Heart Rhythm Clinic Consultation
Case discussion with an Electrophysiologist including review of all pertinent information, including EKGs, telemetry, Holter monitors, underlying cardiac structure and function. From this consultation, the care plan is developed. This plan could include further specialized investigations, rhythm-specific medications.
Cardiac Device Clinic
All of our patients with cardiac devices have their ongoing care at the Clinic. New referrals for device-specific questions are assessed here as well. The Clinic is staffed by our team of Cardiac Device Technologists
Permanent Pacemaker Implantation
Abnormally slow heart rates and rhythms may require permanent pacemaking, using one, two or three wires, or leads. These are placed into the heart using veins which run from the shoulder region below the collarbone.
Loop Recorded Implantation
Very widely spaced symptoms, usually fainting, may require the placement of a small recording device under the skin to observe the heart’s rhythm for up to three years if necessary to make a diagnosis.
For dangerously fast heart rhythms or very weakened hearts at high risk for these rhythms, an Implantable Cardioverter/Defibrillator (ICD) provides life-saving therapies within seconds. ICD systems can be placed through the veins from the shoulder region below the collarbone, or along the outside of the rib cage along the breastbone.
For weakened hearts with advanced conduction disease, cardiac resynchronization, or biventricular pacing, can improve heart function and patient symptoms. This involves the placement of the pacing wires used in a standard pacemaker or cardioverter system, plus one further wire to normalize the electrical activation of an already weakened muscle.
This is a novel form of Implantable Defibrillator in which the wire – or lead – is not placed inside the heart but just under the skin outside the ribcage. The ICD pulse generator is placed along the side of the body, not high on the chest like a standard transvenous system.
Heart rhythm disorders can be best understood through this heart procedure, which uses soft wires (catheters) through leg veins to directly study the heart’s electrical system. Through measurements and pacing maneuvers, a precise diagnosis is achieved.
Once the Electrophysiology Study has found the diagnosis, radiofrequency energy can be used through a catheter to abolish the abnormal tissue and cure the heart rhythm problem. In some cases, instead of radiofrequency energy, liquid cooling is used to abolish abnormal signals, in a procedure called Cryoablation.
Three-dimensional mapping utilizes magnetic or impedance fields to render the heart and the catheters digitally on a specialized computer system. High fidelity, high precision study of the cardiac anatomy, tissue health and all activation pathways can be included in these depictions, which use tens of thousands of individual data points to create their final images. This is critical for the study and cure of certain, less common heart rhythm disorders which cannot be depicted on the standard multi-channel recording system.
Most heart rhythm disorders are ablated with Radiofrequency – a form of unipolar cautery.
Applied to discrete locations where the Electrophysiologist has discovered the abnormal signals or tissue which are producing the clinical heart rhythm disorder.
Tilt Table Testing
The response of the heart rate and blood pressure to changes in posture can be observed using positional challenge testing.