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Cardiac Arrhythmia
October 2001

Q. My boyfriend suffers from irregular heartbeat. He was very active in sports (basketball) during high school until he was diagnosed with this condition. Since that time, he rarely engages in regular physical activities because he is afraid that he may die like the great basketball player, Pistol Pete.

Is he really at risk for dying for this condition? Is there a cure or treatment for irregular heartbeat? If he were to play basketball professionally or semi-professionally, would he increase his risk of death?

Please advise me of his options. He is currently being scouted by a couple of teams and he is afraid that, because of the rigorous practices and amount of running that he'll have to do, he might die. I don't want him to miss out on an opportunity of a lifetime if there is a way that he can overcome his situation.

A. You are describing a cardiac arrhythmia, an irregularity in the heartbeat. It is important to determine the cause of such a rhythm disturbance and decide if it is serious and needs treatment.

The starting point would be to have a complete physical exam, including basic lab work (blood test) and an electrocardiogram. This may be entirely normal. There are ways to study the abnormal rhythm since it occurs intermittently, and may be normal at the time of the physical. One such test is a Holter monitor, a small device like a portable tape player that is worn for 24 hours and makes a continuous recording of the heart rhythm via small electrodes attached to the chest wall. There are also devices that can be used for weeks at a time if the Holter test does not "capture" the abnormal rhythm. In addition it is likely that an echocardiogram would be ordered which uses sound waves to take a picture of the heart anatomy. These tests will give a lot of information quickly and a cardiologist can then direct the treatment. Stress factors and stimulants like caffeine may be playing a role as well, but a thorough evaluation is needed.

HELPFUL WEBSITES:

http://www.familydoctor.org/handouts/286.html

http://www.nhlbi.nih.gov/health/public/heart/other/arrhyth.htm

http://www.americanheart.org/

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