UAMS heart researchers uncover tool to quickly diagnose normal vs. abnormal rapid heartbeat

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Dr Hakan Paydak; Dr Swathi Kovelamudi
Published in JAMA
Congratulations to the Division of Cardiovascular Medicine’s Dr. Hakan Paydak, former faculty member Dr. Krishna Pothineni, and UAMS Cardiology fellow Dr. Swathi Kovelamudi on the publication of their case report in JAMA Internal Medicine. Dr. Pothineni, who recently moved to the University of Pennsylvania, is first author, and Dr. Paydak served as senior author on “Tachycardia in a Patient with Heart Failure, Telemetry Tales.” This stellar team, along with additional residents, fellows and faculty in Internal Medicine, also recently had a paper accepted for publication in Clinical Medicine Insights: Cardiology, and continues to collaborate on innovative cardiology research.

LITTLE ROCK, Ark.- University of Arkansas for Medical Sciences (UAMS) officials say a team of heart researchers has determined a new way to diagnose a dangerous heart rhythm issue using graphs.

Their findings were published as a case study in JAMA Internal Medicine, and they are working on follow-up research, according to officials.

The researchers are Professor Hakan Paydak, M.D., and cardiology fellow Swathi Kovelamudi, M.D. of the Division of Cardiovascular Medicine in the Department of Internal Medicine in the UAMS College of Medicine, along with former faculty member and first author Krishna Pothineni, M.D., who is now at the University of Pennsylvania.

UAMS officials say in a news release sent Thursday their technique is as simple as being able to tell the difference between a bell-shaped curve and a graph with sharp edges like a rectangle or square.

“The ability to produce these graphs is a common capability with just about every form of telemetry heart monitoring,” Paydak said. “This is a technique a lot of health care providers in a lot of contexts will be able to reproduce and easily interpret the results.”

According to officials, when a patient arrives at a doctor’s office or emergency room with an abnormally fast heart rate, which is a type of heart arrhythmia, the exact cause is hard to determine.

UAMS officials say the symptoms are the same if the fast heart rate came up gradually during exercise, which is sinus tachycardia, or from a more serious arrhythmia, called supraventricular tachycardia. According to officials, the first requires no treatment, but the second requires a specific treatment plan.

In the case study, the patient was sent to the catheterization laboratory, where the physicians detected a fast heartbeat in the upper chambers of her heart. According to the news release, they suspected the symptoms had developed gradually, but asked Paydak for a consultation. Paydak gave the patient a medication that would treat the supraventricular tachycardia but that wouldn’t change the symptoms if the cause were gradual, officials say.

“We were watching the heart monitors and all of a sudden we saw a sharp drop in the heartbeat, in the form of a square or rectangle,” Paydak said. “This helped us diagnose that the patient did indeed have an underlying abnormal rhythm problem that weakened the heart muscle due to rapid rates.”

According to researchers, if the patient simply had a rapid form of a normal heartbeat, the graph would have been a gradual curve, like the right side of a bell-shaped curve. According to the news release, the sharp drop-off told Paydak that a more serious condition was to blame.

Officials say Paydak switched the patient to a safer medication and she is now doing fine and does not need additional treatment.

“Using this simple and widely available tool can enable clinicians to confidently diagnose cardiac arrhythmias that impact patient care,” Pothineni said.

The research team says this is an easier tool in comparison to previous methods available.

The research team is also studying the ease of use by introducing the technique to medical students and seeing if the students can use it to correctly make the diagnosis.

“What’s notable about this is that it’s such a simple thing, but it’s so effective and it makes such a dramatic difference in patient management,” Kovelamudi said. “It’s a very simple step, you don’t need a lot of technical expertise to be able to do it, and even our medical students and residents can quickly look at these trends and determine the best course of treatment.”

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