Finding the cause of the rhythm problem provides the basis for selecting the best treatment plan. Generally, the effective and least invasive treatment is chosen.
as arrhythmia can be a part of heart diseases like heart attacks, lifestyle modifications play a big role to prevent such arrhythmia. Also,in arrhythmia which occurs on exertion and those associated with genetic diseases, avoiding exertion and lifestyle changes are paramount. Preventing prolonged standing and taking adequate water can be helpful in preventing the commonest type of fainting.
preventing heart attack by treatment of diabetes, hypertension, blood lipids can prevent arrhythmias that occur as a sequel to heart attack. Medications play an important role in preventing and treating supraventricular and ventricular arrhythmias. Atrial fibrillation can be prevented by effective medications. Also, medications are important to prevent clot formation in the heart as a result of a AF.
Catheter ablation is a procedure where multiple flexible, thin catheters are positioned inside the heart in the area of heart tissue which creates or the reason behind the tachyarrhythmia. Once identified radiofrequency energy is delivered through this catheters and tissue is destroyed, thereby curing the patient from the arrhythmia. Catheter ablation alone does not always restore a normal heart rate and rhythm. You may need other treatments as well. Also, some people who have the procedure may need to have it done again. This can happen if the first procedure does not fully correct the problem.
Cardiac ablation may be an option in any of these cases:
Before the catheter ablation, the patient will be fully evaluated for any coexisting conditions, with full review of patient’s medical history and patient has to undergo some preprocedural investigations as a part of routine evaluation. Some drugs may interfere with the procedures that should be stopped at least 4-5 days, before the procedure as instructed by the doctor. If you are pregnant or you are not sure, you must inform your doctor before having catheter ablation as this procedure involves radiation, which can harm the foetus. Once the procedure is planned, the doctor will instruct you regarding, how long you should fasting and what you should have before the procedure etc.Usually you will need one day stay for simple ablations and more than a day for complicated procedure. This will be decided by your doctor after assessing you and your problem.
This procedure is performed in the hospital which has an electrophysiology unit. This procedure is performed by the doctors who are trained in this field of cardiac electrophysiology. The procedure involves inserting catheters — narrow, flexible tubes — into a blood vessel, often through a site in the groin or neck, and threading them through the vein until they reach the heart. The patient will be given drugs to make the patient sleep and drugs to alleviate the pain. A topical anaesthetic will be given to make the skin numb before the catheters are inserted. Using electrodes on the tip of the catheters, the doctor first conducts a study to pinpoint the location of the short-circuit causing the tachyarrhythmia. Once the precise location is confirmed, the “short-circuit” is destroyed to prevent it from sending faulty signals to the rest of the heart. This is done by sending energy through the catheters to destroy a small amount of tissue at the site. The energy may be either hot (radiofrequency energy), which cauterizes the tissue, or extremely cold, which freezes or “cryoablates” it. Most people may experience only brief moments of discomfort, rather than pain, during the procedure. Patient will need to lie still for four to six hours afterward to make sure that catheter incision site heals properly. Some patients may feel burning sensation when the doctor injects medicine into the area where he or she will insert the catheter and discomfort or burning in your chest when the doctor applies the energy. The patient may feel a faster heartbeat when the doctor stimulates the heart to find out where abnormal heartbeats are starting. The procedure lasts for 2-6 hrs depending on the case.
Previously catheter ablation was done using X Ray imaging to locate the different chambers of the heart and recording the electrical signals from there. This is adequate while dealing with arrhythmias like most supraventricular tachycardias, while the accurate localisation of culprit tissue is important in dealing with complex arrhythmias like atrial fibrillation and ventricular tachycardia. Now we have 3D mapping systems- two types, one using electrical impedance changes and another utilising magnetic field- locates accurately the tissue responsible and guides our ablation catheter accurately to destroy it. These mapping systems are more and more used in ablations in patient with structurally abnormal and damaged hearts.
Immediately after the procedure, the catheters will be removed, and pressure will be applied to the insertion site to minimize or prevent bleeding; a bandage may be applied. It is important to remain still during this time and to not move or bend the leg. Generally, the patient will stay in bed for some hours or overnight after the procedure for observation and go home the next day. Once you can get up and move around, you may feel stiff from lying still for so long. Most people can return to their normal routine within a few days. It is common to have a small bruise or lump (about the size of a walnut) at the site of catheter insertion, but you should contact your doctor immediately if the spot becomes warm, tender, or painful, or if it swells. You should also contact your doctor immediately if you experience fever, dizziness, or any other symptoms. Be certain to carefully follow your doctor’s instructions regarding any medications and follow-up appointments.
Before going home, you will be instructed about: the medicines you have to take, the amount of rest you need, lifestyle modification and about the follow-up.
Like any invasive procedure, radiofrequency ablation carries some risk. However, the risk of these complications is small in most cases. Possible complications include:
Traditionally pacemakers carry the electrical impulse to Right ventricular muscle near the tip of the ventricle and also to the right atrium in order to make the atrium and ventricle beat in unison. Now, there is a technique and tools by which the RV lead or wire can be implanted to electrically stimulate the normal electrical circuit of the heart rather than the RV muscle. This is called His bundle or left bundle pacing. It mimics the normal electrical conduction of the heart and results in better heart muscle function on long run.
This is also a new development where the pacemaker (battery and circuits) are placed directly in right ventricle without need of wires or leads. This prevents a surgical procedure and also prevents problems with the leads on long run. As of now, it can only be used for those who does not require atrial pacing (like patients with atrial fibrillation and very slow ventricular rate of heart block).
The Normal Heart
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2020
This course is designed totrain Cardiologists in the sub-speciality of Cardiac Pacing and Electrophysiology. This will equip them to work as trained Cardiac Electrophysiologists capable of handling paediatric and adult rhythm abnormalities.
This course is designed totrain Cardiologists in the sub-speciality of Cardiac Pacing and Electrophysiology. This will equip them to work as trained Cardiac Electrophysiologists capable of handling paediatric and adult rhythm abnormalities.
This course is designed totrain Cardiologists in the sub-speciality of Cardiac Pacing and Electrophysiology. This will equip them to work as trained Cardiac Electrophysiologists capable of handling paediatric and adult rhythm abnormalities.