Q: I have Palpitations and have Repeatedly Gone to the ER, but I do not arrive with Afib. How do I Know the Difference?

That’s probably one of the greatest sources of frustration for our patients, that episodes are often transient. They know that something’s wrong and they go to their provider or the ER and at that time they’re in a normal rhythm; it’s already passed. We unfortunately can’t figure out what has already passed, but we do have lots of tools to see what’s going on if we look at their heart rhythm over an extended period of time. So there’s rhythm monitors that we have patients wear, they look like patches and they can watch someone’s heart 24 seven for weeks on end. And then we get a report of everything that patient’s heart did for weeks on end, and if the patient was able to say at this time on this date I was feeling my palpitations and we look back and we see they’re in a perfectly normal rhythm, we know that his symptoms may not be from their heart.

The other side of that is, we may find that that patient had two minutes of very symptomatic atrial fibrillation. And two minutes of your heart going 200 beats per minute can be awful, and it’s hard to get someone to believe you if they don’t have a picture of it. So, that’s a great way to do it.

And, even further we have what are called implantable loop recorders or patient activated event monitors that implant under the skin, and they’re more less injectable devices that are very small that can watch the heart 24 seven for currently up to three years, and soon will have one that’ll last up to five years. It takes two to three minutes to put one of those in, and it talks to a system remotely and is actually able to tell us what happens to that patient’s heart every day all day for up to five years. So there’s lots of ways to make it so that we don’t have to keep going to the ER every time we have a palpitation.