It’s hard to believe that turbulence could be a good thing for the heart. Consider how the word turbulent is defined: “Characterized by conflict, disorder, or confusion; not controlled or calm.” Those traits don’t sound very heart-healthy. But when it comes to heart rhythm, it turns out that a turbulent response — to a premature beat — is better than a blunted one. The more turbulent the better.
No, you haven’t missed anything, and turbulence isn’t another of my typos. Until [recently], heart rate turbulence was an obscure phenomenon buried in the bowels of heart rhythm journals.
What Is Heart Rate Turbulence (HRT)?
When you listen to the heart of a young physically-fit patient, you are struck not just by the slowness of the heartbeat, but also by the variability of the rhythm. It isn’t perfectly regular, nor is it chaotic like atrial fibrillation (AF). Doctors describe this — in typical medical speak — as regularly irregular: The heart rate increases as the patient inhales and slows as he or she exhales. This variability occurs as a result of the heart’s responsiveness to its environment. The more robustly and quickly the heart responds, the healthier it is.
HRT seeks to measure how quickly and vigorously the heart rate reacts in response to a single premature beat from the ventricle — a premature ventricular contraction (PVC). Normally after a PVC, the heart rate speeds for a few beats, and then slows back to baseline over the next 10 beats. The healthy heart responds with a more intense rise in heart rate and a quicker return to baseline. Using simple measurements of heart rate from a standard 24-hour electrocardiogram (ECG) monitor, a propriety software program averages many of these responses and comes up with a measurement of turbulence onset and turbulence slope. Read more »
*This blog post was originally published at Dr John M*