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Arrhythmia Techniques and Treatments
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At the St. Elizabeth Heart & Vascular Institute, our interventional electrophysiologists utilize a number of procedures and techniques to treat fast heart rhythm disorders.

Interventional Techniques

  • 3-D Arrhythmia Mapping: a 3D- visual of the heart is created using an electromagnetic mapping system. This helps detect the site of origin of abnormal electrical impulses and helps guide accurate manipulation of catheters within the heart during catheter ablation, while reducing the amount of x-ray exposure to the patient and the physician.
  • Catheter Ablation Techniques: after the arrhythmia has been mapped using either fluoroscopic or 3-D mapping techniques, the origin can be targeted using ablation energy. Ablation destroys abnormal cells inside the heart that cause arrhythmias. Ablation energy comes in two predominant forms – heat energy or cold energy:
    • Radio Frequency Ablation (Heat): this small-tip catheter is used to destroy abnormal cells so the erratic electrical signals are normalized.
    • Cryoablation (Freezing): a catheter that delivers cold energy is used to freeze the heart tissue and ultimately destroy abnormal cells.
    • Cryoballoon: a catheter that has a balloon tip capable of freezing the tissue inside the heart that causes atrial fibrillation.

Cardiac Implantable Electronic Devices

  • Cardiac Resynchronization Therapies (CRT or Heart Pacemakers): implanted devices to control heartbeat
  • Implantable Cardioverter Defibrillator (ICD): an implanted device that can detect and correct dangerous arrhythmias
  • MRI-compatible Pacemaker: a pacemaker that allows patients to utilize MRI diagnostic testing if needed. Patients with traditional pacemakers cannot receive MRIs
  • Subcutaneous Arrhythmia Detection Devices and Implantable Loop Recorders (ILR): implanted devices that monitor heart activity and rhythm
  • Subcutaneous Defibrillator: an implanted device that can detect and correct dangerous arrhythmias that does not require wires into the heart

Lead Extraction Program

  • Laser Lead Extraction: removal of wires (leads) placed in the heart for pacemakers and other implanted devices

Other EP Procedures

  • Cardioversion: an electrical shock is delivered to the heart through paddles or patches placed on the chest to reset the electrical activity within the heart. The shock is delivered during sedation (painless), and patients go home the same day. With electrical cardioversions, there is a high chance of atrial fibrillation recurrence. However, it is worth doing in select cases to supplement the effects of medications that your doctor selects to maintain normal rhythm. Blood thinners are prescribed for 4 weeks before the cardioversion is attempted to reduce the risk of stroke followed by a minimum of another 4 weeks of blood thinners after the procedure. An alternative to this strategy, is performing a trans-esophageal echocardiogram or an ultrasound of the heart on the day of the procedure instead of waiting the 4 weeks, proceed with the electrical cardioversion, followed by a minimum of 4 weeks of the blood thinner medication.
  • Life Vest: a wearable external defibrillator that monitors heart rhythm and can provide a life-saving shock to a person experiencing a dangerous arrhythmia. This treatment was featured on Local 12 news. Please click here to view the story.

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