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Treatments and Services

The Heart Rhythm Program provides specialized treatments and services in the care of patients with arrhythmias. Every case is reviewed by the EP physician who will recommend the best treatment plan. Every patient will have an opportunity to discuss the plan with a member of the Heart Rhythm Team.

Electrophysiology Study
An Electrophysiology (EP) Study is a minimally invasive procedure which provides information that aids in diagnosing and treating arrhythmias. Under local freezing, wires are threaded from a vein in the top of your leg to your heart. Although it is more invasive than an electrocardiogram (ECG) or echocardiogram, the test produces data that makes it possible to:
  • Diagnose the source of arrhythmia symptoms
  • Predict the risk of a future cardiac event, such as Sudden Cardiac Death
  • Assess the need for treatment procedure (Radiofrequency Catheter Ablation)
Electrophysiology Ablation
After the diagnostic aspect of the Electrophysiology (EP) study, an ablation proceeds when appropriate. Similar to an EP study, under local freezing, wires are threaded from a vein in the top of your leg to your heart. Once the abnormal electrical site(s) are identified, electrical energy is used to stop the abnormal circuit. The goal is to end the disturbance of electrical flow through the heart, restoring a healthy heart rhythm.

When is ablation appropriate?
Whether or not an ablation is appropriate for an individual patient, is a decision to be made with an Electrophysiologist.
 
Pulmonary Vein Isolation Ablation (PVI)
A Pulmonary Vein Isolation  (PVI) is an ablation used specifically to treat the symptoms of Atrial Fibrillation. Atrial Fibrillation is a condition where the top chambers of the heart beats irregularly or “fibrillate.” This can cause symptoms including shortness of breath, dizziness, and fatigue, or patients with Atrial Fibrillation may not even know they have the condition.

Highly symptomatic patients may explore a PVI as a possible treatment for symptom relief. This is considered a “complex ablation” and takes several hours to perform. Most patients will notice a decrease in their symptoms after the ablation, however, some may require additional procedure(s). It is important to note that while a PVI should reduce the symptoms of Atrial Fibrillation in most cases, it is not considered a cure for the condition.

Cardioversion
A Cardioversion is a minor outpatient procedure performed to correct abnormal heart rhythms, such as atrial fibrillation and atrial flutter. During a cardioversion, medications are given to put the patient to sleep for a few minutes in order for an electrical shock to be delivered. This is done with special electrical pads placed on the chest.
 
Tilt Table Testing
A Tilt Table Test is used to diagnose individuals who suffer with unexplainable fainting spells. The procedure requires the patient to lie perfectly still on a table, which then raises them, in increments, to a standing position.
 During the test, the heart rhythm and blood pressure are monitored and a medication that is very similar to the patient's own adrenaline may be administered.

Implantable Loop Recorder
In a simple outpatient day-surgery procedure, an Implantable Loop Recorder (ILR) is inserted under the skin in the chest to monitor a patient's heart rhythms and heart rate. This will help to associate the symptoms with any irregularity in the heart rhythm and rate which may be occurring. This is a diagnostic tool. Having an ILR requires regular follow-up appointments in the Cardiac Device Clinic.
 
Permanent Pacemaker (PPM)
A Pacemaker is a device which treats slow heart rates. Permanent Pacemakers are implanted under the skin usually in the upper chest. Wires, called leads, run from the pacemaker through the blood vessels to the heart in order to maintain an appropriate heart rate for the patient.
 
Implantation of a Permanent Pacemaker is a day-surgery procedure, with regular follow-up appointments in the Cardiac Device clinic.
 
Implantable Cardioverter Defibrillator (ICD)
An Implantable Cardioverter Defibrillator is a device that prevents sudden cardiac arrest in certain high-risk patients. Like a pacemaker, ICD's are implanted under the skin usually in the upper chest. Wires, called leads, run from the ICD to the heart so the device can monitor the heart to detect any abnormal heart rhythms. If a dangerous heart rhythm is detected, the ICD delivers electricity and/or shock to restore the heart's normal rhythm. The ICD can also act like a pacemaker if the heart is beating too slowly.
 
Implantation of an ICD is a day-surgery procedure, with regular follow-up appointments in the Cardiac Device clinic.
 
Cardiac Resynchronization Therapy device (CRT)
A Cardiac Resynchronization Therapy (CRT) device can decrease shortness of breath and improve symptoms in certain patients with congestive heart failure (CHF). A CRT device will simultaneously stimulate the left and right lower chambers and restore a coordinated “synchronous” squeezing pattern. This is sometimes referred to as “bi-ventricular pacing” because both lower chambers (ventricles) are electrically stimulated (paced) at the same time. A CRT device may or may not have defibrillation capacity, it will depend on whether this capacity is appropriate for the patient.
 
Implantation of a CRT device is a day-surgery procedure, with regular follow-up appointments in the Cardiac Device clinic and possibly the Heart Function Clinic.
 
For more information on any of these individual treatments, visit the Canadian Heart Rhythm Society at www.chrsonline.ca
Southlake Regional Health Centre
596 Davis Drive, Newmarket, Ontario   L3Y 2P9
Tel: 905-895-4521   |   TTY: 905-952-3062
Copyright © 2012 Southlake Regional Health Centre
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