Patients come to me all the time and
they have palpitations. They feel their
heart beating. Most of these people
actually it's their own rate going fast
at times. And it's what I call the
princess and the pea syndrome. Some
people feel everything and you can put
as many mattresses as you want on top of
that pea and they still feel it. And that's
very unfortunate. Whereas other people
can be in almost life-threatening
rhythms and they don't feel anything. So
the sensation of an arrhythmia is very
difficult to pinpoint even for a doctor.
You need proof. So if you're having a
feeling of palpitations, it's a very
simple way to figure it out. We just give
you a monitor to wear for a given period
of time and we correlate your symptoms
with the electrocardiographic
representation. We can even use phone
apps now to do it, and if your symptoms
turn out to be atrial fibrillation then
we have to go down that path. This is not
to be disparaging to any doctor who
listens for 15 seconds on a patient's
chest but they haven't figured it out.
It's just like an ECG. An ECG is 12 to 15
seconds of your life. So you come and
tell me, "I have palpitations," we do an
electrocardiogram, I listen to you, I
don't hear anything abnormal, I don't see
anything so for maybe 30 seconds of your
life I've evaluated you. That's totally
inappropriate to make a decision I need
to correlate your symptom with the
electrocardiogram. So no, if your doctor
doesn't have the either desire or the
knowledge to take it to the next step,
you should probably see a cardiologist
or an electrophysiologist- they're going
to give you a monitor and they're going
to at least make the correlation. You
need documentation of the cause of your
palpitations. It might be atrial
fibrillation it might be your own rhythm,
it might simply be premature beats. The
important thing is you need a diagnosis.
it's easy to get, and there's no reason
why someone shouldn't do it for you. The
more difficult problem is people who may
be at risk for atrial fib who have no
symptoms but still are at risk for
stroke if they get it. And that's a very
difficult group of folks that I'm
approaching now in a little different
way. So if I think somebody has a high
stroke risk and they have a number of
things about their medical history that
suggests they're at a relatively high
risk for atrial fibrillation I've even
done some very long-term monitoring in
those people. So if you have symptoms, it's
straightforward: put a monitor on, figure
it out, and see where you're going. If you
have no symptoms, but let's say you've
had relatives who've had afib, you've had
somebody who's had a stroke, and you're just
concerned, "What if I'm next? And how am I
going to figure that out?" Then I think
depending on how high your risks are for
a stroke, you can have that discussion.
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