Heart and Vascular Care
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An arrhythmia, or irregular heartbeat, occurs when there is a change in the heart's electrical impulses. If the impulses are too rapid or too slow, the abnormal rhythm causes the heart to pump blood less effectively.
A common condition associated with arrhythmia is atrial fibrillation (AFib). AFib occurs when electrical signals in the upper heart chamber (atrium) fire incorrectly. As a result, the heart beats out of rhythm — which can cause clots to form and travel to the brain, possibly blocking flow and causing a stroke. People with AFib are five times more likely to have a stroke, but many have no symptoms and are often unaware of their condition until it is discovered during a physical examination.
To minimize stroke risk, one of the first treatments for AFib is often blood-thinning medication like Coumadin (warfarin). Other medications to control heart rate or rhythm may also be prescribed. These medications carry their own risks and while they can help manage symptoms, they alone can't cure AFib.
The longer your heart beats abnormally, the more difficult it is to reestablish a normal rhythm. It's important to seek AFib treatment sooner rather than later.
At Sharp, arrhythmias are diagnosed and treated with a full range of nonsurgical, minimally invasive and surgical treatment options.
Sharp uses advanced technology to produce 3-D images that show the electrical signals passing through the heart. Anatomical mapping is a type of electrophysiology study. Your doctor uses these images to identify the source of the arrhythmia.
Catheter ablation is a minimally invasive procedure that scars small areas of heart tissue to block the abnormal electrical signals and restore regular rhythm. Patients who undergo successful ablations have relief of symptoms due to AFib and may have a reduced risk of stroke.
In most cases, patients are admitted the morning of the procedure for an overnight hospital stay, and are able to resume normal activities the next day.
Hybrid Maze procedure
A new, two-stage technique, hybrid Maze combines a mini-Maze and left atrial appendage exclusion performed by a surgeon with a catheter ablation performed by an electrophysiologist. Sharp Memorial Hospital is the only hospital in San Diego — and one of only three in California — to offer this unique team approach to AFib treatment.
Implantable cardioverter defibrillator (ICD)
For some patients, irregular heart rhythm can be extremely dangerous and life threatening. These patients may be treated with an implantable cardioverter defibrillator (ICD) or a subcutaneous implantable cardioverter defibrillator device (S-ICD).
In this procedure, the doctor implants the small device under the left or right collarbone. Once the device is in place, the doctor inserts small wires that lead from the device to the heart. If a life-threatening incident occurs in the heart's rhythm, the device automatically shocks the heart to return to a normal rhythm. This device can prevent future life-threatening cardiac events, including sudden cardiac death.
Sharp offers support groups for patients and family members who want to learn more about their ICD.
Left atrial appendage exclusion procedure
A portion of the left atrium is clamped off where blood clots tend to form, reducing the risk of stroke. This procedure is routinely performed along with Maze or mini-Maze. Patients can often stop taking blood thinners immediately after this procedure.
Surgeons perform Maze surgery to treat chronic AFib. Maze surgery cures AFib by literally creating a maze of new electrical pathways to let electrical impulses travel easily throughout the heart. The Maze procedure uses sophisticated, minimally invasive methods, providing patients with a faster recovery and smaller incisions. Because patients with mitral valve disease often experience AFib, the Maze procedure may be performed in combination with mitral valve surgery.
Tiny incisions are created in the chest and an energy source is used to heat the tissue and create a lesion that blocks the arrhythmia's path. This minimally invasive procedure does not require opening the chest, so patients experience a shorter recovery time than they would with more invasive surgeries.
A variety of heart rhythm disorders can be controlled with an artificial pacemaker. A pacemaker delivers timed, electrical impulses to the heart muscles through tiny wire leads. Traditionally, pacemakers have had only one or two leads that could pace just the ventricles or the atria. Now biventricular pacemakers use three leads to treat the delay in heart ventricle contractions.
Pulmonary vein isolation/atrial fibrillation ablation procedure
Pulmonary vein isolation — also called pulmonary vein antrum isolation (PVAI) or atrial fibrillation ablation — is one of the latest technologies for treating AFib. Research has identified areas in the left atrium, specifically around the pulmonary veins, as initiators of atrial fibrillation. In this relatively noninvasive procedure, doctors use radio waves to destroy the tissue surrounding the pulmonary veins in the left atrium.
Watchman™ left atrial appendage closure implant
For patients with AFib, blood thinners (also called warfarins or anticoagulants) are the most commonly prescribed treatment to reduce stroke risk. However, some patients can't tolerate long-term blood thinner use or the risk of bleeding complications.
Watchman offers an FDA-approved alternative to blood thinners through a small, permanent implant. The implant closes off an area of the heart called the left atrial appendage to keep harmful blood clots from entering the bloodstream. This can reduce stroke risk, and, over time, patients may even be able to stop taking blood thinners.
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