Treatment
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Physicians have two goals in treating arrhythmias: reducing the risk of stroke and alleviating or improving symptoms. Treatment ranges from proven noninvasive interventions to advanced device therapy and minimally invasive procedures that reduce trauma and allow for faster recovery.
Electrophysiology is used to diagnose, treat and often cure arrhythmia. It has also been shown to dramatically improve the quality of life for patients with heart failure. Electrophysiologists and surgeons affiliated with the Heart & Vascular Institute-Texas Medical Center are experts in treating atrial fibrillation, other supraventricular arrhythmias and ventricular tachycardia, a less common and potentially life-threatening arrhythmia.
Specializing in complex procedures that require state-of-the-art equipment and advanced trainings, the physicians at the Complex Arrhythmia Center are equipped to provide a broad range of treatment options, from noninvasive interventions to device therapy to minimally invasive surgery. CAC expertise includes VT ablation and lead extraction, two cutting-edge techniques in the field.
MEDICATION. Cardiologists on staff normally prescribe medications as the first course of treatment for atrial fibrillation, including heart rate control medications, antiarrhythmic drugs and anticoagulants.
ELECTRICAL CARDIOVERSION. Depending on the results of a patient’s examination and diagnosis, electrophysiologists may recommend electrical cardioversion to restore the heart to its natural rhythm. Following administration of a short-acting general anesthetic, a synchronized electric shock delivered to the chest wall restores natural rhythm in 70 percent to 90 percent of cases.
VT ABLATION. A minimally invasive treatment option offered to patients who do not respond to or tolerate medication, ablation works by destroying tissue that blocks the electrical signal that travels through the heart to make it beat. For ventricular tachycardia ablation, the physician passes a catheter into a specific area of the heart, and a machine directs energy through the catheter to burn away the tachycardia circuit.
CATHETER RADIOFREQUENCY ABLATION. Radiofrequency ablation (RFA) is offered to patients who do not respond to or tolerate medication. The electrophysiologist isolates areas in the atria that trigger fibrillation, then uses a small, flexible catheter capped with an electrode to ablate lesions outside the pulmonary veins. The procedure is repeated around all four pulmonary veins where they connect with the left atrium, forming lesions that create a circular electrical barrier around the veins to block abnormal impulses. The minimally invasive procedure stops or greatly suppresses atrial fibrillation in 70-80 percent of cases.
LEAD EXTRACTION. Pacemakers or ICDs are connected to the heart by a flexible wire called a lead. If the lead becomes infected or damaged or causes a mechanical problem, it must be removed. With special tools, physicians can safely release the lead from the scar tissue that surrounds it, and extract it from the heart.
MAZE SURGERY. In open-heart maze surgery, surgeons make a series of precise incisions in the muscles of the atria, allowing scar tissue to form, which blocks abnormal electrical impulses. While open surgery has shown a high success rate in treating atrial fibrillation, it requires a sternotomy and heart-lung support.
The minimally invasive approach requires three small incisions on both sides of the chest. Guided by a tiny camera, the physician inserts a special device through the ribs to clamp the sections of the atria where the disruptive electrical impulses originate. Radiofrequency ablation creates thermal lesions that interrupt abnormal electrical signals. Surgeons reduce the risk of postoperative clotting by removing the left atrial appendage, an extraneous structure where blood clots can form.
Minimally invasive maze surgery stops atrial fibrillation in 80 percent to 90 percent of cases. Patients normally return to work in a few days, compared to four to six weeks for the traditional open surgery.
PACEMAKER IMPLANTATION. A pacemaker is a small device that uses electrical impulses to regulate and maintain a suitable heart rate or to stimulate the lower chambers of the heart (ventricles). A pacemaker may also be used to treat fainting spells (syncope) and congestive heart failure. Pacemakers are occasionally used in combination with an invasive procedure that disconnects the ventricles from the atria to control pulse rate during atrial fibrillation
ICD INSERTION. Implantable cardioverter-defibrillators (ICDs) implanted in the chest below the collarbone continuously monitor heart rhythm and deliver electrical shocks to restore rhythm and prevent sudden cardiac arrest. ICDs work through cardioversion (a low-energy shock delivered at the same time as the heartbeat), a higher energy shock and antitachycardia pacing.
CARDIAC RESYNCHRONIZATION THERAPY (CRT). Resynchronization therapy uses a specialized implantable device to restore the symmetry of cardiac contractions, improving the efficiency of the heartbeat. This new and innovative form of therapy is useful in relieving symptoms of congestive heart failure in some patients.
Each year, the affiliated physicians at the Complex Arrhythmia Center perform over 250 atrial fibrillation ablations, 1,400 complex procedures, 700 device implantations, 700 ablations and 50 ventricular tachycardia ablations.
Through participation in clinical research trials, our patients also have access to leading-edge treatments unavailable at other medical centers. Learn about current research studies related to this condition and information on enrollment as a study participant.
For more information on our services for patients with arrhythmia and atrial fibrillation, or for a referral to an affiliated physician, call 713.704-2221.