When the beat goes off

An irregular heartbeat is more common than we might expect

When the beat goes offToronto Maple Leafs goalie Jonas Gustavsson is not a likely candidate for heart trouble. For months, the 24-year-old Swede, whose six-foot-three, 192-lb. frame and quick reflexes have earned him the moniker “the Monster,” geared up for his NHL debut with a rigorous schedule of weightlifting and long shifts on the stationary bike. But after a fitness test on Sept. 12, Gustavsson’s heart would not stop racing. He was taken to hospital, underwent minor surgery to correct the problem, and was back at practice within a week.

But despite his quick recovery, many remain puzzled: how could this happen to someone so young, under close medical scrutiny? While the organization remains tight-lipped, according to experts, many of the conditions that cause the heart to race often go undetected, and are far more common than one might expect.

Michael Gollob, a cardiac electrophysiologist at the University of Ottawa Heart Institute, says that among young people, the most frequent explanation for the kind of symptoms—and treatment—Gustavsson had is SVT (supraventricular tachycardia), which he describes as “an extra circuit in the heart.” Though this “microscopic” abnormality is present in one per cent of the population, Gollob says that in many cases, the extra circuit never becomes active. But when it does, “the rhythm will go very rapidly, using the normal electric circuit with the extra circuit.” Though SVT isn’t more common in athletes, they may discover it more readily; exercise, says Gollob, is a frequent trigger. (Unlike arrhythmias that are caused by serious structural abnormalities, and that have resulted in the sudden deaths of seemingly healthy athletes, SVT is considered low-risk.)

In older people, however, there is a more common reason for a heart that kicks into overdrive: atrial fibrillation (AFIB). According to Gollob, AFIB, which is a sustained abnormal rhythm in the upper chambers, affects 10 per cent of those between the ages of 70 and 80. During AFIB, the heart can reach up to 200 beats per minute (the normal rate ranges from 60 to 100). “It can be very alarming and very uncomfortable,” says Charles Kerr, Vancouver cardiologist and head of the Canadian Cardiovascular Society. In AFIB, the heart isn’t pumping properly, which can cause clots to form—if a clot reaches the brain, a stroke can occur. (AFIB patients are often put on blood thinners.) Already the leading cause of stroke, “as the population ages,” says Gollob, “AFIB is going to become an epidemic.”

The trouble with AFIB and SVT is they’re difficult to detect; unless a person is experiencing the rapid heartbeat, the condition isn’t visible on electrocardiograms (ECGs). But once diagnosed, they are often easy to treat. Gustavsson had a catheter ablation, a procedure with a 90 to 95 per cent success rate that involves inserting a catheter near the groin, and running it up to the heart. Once the problem area is located, it is burnt off. Though ablation isn’t as effective for AFIB patients, breakthroughs in medications offer new hope for keeping the rapid heartbeat at bay. The message, says Gollob, is “to listen to your body. If you detect abnormal heart rhythms, that’s worth seeing your physician for an evaluation.”

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