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Memorial Hermann Heart & Vascular Institute-Texas Medical Center Arrhythmias are classified based on the presence or absence of heart disease. Common types of arrhythmia include: - Atrial Fibrillation
- Atrial Flutter
- Atrial tachycardia, also known as supraventricular tachycardia
- Heart Block
- Sick Sinus Syndrome
- Wolff-Parkinson-White Syndrome
- Premature Ventricular Contractions
- Ventricular Tachycardia
- Ventricular Fibrillation
Atrial Fibrillation A common cause of arrhythmia, atrial fibrillation affects about 2.2 million Americans, with 160,000 new cases diagnosed annually. Symptoms include heart palpitations, weakness, dizziness, faintness and chest pain. Whether the condition is intermittent or chronic, patients with atrial fibrillation are at higher risk for blood clots and stroke. Physicians have two goals in treating atrial fibrillation: Reducing the risk of stroke and alleviating or improving symptoms. Ventricular Tachycardia (VT) Ventricular tachycardia (VT) can develop following heart attack or heart surgery, or as a result of cardiomyopathy, myocarditis and valvular heart disease. It can also arise spontaneously in the absence of apparent symptoms of heart disease. During episodes of ventricular tachycardia, the heartbeat increases to a very rapid rate, often greater than 150 beats per minute. VT is particularly dangerous because of its origin in the lower ventricles. Rapid beating may interfere with the heart’s ability to pump an adequate blood supply through the body, resulting in sudden cardiac death. Treatments Medication Cardiologists on staff normally prescribe medications as the first course of treatment to control the heart rate. Electrical Cardioversion Depending on the results of the 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. Arrhythmia recurs in about 75 percent of patients. Catheter Radiofrequency Ablation Radiofrequency ablation (RFA) is offered to patients who do not respond to or tolerate medication. The electrophysiologist uses a small, flexible catheter capped with an electrode to ablate, or destroy, abnormal areas of tissue in the heart. This area of tissue is heated to form lesions that create circular electrical barriers to block abnormal impulses. This minimally invasive procedure stops, or greatly suppresses, atrial fibrillation in 70 percent to 80 percent of cases. RFA has a success rate of more than 90 percent in treating patients with ventricular tachycardia who qualify for this procedure. Pacemaker Implantation A pacemaker is a small device which 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. Implantable Cardioverter Defibrillator (ICD) Insertion Implantable cardioverter defibrillators are implanted in the chest below the collarbone to continuously monitor heart rhythm. They will deliver electrical shocks when necessary to restore rhythm and prevent sudden cardiac arrest. 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. Maze Surgery Maze surgery is used to treat chronic atrial fibrillation. 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, a type of incision in the center of the chest, and heart-lung support. Minimally Invasive Maze Surgery The minimally invasive approach to maze surgery 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 and create a “maze” of new pathways. 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.
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