Do you get an occasional fluttering in your chest, or sometimes experience a racing heart beat or slow heart beat that comes on suddenly, then goes away just as fast as it came?

For most, these occasional, irregular heartbeats are common and harmless, especially if the heart is otherwise normal. However when an irregular heartbeat (or heart rhythm) is combined with a diagnosis of heart failure, it can be serious. If left untreated, it can make heart failure worse.

If you've been experiencing these symptoms with some regularity, make an appointment with a doctor, who'll check to see if you're suffering from heart failure, a condition in which the heart doesn't pump blood through the body as well as it should.

Diagnosing the Problem

The first thing your doctor will do is order an electrocardiogram (ECG), which records the electrical activity in your heart. ECG adhesive patches (electrodes) will be placed on your chest, arms and legs. The patches are attached to wires and connected to a machine that records the electrical activity in your heart on graph paper.

If no explanation for your heart rhythm irregularity turns up on the ECG, your doctor might ask you to wear a Holter Monitor, a small portable device used to make a tape recording of your heartbeats over a longer period of time. Patients typically wear the device for 24 to 48 hours and keep a diary of their symptoms.

After the test is done, the tape is sent to the lab for analysis and an explanation for the irregularities can become apparent. Most importantly, expect to have pictures of your heart made, especially an echocardiogram, or "sono," of your heart. If weakened or abnormal heart function is noted, you might need to take more tests and consider certain therapies.

Other methods used to diagnose heart rhythm problems include the Tilt Table Test, which involves monitoring a patient's ECG and blood pressure in different positions; and the Electrophysiology (EP) Study, in which special catheters (thin insulated wires) are inserted into a blood vessel and threaded into the heart to record its electrical activity. During an EP study, the doctor will try to provoke a heart rhythm problem to pinpoint the starting location in the heart and evaluate how the patient responds to the abnormal rhythm.

Treating the Problem

After your heart rhythm problem has been diagnosed, your doctor will develop a treatment plan that's right for you. It might include medicines such as anticoagulants (blood thinners), which help prevent blood clots and reduce the risk of stroke; an implantable device, such as a cardiac pacemaker, used to treat slow heartbeats; an implantable cardioverter defibrillator (ICD), which treats very fast heartbeats; or surgery.

To minimize heart rhythm problems it is highly recommended that you consult your doctor or nurse before taking over-the-counter remedies, including nutrient supplements. You should also reduce or eliminate your caffeine intake, drink less alcohol, quit smoking, get more sleep, start an exercise program after consultation with your doctor or nurse, and take all your medicines as prescribed. If it is discovered that in addition to the heart rhythm problems there is evidence of heart failure, additional treatment recommendations might be necessary.

To learn more about heart failure and rhythm problems, visit the Heart Failure Society of America's Web site, www.abouthf.org.