Rapid Heart Rate: Why an Electrophysiologist Might Be Your Best Choice

A heart that suddenly starts racing can be unsettling, particularly when there is no obvious reason for it. Sometimes a faster heartbeat is simply the body's response to exercise, fever, stress, dehydration or certain medicines. At other times, repeated episodes of a rapid heartbeat can point towards an arrhythmia, or an abnormality in the heart's electrical system.

This is where an electrophysiologist (EP) can be particularly useful. An electrophysiologist is a cardiologist with specialised training in diagnosing and treating disorders of the heart's electrical system. If the problem is primarily a rhythm disturbance, seeing an EP can help move the evaluation beyond simply asking how fast the heart is beating to understanding why it is beating that way.

When is a fast heart rate a concern?

For most adults, a resting heart rate above 100 beats per minute is considered tachycardia. However, the number alone does not tell the whole story. A temporary increase during exercise or fever is different from a heart rate that suddenly becomes very fast while you are sitting quietly.

Pay attention when a rapid heartbeat is:

• Sudden in onset and equally sudden in stopping
• Happening repeatedly without an obvious trigger
• Accompanied by palpitations or a fluttering sensation in the chest
• Associated with dizziness, weakness or breathlessness
• Accompanied by chest discomfort or fainting
• Occurring in someone with known heart disease or a previous cardiac procedure

Some rhythm problems, such as supraventricular tachycardia (SVT), begin in the upper chambers of the heart. Others, including ventricular tachycardia (VT), arise from the lower chambers and can be considerably more serious.

A rapid heartbeat can also have causes outside the heart, including anaemia, thyroid disorders, infection, electrolyte disturbances, dehydration and certain medicines. A proper assessment is therefore important before deciding that the problem is an arrhythmia.

What does an electrophysiologist do?

An EP observes the heart's electrical activity.

• The first step may include an ECG, Holter monitoring or another form of ambulatory rhythm monitoring, depending on how frequently the episodes occur. An ECG can be completely normal between ​​​​​​episodes; consequently, extended monitoring may be necessary to capture an intermittent heart rhythm issue.
• If the rhythm problem needs more detailed investigation, an electrophysiology study (EPS) may be recommended. During an EPS, thin catheters are introduced through a blood vessel into the heart. They record electrical signals and can help identify where an abnormal rhythm originates. The study can also help determine whether catheter ablation or an implanted device may be appropriate.

The treatment depends entirely on the rhythm involved. It may include observation, medicines, cardioversion, catheter ablation or an implanted cardiac device.

When is ablation considered?

For certain recurrent arrhythmias, particularly SVT, catheter ablation can offer a way of treating the electrical pathway responsible for the abnormal rhythm.

• During the procedure, the EP uses specialised catheters to locate the source of the abnormal electrical activity and delivers energy to a small area of tissue to prevent the abnormal signals from continuing.

Ablation is also used for selected patients with atrial flutter, atrial fibrillation and some ventricular arrhythmias. It is not automatically the right choice for every person with a fast heartbeat. The decision depends on the type of arrhythmia, how often it occurs, symptoms, underlying heart disease, response to medication and the patient's overall risk.

Electrophysiology services at STAR Hospitals

At STAR Hospitals, cardiac electrophysiology is part of the hospital's cardiology service, with dedicated evaluation and treatment for rhythm disorders. We provide curative treatment options for cardiac arrhythmias, including atrial fibrillation ablation using advanced mapping systems, while our device clinic manages pacemakers, defibrillators and cardiac resynchronisation devices.

Our electrophysiology services include:

• Electrophysiology studies and 3D cardiac mapping
• Catheter ablation for SVT, atrial fibrillation and ventricular tachycardia
• Pacemaker implantation
• ICD implantation
• Cardiac resynchronisation therapy (CRT)
• Conduction-system and physiological pacing
• Leadless pacing
• Lead revisions and transvenous lead extraction
• Device follow-up through a dedicated device clinic

STAR Hospitals houses ECG, Holter monitoring, treadmill testing, echocardiography, cardiac CT and MRI under one roof. This allows rhythm problems to be assessed alongside structural and other cardiovascular conditions rather than in isolation. The electrophysiology team also has experience with newer and more specialised procedures such as pulsed-field ablation for atrial fibrillation and atypical atrial flutter, scar-related VT and epicardial ablation, as well as leadless and physiological pacing. 

When should you see an electrophysiologist?

A single episode of a fast heartbeat does not necessarily mean you need an EP consultation. But if the episodes keep returning, begin suddenly, interfere with everyday life, or come with dizziness, fainting, breathlessness or chest discomfort, it is worth having the rhythm properly evaluated.

In some cases, the answer may be as straightforward as treating an underlying cause or adjusting medication. In others, identifying a specific electrical problem can open the door to a more targeted treatment such as ablation or device therapy. That is where an electrophysiologist's specialised training becomes particularly relevant.

To avail the best electrophysiologist services in Hyderabad, book an appointment with us today.