July 2, 2008 > Keeping the Beat
Keeping the Beat
Less invasive treatment restores the heart's normal rhythm
Seventy-two times a minute - or 2.5 billion times in the first 66 years of a person's life.
That's how often the normal human heart beats. This amazing vital organ functions through electricity and "plumbing:" Electricity that causes the heart to beat and "plumbing" that pumps blood throughout the body.
Your heartbeat is stimulated by electrical signals traveling on a path from cell to cell inside the heart. In some people, this system gets blocked or it is "short-circuited," causing the heartbeat to race or become erratic. Called arrhythmia, this condition occurs when areas of abnormal tissue form, interrupting the usual path of the heart's electrical signals. The resulting flow may travel in a circle, or the cells may fire more rapidly - as many as 200 times a minute.
Cardiac arrhythmia is a relatively common condition, especially in older adults. There are a number of different types of arrhythmias, and the problem is not necessarily life-threatening. People with cardiac arrhythmia experience a wide range of symptoms. In some cases, the heart starts racing suddenly for no apparent reason. The person may feel light-headedness, fatigue and shortness of breath and may even pass out.
People who think they have a problem with episodes of cardiac arrhythmia should contact their physician. Once a doctor has diagnosed the condition, patients are usually treated with medication, which can sometimes cause side-effects. Changes in lifestyle can also help. In the past, if these treatments were unsuccessful, cardiac surgery was the next step to correct the arrhythmia.
Over the last 15 years, the ease and effectiveness of medical treatment for cardiac arrhythmia have improved dramatically through a non-surgical approach called cardiac ablation. The procedure is performed by an electrophysiologist, a physician who specializes in correcting heart rhythm problems.
According to the Heart Rhythm Society, a leading professional group of heart rhythm specialists, cardiac ablation is most often used to treat rapid heartbeats that begin in the upper chambers of the heart. These are called supraventricular tachycardias or SVTs. The procedure can also be used to treat rarer forms of arrhythmias that begin in the lower chambers of the heart, called ventricular tachycardias or VTs.
At Washington Hospital, electrophysiologists perform cardiac ablation in the hospital's Cardiac Catheterization Laboratory. Washington is the only hospital in the Tri-City area with the sophisticated computers and mapping systems required for this treatment.
"Through cardiac ablation, we locate the problem area in the heart and apply energy, usually in the form of microwaves, to destroy a small amount of abnormal tissue," says Hanh Bui, M.D., an electrophysiologist with California Cardiovascular Consultants and a member of the Medical Staff at Washington Hospital. "This relatively painless, minimally invasive procedure is designed to end the disturbance and restore the heart's healthy rhythm. Patients can usually return home the same day or after one night in the hospital."
During cardiac ablation, narrow flexible wires called catheters are inserted through a blood vessel and into the heart, usually from a site in the groin or neck. The electrophysiologist navigates the journey of the catheters by observing continuous "live" images created by an X-ray-like machine called a fluoroscope.
Once the catheters reach the heart, electrodes at the catheter tip confirm and "map" the location of the problem area. Then, the physician burns away a small amount of tissue at the site, ending the disturbance of heart's electrical flow. Most patients report feeling no pain during the procedure but may experience a feeling of discomfort. With trained experts and advanced equipment close at hand, cardiac ablation is considered to be safe, especially when compared to the alternative cardiac surgery.
"Cardiac arrhythmia is not something people have to live with," Dr. Bui states. "We can eliminate the trigger of an arrhythmia and help someone feel a whole lot better without the need for medication."
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