemakers do improve the quality of life and the implant is 

a small procedure, but check with the doctor before taking 

any decision.

What does a pacemaker do?

Relieves arrhythmia symptoms, such as fatigue and 

fainting

Helps a person with abnormal heart rhythms 

resume a more active lifestyle

.

Monitors and records heart's electrical activity and 

rhythm

.

Newer pacemakers also monitor blood temperature, breathing rate, and other factors and also adjust heart rate to changes in activity.


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Simple Breath Test Might Diagnose Heart Failure

 An experimental breath test, designed to quickly identify 

patients suffering from heart failure simply by analysing the 

contents of a single exhaled breath, has demonstrated 

promise in early trials, a team of researchers says.

The investigators stressed that their evaluation is based on a 

small group of participating patients, and that more 

extensive research will have to be done to confirm their initial 

success.

But by subjecting a patient's breath to a rigorous but fast 

analysis of the hundreds of so-called volatile organic 

compounds contained therein, the study team said it has so 

far been able to correctly diagnose heart failure among 

newly hospitalized patients with a 100 percent accuracy.

Every individual has a breath print that differentiates them 

from other people, depending on what's going on in their 

body," explained study lead author. And that print can tell us 

a lot about a person, what they've been exposed to and what 

disease they have," he added.

That's what makes the new field of breath testing so 

promising, because it is non-intrusive, so there is no risk 

involved. And you can do it anywhere, in a clinic, in a 

hospital, anywhere.

Currently, a diagnosis of heart failure comes from a variety of 

factors. These include medical history and symptoms, and a 

physical exam in which a doctor will listen to a patient's heart 

and lung sounds, and check ankles, feet, legs and abdomen 

for signs of fluid build-up. Blood tests and an 

electrocardiogram can help confirm that heart failure exists.

In the new study, to gauge how well the non-invasive breath 

test could identify heart failure, the team collected exhaled 

breath samples from 41 patients who had been admitted as 

in-patients to the Clinic.

Of those, 25 had been admitted with a primary diagnosis of 

"acute de compensated heart failure" while another 16 

patients had shown no signs of heart failure but did have 

other cardiovascular issues. A single breath sample was 

obtained from each of the patients within 24 hours of 

admission, as well as from an additional 36 patients with 

acute de- compensated heart failure as an independent 

point of comparison.

Within two hours of collection, all the samples were subject 

to the breath test analysis, which relied upon "mass 

spectrometry" technology to scan the samples for their 

molecular and chemical compound content. Some of those 

compounds had been pegged as potential tell-tale signs of 

heart failure.

The result: The breath test correctly identified all the patients 

with heart failure, clearly distinguishing them from those 

cardiac cases where heart failure was not an issue.

A Dr.  said that if further research were able to establish its 

effectiveness, a breath-driven tool for identifying heart failure 

would be a helpful diagnostic innovation -- but more so in a 

doctor's office or clinic than in the hospital.

If it is clear that it is highly reliable and specific and sensitive, 

then yes, it would be a welcome advance, he said. But I 

would say it would be perhaps more helpful for primary care 

physicians in an outpatient setting, because that is where it's 

most challenging to identify heart failure. Today a diagnosis 

in that environment is based on a patient's history and exam, 

but symptoms for heart failure can easily overlap with a lot of 

other diagnoses. And the blood work that would be taken in 

a doctor's office might not come back until the next day, 

delaying identification," he noted.

Study author added that the test is "theoretically cheap. But 

of course we're still early in the process of exploring its 

potential. This study is really a proof of concept. There is 

much more work that needs to be done to get it to the point 

where it would become widely available.