Arrhythmia
Pulsed Field Ablation – A Revolution in Electrophysiology?
The specialty of electrophysiology is one of the most advanced in medicine and is primed for technological disruption by new and exciting therapies and procedures. After all, we are working with the heart’s electrical system rather than the body’s mechanics, as most other specialties do. With that said, the gold standard and potentially curative treatment for Afib and several other arrhythmias is a procedure known as cardiac catheter ablation. It is often more effective than front-line medical therapies, including antiarrhythmics.
Shocking Study on Electronic Games and Arrhythmias
In what could only be described as shocking research, a recent study of 22 children has found that electronic video games can cause dangerous ventricular arrhythmias in kids, with those having congenital and/or proarrhythmic heart issues being the most at risk. Of those 22 kids, six experienced cardiac arrests, and four died. Ten kids had been previously diagnosed with catecholaminergic polymorphic ventricular tachycardia, four had long QT syndrome, and two underwent prior congenital heart surgery. These children seemed to have the highest risk of syncope – unexplained fainting – or even death after playing certain electronic games.
We have known that athletic kids with congenital heart problems can develop arrhythmias, some life-threatening, due to the exertion on the heart. But this was the first review to delve into electronic games, especially those not requiring physical activity. One would assume that playing a game would not have a similar effect on the heart as vigorous physical exertion, but that seems not to be the case.
Unclogging Your Arteries Naturally – Is It Possible?
Coronary artery disease, or CAD, is one of the most common cardiovascular diseases in the world and involves the arteries that transport oxygen-rich blood around the entire body. These incredible delivery vehicles constantly expand and contract, 24 hours a day, to ensure that blood reaches its destinations around the body efficiently. However, as we age, and are largely dependent on our dietary and lifestyle choices, these arteries can begin accumulating plaque deposits. The arteries become progressively narrower, and less blood can reach its destination, the heart. The result significantly increases the risk of a deadly heart attack. When this occlusion happens in the extremities, it is known as peripheral artery disease (PAD). It can cause significant problems in the arms and legs, including, if left untreated, amputation of the affected limb.
Wearable EKGs – Help or Hindrance
If you are reaching middle age or left that behind a while ago, you have likely had an EKG or electrocardiogram at your annual physical with your primary care physician. If you have visited a cardiologist, you’ve likely had one at their office too. The EKG was a transformative medical device that allowed us, as cardiologists, to accurately track the rhythm of the heart and see if there were any apparent abnormalities. The non-invasive nature of the EKG, such that the test can be administered quickly and inexpensively in any medical setting, offers your physician a great deal of information about the workings of your heart.
Of course, with this excellent and convenient option come some limitations. An EKG is simply a snapshot of your heart’s rhythm at one point in time and cannot give us a longer-term picture. As such, it may not always be the best option when diagnosing heart rhythm disorders known as arrhythmias. A cardiac arrhythmia is a fast (tachycardia) or alternately slow (bradycardia) heartbeat caused by several potential factors. However, one of the hallmarks of arrhythmias, especially early on, is that they often do not present consistently. Known as paroxysmal arrhythmias, these irregular heartbeats can happen once a day, once a week, or once a month in varying degrees of severity. There is no accurate way to predict when the next episode will occur. Patients who come into their primary care physician’s office complaining of heart palpitations may not get a definitive answer because the equipment cannot detect an irregular heartbeat when the patient is not at the office.
My EKG Says Nothing, but I’m Sure There’s a Problem. What Do I Do?
The EKG is an instrumental diagnostic test for patients regardless of whether they have concerns about their heart. EKGs have been instrumental in saving countless lives over the past several decades.
To that end, you may have become used to an electrocardiogram or EKG at each of your annual checkups with your primary care physician and even your cardiologist. We use EKGs to monitor your heart rhythm and, in doing so, try to detect irregular heartbeats and rhythms at their earliest stages.
An Advanced Solution for Arrhythmia-Related Stroke Risk
Most patients who suffer from Atrial Fibrillation/Afib or other supraventricular tachycardia are surprised to know that it is not the arrhythmia itself that we are most concerned about but the significantly increased risk of stroke, heart attack, and long-term heart failure. Indeed, because arrhythmias reduce the pumping efficiency of the heart, blood can begin to pool in a small outpouching of the heart known as the left atrial appendage or LAA, for short. Before minimally invasive treatment advances and catheter technology, patients would have to take antiarrhythmic and blood-thinning medications in perpetuity. While often effective, up to 50% of patients on medical therapy experience unacceptable side effects or do not get sufficient relief.
In the spirit of advancement and the treatment of significant potential risk with minimally invasive solutions, electrophysiologists like ours at Nevada Cardiology often use a clever medical device to seal the LAA and dramatically reduce stroke risk. This device, known as the Watchman, looks much like a parachute connected to a metal lattice. The Watchman fits snugly over the opening to the LAA and, over time, creates a strong barrier between the LAA and the rest of the left atrium.
What is Atrial Fibrillation or AFib?
Atrial fibrillation is the most common sustained heart rhythm in the United States, affecting about 3 million Americans. Instead of beating normally, the upper chambers quiver or fibrillate. The upper chambers no longer fill the lower chambers with blood, and heart output can be reduced by 20-40%. During atrial fibrillation, the upper chambers send about 600 impulses a minute down to the lower chambers. While the lower chambers do not beat 600 times a minute, they can still beat very fast and irregularly. Over time, this can cause the important lower pumping chambers to fail. Possibly the worst complication of atrial fibrillation is stroke. When the upper chambers stop contracting, blood can stagnate and form a clot. This clot can break off and go anywhere in the body, including the brain. 75% of strokes associated with atrial fibrillation leave a patient in a nursing home or are fatal.