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Non-Surgical Treatment

Implantable cardiac devices including pacemakers and defibrillators

Many types of small, implantable devices can be used to monitor and treat fast, slow and irregular heart rhythm problems. These devices include pacemakers, implantable cardioverter defibrillators (ICD) and insertable heart monitoring devices used to help diagnose suspected heart rhythm disorders.

Our interventional cardiologists and electrophysiologists are rhythm experts and have vast experience implanting these life-saving instruments in our state-of-the-art lab. Our physicians have access to the newest technology, and they are highly skilled at implanting the devices and selecting the right device for each patient's heart problem.

Implantation of pacemakers and defibrillators involves the insertion of the device's leads (wires) into the heart through a catheter, or thin tube that is inserted into the body through a blood vessel. These leads are attached to the device that is inserted beneath the skin, usually just below the collarbone. When the heart rate is too slow, these devices send low-energy electrical current through the leads and to the heart muscle to pace the heart, stimulating the muscle to contract. Defibrillators also are capable of delivering a high energy shock to the heart when the heart rate is dangerously fast.

Unlike pacemakers or defibrillators, insertable cardiac monitoring devices do not have any wires. These devices are placed just under the skin on the chest.

  • Biventricular pacemakers are devices specifically used to treat arrhythmias associated with certain complications of heart failure
  • Pacemakers are used to treat slow rhythms
  • Implantable Cardioverter Defibrillators (ICD) restore normal heart rhythm when the heart beats too fast, and can also act as a pacemaker for slow heart rates
  • Insertable cardiac monitoring devices record heart activity to help detect suspected arrhythmias or to rule out the presence of a heart rhythm problem

Biventricular pacemakers (cardiac resynchronization therapy) for heart failure

Normally, the left and right ventricles--the lower chambers of the heart--contract at the same time. Heart failure can disturb the heart's normal electrical pathway, causing uncoordinated, "asynchronous" pumping of the ventricles, further decreasing the heart's ability to properly pump blood. This defect of the heart's electrical system is called bundle branch block and is common among patients with congestive heart failure.

The biventricular pacemaker has three leads, one for the right atrium and right ventricle, and one that is placed in a vein on the surface of the left ventricle. The biventricular pacemaker stimulates the ventricles to contract together. This treatment is called cardiac resynchronization therapy.

At the Arrhythmia Center, electrophysiologists work side-by-side with our heart failure care team to identify patients who may benefit from cardiac resynchronization therapy.

Defibrillators

Defibrillators, also called implantable cardioverter defibrillators (ICD), are devices for people who have life-threatening abnormal or fast heart rhythms or are determined to be at a high risk for cardiac arrest. ICDs continuously monitor heartbeats. When a dangerously fast heart rhythm occurs, the device is triggered to deliver a life-saving, high-energy electrical shock to restore proper heart rhythm.

ICDs may be appropriate for people who are at an increased risk of a cardiac arrest based on any of the following criteria:

  • People who have had a heart attack or have cardiomyopathy and have congestive heart failure
  • Diagnosis of ventricular tachycardia or ventricular fibrillation, or other disorders that cause abnormally fast or erratic heartbeats
  • Survivors of cardiac arrest
  • People with certain forms of inherited heart disease, such as hypertrophic cardiomyopathy, or a family history of sudden cardiac death

Electrical cardioversion

Used for many types of arrhythmias, electrical cardioversion involves delivering a short electrical shock to the chest which helps reset the heart to a normal heart rhythm. The procedure is performed in a special lab called the electrophysiology laboratory. During this non-surgical procedure a catheter is inserted in a specific area of the heart. A special machine directs energy through the catheter to small areas of the heart muscle that cause the abnormal heart rhythm. This energy “disconnects” the source of the abnormal rhythm from the rest of the heart. It can also be used to disconnect the electrical pathway between the upper chambers (atria) and the lower chambers (ventricles) of the heart. Patients can typically go home the same day of the procedure after being monitored.

Implantable cardioverter defibrillator (ICD)

An implantable cardioverter defibrillator is a small device placed in a patient’s chest or abdomen that uses electrical pulses to help control arrhythmias, especially arrhythmias that can cause sudden cardiac arrest. ICDs continually monitor heartbeats and deliver electrical shocks to restore a normal heart rhythm when necessary.

Insertable cardiac monitoring devices

An insertable cardiac monitoring device is used to detect heart rhythm-related episodes of unexplained fainting (syncope) or palpitations.

An insertable cardiac monitoring device continuously monitors heart rhythm and records your heart's activity in the form of an electrocardiogram (ECG). When a fainting episode occurs, the device is triggered to save and record the heart's activity before, during and after the episode. The device can be programmed to automatically record the episode or it can be prompted to save the ECG via a small hand-held device placed over the cardiac monitor. Our electrophysiologists can then read the ECG recording to determine if an arrhythmia is present.

Other types of heart monitoring devices such as holter monitors, zio patch and event recorders are worn outside the body and are designed for more short-term use. An insertable cardiac monitoring device can be in place for up to three years, increasing the chances of documenting an infrequent fainting spell.

Pacemakers

Pacemakers are small, electronic devices used to treat excessively slow heart rhythms (bradycardia). Pacemakers send signals to the heart muscle that cause the muscle to contract at the correct pace, so that blood is pumped properly through the body. Today's advanced pacemakers adjust heart rates according to changes in the body's activity level. Thus, the pacemaker adjusts the heart's rate when the person is resting or exercising. Different types of pacemakers exist. Single-chamber pacemakers send electrical impulses to one chamber (atrium or ventricle) of the heart, while dual-chamber pacemakers have wires placed in one atrium and one ventricle.

Radiofrequency catheter ablation

Radiofrequency catheter ablation is a treatment that uses high frequency radio waves to ablate, via heat, tiny areas of the heart that is the source of atrial fibrillation. Catheter ablation can cure atrial fibrillation – especially in patients who are not in atrial fibrillation all of the time with success rates reaching 70 – 80 percent.

The procedure involves the use of a specially designed catheter that is threaded through an artery in the groin and into the heart. While in the heart, the catheter is directed to the arrhythmia source, which most often originates form the pulmonary veins. The catheter emits high frequency radio waves to create lesions on the abnormal tissue. These lesions are designed to block the pathway of erratic impulses of atrial fibrillation, thereby restoring a more normal heart rhythm.

Cryoablation

Cryoablation is performed to restore normal heart rhythm by disabling heart cells that create an irregular heartbeat. Like radiofrequency ablation, a thin flexible tube called a balloon catheter is used to locate and freeze the heart tissue that triggers an irregular heartbeat.

Benefits of catheter ablation:

  • 70 to 80% success rates in curing some types of atrial fibrillation
  • Few or no symptoms associated with atrial fibrillation
  • Better ability to exercise more frequently and for longer periods of time
  • Improved quality of life
  • Reduction in the need for antiarrhythmic drugs
  • No large incisions – just a small incision that leaves little to no scarring

Catheter ablations are performed in our state-of-the-art catheterization laboratory. This lab is equipped with advanced imaging and electrical mapping tools that give our interventional cardiologists a very detailed view of the heart.

In most cases, catheter ablation procedures take approximately two to five hours. Patients typically stay for one night in the hospital.

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The Adventist Heart Institute values your privacy and handles your personal information with care. Your email address and information is secure, confidential and will not be sold to any third party sources.

AHI Rebrand