Cardiac electrophysiology is the study and treatment of disorders within the heart’s electrical system. An electrical signal in the heart causes it to contract and pump blood. When that signal is disrupted, it affects the heart’s rhythm, making it beat too fast or too slow. An abnormal heart rhythm, also called an arrhythmia, can cause heart palpitations, dizziness, fainting, sweating, shortness of breath, heart failure, or stroke.
It is important to have any arrhythmia investigated by a specialist. If your heart rate is too fast or too slow, your cardiac electrophysiologist may recommend one of the following treatments.
Medications and pharmacologic agents can often control an abnormal heart rhythm, but they must be taken consistently and under the supervision of a heart specialist. Some of the commonly used medications include anticoagulants, beta-blockers, or calcium channel blockers.
A highly effective non-surgical treatment for atrial fibrillation, atrial flutter, supraventricular tachycardia, premature ventricular contractions, and ventricular tachycardia. A thin tube (catheter) is placed in a vein in the groin and threaded up to the portion of the heart that is creating an abnormal rhythm. Doctors deliver radiofrequency or cryotherapy energy through the catheter to scar the tissue in the damaged part of the heart, stopping the rapid impulses.
Hybrid Atrial Fibrillation Ablation
A two-stage ablation therapy for long-standing persistent atrial fibrillation and recurrences from prior ablations. This procedure combines minimally invasive surgery and catheter ablation together to create scar tissue inside and outside of the heart, restoring a normal rhythm.
Delivering a quick and controlled electrical shock to the heart to reset the heart’s rhythm. It can be delivered externally through pads placed on the chest, or internally through a small tube (catheter) that is threaded through a vein and into the heart.
Automatic Implantable Cardiac Defibrillator Insertion
An automatic implantable cardiac defibrillator (ICD) is an electronic device that includes a pulse generator and leads. The pulse generator is about the size and shape of a credit card and weighs less than 2 ounces. It is implanted into the chest just underneath the skin. The ICD is connected to one or more leads that are placed in and near the heart. The lead system sends electrical signals from the heart to the pulse generator, which continuously monitors the heart's rhythm. When the pulse generator receives signals from the lead system that the heart rhythm is shockable (such as during ventricle tachycardia or ventricular fibrillation), it sends energy through the lead system to the heart to stop the abnormal rhythm. If the heart rhythm remains normal, the ICD monitors the rhythm and waits until a shock is needed.
People who receive an ICD have generally had a prior heart attack, have a significantly damaged heart, show brief bursts of abnormal rhythm when on a heart monitor, and have successfully undergone electrophysiology testing to rule out other dangerous rhythm abnormalities. Only about 10 percent of all heart attack patients end up needing an ICD.
When the heart’s electrical system malfunctions, it can result in an abnormally slow heart rate (bradycardia) or an abnormally rapid rhythm (tachycardia). Most pacemakers are designed to correct bradycardias. Left untreated, bradycardias can cause weakness, fatigue, lightheadedness, dizziness, loss of consciousness, or even death. When used properly, pacemakers can correct the problem.
Pacemakers consist of a generator and leads. The generator is a tiny battery-operated computer roughly the size of a 50-cent piece and about three times as thick. The battery lasts for five to eight years. The lead is a flexible electrical wire. One end is attached to the generator and the other end is passed through a vein into the heart. Generally, one lead is placed in the right atrium and the other in the right ventricle. The pacemaker then helps to regulate the timing of the heartbeat.
Today’s pacemakers are rate responsive, meaning they determine what the heart rate should be from moment to moment. To determine proper heart rate, the pacemaker may use the following technologies:
- An activity sensor in the pacemaker determines body movement. The more the body is moving, the faster the heart rate moves.
- A breathing sensor measures the breathing rate. The faster a person breathes, the faster the heart beats.
Both of these technologies allow pacemakers to mimic the changes in a normal, healthy heart.
Pacemakers can be implanted under the skin (right or left side). The person receives a local analgesic in the chest area. A small incision is made, and the leads are guided through a vein toward the heart. The generator is then placed in the incision site. The entire process generally takes less than 45 minutes. The newest leadless pacemaker devices are delivered through a catheter directly into your heart, through a small puncture in the groin, without the need for surgery.
After the pacemaker is implanted, a physician must program it. Every so often, it may need to be reprogrammed or changed to suit the individual user. It can be programmed with a handheld device that does not require any surgery.
Pacemaker/ICD Support Group
People with pacemakers or ICDs often have questions and concerns, such as:
- How do I take care of it?
- How long does it last?
- Can I use a microwave oven?
- What does a shock feel like?
- Will airport security scanners affect it?
- Can I still do the things I enjoy?
You can get answers and talk to other pacemaker/ICD users at our quarterly support group meetings. The meetings are open to device users, their family members, and caregivers. There is no charge to attend.
Cardiac nurse educators lead each session and guest speakers provide information and answer questions. Meetings are held in the Mercer Auditorium located on the Memorial Health University Medical Center campus. Light refreshments are served at 5:30 p.m. and the meetings begin at 6:00pm
For reservations or more information, please call (912) 350-4284