Electrophysiology Interventional Procedures
In the realm of cardiac care, Electrophysiology Interventional Procedures stand as a crucial frontier. At Pomona Valley Hospital Medical Center, our adept electrophysiologists employ a diverse array of advanced techniques to diagnose and address an array of cardiac rhythm disorders. These interventions play a pivotal role in managing conditions like arrhythmias, irregular heartbeats, and other cardiovascular complexities. Let's delve into the innovative procedures that form the cornerstone of our cardiac interventional expertise.
Cardioversion
Cardioversion for atrial fibrillation provides an external synchronized direct current shock to the heart, essentially “shocking” the heart out of the irregular a fib rhythm. This procedure has a high success rate. An Internal defibrillation with catheters inside the heart has an even higher success rate.
Pacemaker Placement
A pacemaker is a small, battery-powered device that sends out weak electrical impulses that cause the heart muscle to contract. A pacemaker can be used to replace the function of the natural pacemaker of the heart when the heart is beating too slowly. It consists of wires (leads), which transmit electricity to the heart, and the pulse generator and battery, which generate the electrical impulses. The battery in a permanent pacemaker usually lasts 5 to 15 years. Your doctor will monitor your pacemaker regularly to decide when the battery should be changed.
Pacemakers are surgically placed into the chest (a permanent pacemaker) through a small incision. There are several types of implantable pacemakers.
- A fixed-rate pacemaker gives off electrical impulses at a steady, regular rate, regardless of your level of activity. A rate-responsive pacemaker changes the rate of electrical impulses as your activity level changes.
- A single-chamber pacemaker controls only the lower chamber of the heart (ventricle).
- A dual-chamber pacemaker controls both the top (atrium) and bottom (ventricle) chambers of the heart.
- Many times the pacemaker is set to work only when the heart rate falls below a certain predetermined rate (demand mode).
The surgery needed to implant a permanent pacemaker is considered a minor surgical procedure. It can usually be done using local anesthesia, which means part of your body is numbed, but you stay awake. A small incision is made in the chest wall. The pacemaker leads are usually threaded through the incision into a large blood vessel in the upper chest and into the heart. Using the same incision, a small pocket is created under the skin to hold the pulse generator. The leads are then hooked up to the pulse generator. The entire procedure usually takes about 1 hour.
Implantable Cardioverter Defibrillator (ICD)
Each year more than 300,000 people die suddenly in the United States. This is termed sudden cardiac death or sudden cardiac arrest. The most common arrhythmia leading to sudden cardiac arrest (SCA) is ventricular fibrillation (VF), an arrhythmia of the heart in which the heart quivers rather than beats effectively. When this happens, the heart no longer supports circulation, the patient loses consciousness and, if the normal rhythm is not restored quickly, the patient will not survive. VF is often preceded by another abnormal, fast rhythm called ventricular tachycardia (VT). In VT the heart usually maintains some pumping function although in the majority of patients it is not enough to support circulation either. VT usually degenerates into VF if the normal rhythm is not restored quickly.
There are several types and manufacturers of ICD. Generally, they consist of an oval-shaped device generator and two or three leads. The generator contains the small computer that monitors the rhythm, detects arrhythmia and determines if treatment is needed. It also houses the battery and the device that delivers the shock through the leads. The leads are essentially wires that are attached to the ICD on one end, with the other ends positioned in different locations within the heart chambers. Implanting an ICD is generally considered a minor surgical procedure and is usually done with sedation and local anesthetic. Following the implant, the doctor will monitor you and your device regularly to maintain proper functioning.
