Understanding and Treating Abnormal Heart Rhythms

Electrophysiology is a medical specialty that deals with electrical problems in the heart. These electrical problems can lead to abnormal heart rhythms (arrhythmias) that may affect quality of life and may even be dangerous in some cases.

MyMichigan Medical Center Midland has an electrophysiology (EP) lab that is specially equipped to enable a type of cardiologist called an electrophysiologist to diagnose and often treat these rhythm problems. Arrhythmias have traditionally been treated with medications or pacemakers. The lab enables many of these conditions to be treated and sometimes even permanently cured through minimally procedures. The lab offers every diagnostic and therapeutic EP procedure.

Procedures

Types of procedures performed in the EP lab:

• Electrophysiology (EP) Studies – This is a diagnostic procedure that produces a complex 3-D mapping of the electrical activity in the heart. This enables the physician to pinpoint the type and the source of the abnormal rhythm.
• Implantable Devices – Some arrhythmias may be treated by implanting a device such as a pacemaker (PPM) or cardioverter-defibrillator (ICD) that controls the heart’s rhythm.
• Cardiac Ablation or Radiofrequency Ablation (RFA) – In other cases, the physician may be able to permanently eliminate the source of electrical disruption. She does this by inserting a catheter into the veins, guiding it to the heart and delivering radiofrequency energy to neutralize the electrical cells that are causing the problem.
• Micra™ Transcatheter Pacing System - This miniature pacemaker device is a self-contained generator and electrode system which is implanted directly into the patient’s right ventricle using a femoral vein transcatheter approach. This minimally-invasive procedure requires no chest incision and the pacemaker is leadless, which also reduces complications. With transvenous pacemakers, which have thin wires called leads, pocket infections, hematomas, lead dislodgment and lead fractures can occur. Because the device is implanted using a catheter and is completely self-contained within the heart, the patient has no chest scar and there no visible bump or physical reminder of a pacemaker under the skin. This also results in fewer post-implant activity restrictions. Leadless pacemakers are not appropriate for all atrial fibrillation patients. This device is designed for patients with permanent atrial fibrillation with bradycardia. Those with sick sinus syndrome, also known as sinus node disease or sinus node dysfunction, are not currently candidates.
• WATCHMAN - patients with non-valvular atrial fibrillation (AF) may have an alternative to long-term warfarin (Coumadin^®) medication with the WATCHMAN FLX™ Left Atrial Appendage Closure (LAAC) Implant procedure.

Equipment

• Velocity™ 3-D mapping system
• A pacing device that speeds up or slows down the heartbeat to simulate abnormal rhythms for diagnosis
• Equipment to monitor the patient’s heart rhythm, blood pressure, blood oxygen level and other vital signs
• Specialized catheters and a radiofrequency generator for ablation
• Hands-free defibrillator pads to restore normal heart rate if needed
• Cautery grounding pads to protect patients from electrical shock

^{Micra™ is a trademark of Medtronic, Velocity™ is a trademark of St. Jude Medical, Inc., WATCHMAN™ is a trademark of Boston Scientific.}