Electrophysiology & Heart Rhythym Services
Your heart is a pump — and a spark plug. And if the pumping and electrical functions don't work together, then your heart might stop working.
Southcoast Hospitals' Cardiac Electrophysiology (EP) Lab, based at Charlton Memorial Hospital, offers the very latest diagnostic and treatment technology for heart rhythm problems.
Treatment options offered include atrial fibrillation ablation, pacemaker and defibrillator implants, cardiac resynchronization and drug therapies.
Southcoast's EP Lab
Southcoast's Electrophysiology (EP) Laboratory provides diagnostic and treatment for cardiac arrhythmias.
A highly skilled team of physicians and nurses works with patients to determine the cause of their heart rhythm disturbances. Together, they develop a plan of care to treat the underlying cause of the heart rhythm disturbance and monitor the patient's progress and response to treatment.
The electrical system of the heart creates electrical impulses that help your heart to contract in a steady rhythm and pump blood throughout your body. If your heart's electrical system is not working correctly — a condition known as an irregular heart rhythm or "arrhythmia" — can develop, and serious health problems, even death, can result.
The heart is divided into upper and lower chambers and each send impulses that make the heart contract. Signals start in the upper part of the heart — the atrium, and travel to the lower part of the heart — the ventricles.
Abnormal heart rhythms might occur from:
- Abnormal functioning of cells in the atrium and the ventricles.
- Delays in the conduction of impulses from the atrium to the ventricles. When your heart beats too fast it is called tachycardia, when it beats too slow it is called bradycardia.
Some heart-related problems that can lead to arrhythmias include:
- Damage to the heart from a heart attack or coronary artery disease.
- Heart defects or congenital heart disease.
- Effects from medications.
- Disease affecting the heart valves or the heart muscle (cardiomyopathy).
Other causes might include excess caffeine or alcohol use, smoking or lack of sleep.
Some people may never know they have an arrhythmia. Others may be bothered by symptoms that include:
- Lightheadedness, dizziness or fainting.
- Shortness of breath.
- A feeling that your heart has skipped a beat or is beating too rapidly.
- Chest pain or discomfort.
Arrhythmias are diagnosed by two types of testing: non-invasive testing that records the heart's electrical activity externally and invasive testing that provides a "picture" of the heart's activity through a special catheter that is inserted directly into the heart.
Some types of non-invasive testing include:
- Holter monitoring, which provides a continuous heart reading for 24 hours.
- Event recorder, in which the patient can record the heart rhythm when they experience symptoms.
- Echocardiogram, which uses sound waves to provide a three dimensional picture of the beating heart's chambers.
- Treadmill test, which allows your doctor to record your heart's activity while you exercise.
- Tilt table testing, which monitors heart rate and blood pressure while your body is tilted at an upright angle.
- Implantable loop recorder which provides a long-term recording of heart rhythms when symptoms are expected.
If these non-invasive tests are not able to assist in diagnosing your problem, your doctor may recommend an Electrophysiology Study. Southcoast Hospitals is the only medical center in the region to provide this advanced diagnostic heart care.
An Electrophysiology Study is performed in a specially equipped room. During the study, doctors place special electrode catheters (long, flexible wires) into the veins and guide them into the heart. These catheters measure the electrical activity of the heart and also stimulate various areas of the heart — called pacing — in an attempt to induce an arrhythmia. During certain procedures, doctors can view a three-dimensional picture of the heart on a large computer screen. This technology provides a roadmap for identifying the exact location of the arrhythmia, thus making it easier to treat.
Our team of highly skilled physicians, nurses and technologists will offer comprehensive care for the treatment of heart rhythm disturbances such as:
- Drug therapy to help control and prevent arrhythmias.
- Cardioversion, a procedure used to restore normal heart rhythm.
- Permanent pacemaker implants to relieve symptoms of bradycardia (slow heart beat).
- Catheter ablation, a treatment that destroys the abnormal pathways in your heart that are causing various types of heart arrhythmias.
- Cardiac resynchronization therapy for congestive heart failure with PPM or ICD.
- Implantable cardioverter-defibrillator therapy for the prevention of sudden cardiac death.
- Laser lead extraction
About Laser Lead Extraction
When pacemakers and other heart pacing devices are implanted in a patient, doctors expect they will last the patient's lifetime. However sometimes it may be necessary to replace the device because of infection or device failure. In these cases, patients can find comfort knowing that Southcoast offers an innovative, less invasive and more effective option for removing leads – the wires attached to the device that follow blood vessels into the heart muscle. Using a laser device to break up scar tissue around the leads, the device can be safely and more easily removed before implanting a new device.
Southcoast Among the First to Offer New Defibrillator for Heart Patients
In another example of offering the latest, state-of-the-art technology to its patients, Southcoast will begin offering subcutaneous implantable cardioverter defibrillators (S-ICDs) to specific high-risk patients.
Unlike a pacemaker, which can only give low-level electrical pulses to correct certain types of irregular heartbeats, or arrhythmias, ICDs send high-energy electrical shocks to correct dangerous arrhythmias in the heart's lower chambers.
Some patients are not candidates for traditional ICDs because they are at high risk for infection, or have limited access to the major veins to the heart. However, an S-ICD, implanted just beneath the skin, does not have the traditional ICD's lead wires that go directly into the heart, but studies have shown the newer device to be just as effective in controlling irregular heartbeats - without actually touching the heart itself.
The U.S. Food and Drug Administration granted regulatory approval for the S-ICD System in September 2012. Southcoast has been chosen to be one of the first heart centers in the U.S. to begin
Cryoablation has been used in the treatment of arrhythmias, or irregular heartbeats. More recently cryoablation is being employed for atrial fibrillation ablation. Recent studies have shown this to be more effective than medicines in treating atrial fibrillation. This new treatment is now available at Southcoast.
How does it work? The connections of the left top chamber of the heart to the pulmonary (lung) veins has been shown to be responsible for genesis of atrial fibrillation. The goal of atrial fibrillation treatment with procedure is to break these connections.
During this procedure, a thin tube is inserted into a vein in the patient’s leg and directed through the vein to the heart. When it reaches the targeted area, a tiny balloon at the end of the tube is inflated to the entire inner circumference of the entrance of the pulmonary vein to the atrium. The balloon is then cooled to sub-zero temperatures using a refrigerant like liquid nitrous oxide, which destroys the contacted cells and their ability to disrupt the normal rhythm of the heart. After the targeted tissue is frozen, the coolant is removed, the balloon deflated, and the catheter withdrawn.
The alternative technique to eliminate these triggers is by heating the tissue with radiofrequency ablation. Cryoablation has been shown in studies to cause less damage to the structures surrounding the heart like the esophagus (food pipe) that lies behind the heart. Patient also have been shown in studies to have less chest pain and inflammation after the procedure when compared to radiofrequency ablation with heat.
Catheter-based cryoablation is a procedure that takes only about two hours, with one night stay and return to normal activity within 2 to 3 days. However, like any procedure rare complications such as bleeding, perforation of heart, stroke, narrowing of pulmonary veins and death can occur. Please contact our doctors to discuss this further.
Learn more about Dr. Sood, one of the electrophysiologists who perform this procedure at Southcoast.