Cardiology

Pacemakers

A pacemaker is a device implanted in the chest that sends small electrical impulses to the heart muscle to maintain a suitable heart rate by stimulating the upper or the lower chambers of the heart. A pacemaker may also be used to treat fainting spells (syncope) caused by a slow heart rate.

Types of pacemakers
There are many configurations and types of pacemakers available. Your doctor will decide what type of pacemaker you need based on your heart condition. Your doctor also determines the minimum rate (lowest heart rate) to set your pacemaker. When your heart rate drops below the set rate, the pacemaker generates a painless impulse that passes through the lead to the heart muscle. This causes the heart muscle to contract, creating a heartbeat.

Why do I need a pacemaker?
If the electrical pathway described above is interrupted for any reason, changes in the heart rate and rhythm occur that make a pacemaker necessary. Pacemakers are used to treat brady-arrythmias, slow heart rhythms that may occur as a result of disease in the heart’s conduction system.

Defibrillators

An ICD (implantable cardioverter defibrillator) is an electronic device that constantly monitors your heart rhythm. When it detects a very fast, abnormal heart rhythm, it delivers energy to the heart muscle. This causes the heart to beat in a normal rhythm again. Defibrillators can also function as pacemakers to treat slow heart rates.

Why is an ICD needed?
Ventricular tachycardia and ventricular fibrillation are two life-threatening heart rhythms that cause the heart to beat very fast. These conditions can be fatal if not treated immediately. Your doctor has recommended that you receive an ICD because you have had at least one episode of these heart rhythms or are at high risk of developing these types of heart rhythms.

Who needs an ICD?
An ICD may be recommended for people who:
  • Had a prior episode of sudden cardiac arrest
  • Had a prior episode of ventricular fibrillation
  • Had at least one episode of ventricular tachycardia
  • Diminished ejection faction (EF) less than 35% (normal EF is 50-70%) secondary cardiomyopathy despite optimal medical therapy.

Cardiac Ablations

Cardiac ablation is a procedure that is used to scar small areas in the heart muscle that may be causing an abnormal heart rhythm. At FMH we offer atrial flutter and AV nodal ablations.

What is catheter ablation?
Catheter ablation is a treatment for cardiac arrhythmias. During ablation, a doctor inserts a catheter (thin, flexible wire) into the heart. A special machine delivers energy through the catheter to tiny areas of the heart muscle that cause the abnormal heart rhythm. This energy cauterizes the pathway of the abnormal rhythm. Ablation can also be used to disconnect the electrical pathway between the upper chambers (atria) and lower chambers (ventricles) of the heart. The type of ablation performed depends upon the type of arrhythmia.

Cardioversions
A cardioversion is a non-invasive medical procedure by which an abnormally fast heart rate (tachycardia) or cardiac arrhythmia is converted to a normal rhythm using electricity. Cardioversion can be used to treat many types of fast or irregular heart rhythms. The most common irregular heart rhythms that require cardioversion include atrial fibrillation and atrial flutter. Life-saving cardioversion may be used to treat ventricular tachycardia (a rapid, lifethreatening rhythm originating from the lower chambers of the heart).

Why is the cardioversion procedure needed?
Your doctor may recommended that you have a cardioversion procedure to restore your heart rate and rhythm to normal, so you heart can pump as it should. Irregular heart rhythms can sometimes cause symptoms including:
  • A pounding or fluttering in your chest
  • Shortness of breath
  • Chest discomfort
  • Dizziness or extreme fatigue

Implantable Loop Recorder
n insertable cardiac monitor or implantable loop recorder (ILR) is a small device that continuously monitors heart rhythms and records them automatically and possibly manually by using a hand-held control. The device is inserted just beneath the skin in the chest area during a simple out-patient procedure.

There are a variety of indications that your physician may choose when determining if an ILR is necessary. Indications include unexplained fainting spells, palpitations, or stroke where a rhythm such as atrial fibrillation may be a cause. In the event that your device detects an unusual rhythm, it will be triggered to record this event.

The ILR will record the heart’s rhythm before, during, and after the unexplained symptoms. Reports may be sent automatically to your physician for review. Your doctor has a better possibility of determining the cause of your symptoms and offer the most appropriate treatment once a definitive diagnosis has been achieved