Device implementation allows physicians to insert small mechanisms into the patient's body to treat a variety of symptoms. A pacemaker, which helps a heart function properly, is just one example of the tools now available to electrophysiologists.
A pacemaker is a small, battery-powered device that is implanted permanently into the body. The pacemaker monitors the electrical impulses in the heart and, when needed, delivers electrical stimuli to make the heart beat (contract) in a more normal rhythm.
This device is used when the heart beats too slowly (bradycardia) or has other abnormal rhythms (arrhythmias). In some cases, pacemakers are also used to treat the symptoms of heart failure.
A pacemaker consists of a battery and electrical circuitry (pulse generator). The battery powers the pacemaker. The circuitry checks the heart rate and produces tiny electrical pulses that keep the heart beating at the correct pace.
A pacemaker is connected to the heart through one to three insulated wires (leads) that are attached directly to the heart's chambers.
An implantable cardioverter defibrillator (ICD) is a device that monitors heart rhythms and delivers shocks when dangerous rhythms are detected.
Many ICDs record the heart's electrical patterns whenever an abnormal heartbeat occurs. Doctors can review this record during regular check-ups to help plan future treatment options.
ICDs are used to treat patients whose lower heart chambers (ventricles) beat too quickly (tachycardia) or quiver ineffectively (fibrillation). They are also used in patients who are at risk of these conditions due to previous cardiac arrest, heart failure or ineffective drug therapy for abnormal heart rhythms.
An ICD consists of a battery and electrical circuitry (pulse generator) connected to one or more insulated wires. The pulse generator and batteries are sealed together and implanted under the skin, usually near the shoulder. The wires are threaded through blood vessels from the ICD to the heart muscle.
The ICD continuously checks the heart rate. When it detects a heartbeat that is irregular or too rapid, it delivers a shock that resets the heart to a more normal rate and electrical pattern (cardioversion).
Implantation of an ICD can be a life-saving measure in people prone to developing fast heart rhythms, such as some individuals with heart failure or a history of heart attacks.
Cardiac resynchronization therapy (CRT), also referred to as biventricular pacing, is used for patients with congestive heart failure. Unlike typical pacemakers, special pacemakers that coordinate the beating for both the left and right ventricles are used for CRT.
CRT can benefit patients with moderate to severe congestive heart failure symptoms, weakened and/or enlarged heart muscles, or a significant electrical delay in the lower pumping chambers of the heart. It has been shown to improve a person's energy level and quality of life.
Atrial fibrillation is a disorganized rhythm originating in the upper chambers of the heart that can contribute to palpitations (fast heart rates), worsening of heart failure or stroke. While medical therapy offers some relief, therapy fails many patients eventually or they cannot tolerate it because of side effects. Recent advances have allowed physicians to perform ablations to eliminate atrial fibrillation.
Atrial fibrillation ablation is a specialized technique that requires expertise, specialized technology, careful patient selection and close follow-up.
Prior to the procedure, the physicians utilize the Department of Cardiology’s specialized cardiac MR (magnetic resonance) scanner to visualize the left atrium and pulmonary veins. This is where much of this rhythm disturbance originates. The physician uses these images to more precisely plan and guide the placement of catheters and ablation lesions during the procedure.
The procedure is performed under conscious sedation to maximize the patient’s comfort. Patients can expect to spend one night in the hospital after the procedure. Most patients resume their normal activities within a few days. The physicians use extensive outpatient event monitoring before and after the procedure to document all symptomatic episodes and as a surveillance measure to document possible asymptomatic episodes. An in-depth consultation can be arranged to see if ablation therapy is suitable for you.
Cardiac catheter ablation, which is a relatively non-invasive procedure, is used to treat abnormally rapid heartbeats that cannot be controlled with medication, or in patients that cannot tolerate these medications. This procedure can restore a normal heart rhythm and eliminate the need for open-heart surgery or long-term drug therapies. During a cardiac catheter ablation, a long, thin tube is threaded into or onto the heart to cauterize (ablate) the area of heart tissue that is causing abnormal heart rhythms.
Cardiac ablation catheters are used most often to treat abnormal rhythms that begin in the upper heart chambers (atria) including:
Ablation can also be used to treat heart rhythm disorders of the lower heart chambers (ventricles) such as ventricular tachycardia