Heart Rhythm Center
Not all cardiologists are alike. The Heart Rhythm Center at Healient is staffed with a highly trained EP doctor near you that specializes in treating heart arrhythmias and other heart rhythm disorders. This specialist is called an Electrophysiologist or EP doctor. These can include irregular heartbeats, including instances where the heart beats too quickly or too slowly.
One of the most common arrhythmias that electrophysiologists treat is atrial fibrillation, also known as AFib. AFib occurs when the heart’s upper chambers—the atria—contract irregularly. AFib is the most common type of heart arrhythmia in the U.S., and it is a leading cause of blood clots that can cause a deadly stroke.
Learn more about common heart rhythm disorders.
Atrial fibrillation, also known as Afib , is an abnormal heart rhythm where the top chambers of the heart beat rapidly (300-600 beats per minute) and irregularly. It is estimated that eight million Americans have atrial fibrillation. Currently, 9% of Americans over the age of 65 have this condition. Atrial fibrillation also increases a patient’s risk for stroke 5 fold. Risk factors for atrial fibrillation include advanced age, high blood pressure, diabetes, obesity, obstructive sleep apnea, as well as tobacco and alcohol abuse. However, some patients have no risk factors for atrial fibrillation and may have a genetic predisposition for developing this disorder.
Symptoms of atrial fibrillation include fatigue, shortness of breath, chest pain, palpitations, and lightheadedness. However, some patient may have no symptoms with atrial fibrillation. We typically diagnose atrial fibrillation by obtaining an electrical recording of a patient’s heart rhythm called an EKG or by wearing a long-term monitor at home to find this rhythm disorder. Once diagnosed with atrial fibrillation, patient’s risk for stroke is assessed.
Based on certain risk factors, we may recommend aspirin therapy or anticoagulation therapy with drugs such as coumadin (warfarin), or newer agents such as Pradaxa, Xarelto, or Eliquis. To prevent atrial fibrillation, medication options include starting antiarrhythmic drugs, that help prevent the heart from going back into atrial fibrillation. Other options include atrial fibrillation ablation, where we enter the heart to eliminate the triggers of atrial fibrillation that typically arise from the left atrium.
Watch Dr. Couchonnal’s Video on AFib
Read Dr. Couchonnal’s article in Healthy Kansas City magazine
Additional Links for Atrial Fibrillation
Atrial flutter is an abnormal heart rhythm that typically occurs within the right atrium. This abnormal rhythm results in the top chamber of the heart to beat around 250 beats per minute. Atrial flutter is closely related to atrial fibrillation, and it is not uncommon for a patient to have both arrhythmias. Symptoms of atrial flutter are like those of atrial fibrillation. Atrial flutter also increases a patient’s risk for stroke. Patients can manage atrial flutter with medications or invasively with an atrial flutter ablation to cure the arrhythmia.
Links for atrial flutter
SVT is an abnormal heart rhythm disorder that originate from the top chambers of the heart. SVT can occur in both children and adults. The three most common forms of SVT include Atrioventricular nodal reentrant tachycardia (AVNRT), Atrioventricular reciprocating tachycardia (AVRT of WPW), and atrial tachycardia. Symptoms of SVT include fatigue, shortness of breath, chest pain, palpitations, and lightheadedness. We can diagnose SVT with an EKG or by wearing a heart monitor at home. During severe episodes, patients may need to go to the emergency room to be given medications such as adenosine to terminate the arrhythmia. For long-term management of SVT, patients can be treated with medication. However, most patients with SVT can undergo cardiac catheter ablation to have this rhythm disorder cured.
Links for SVT
Ventricular tachycardia (VT) is an abnormal heart rhythm that originates from the bottom chamber of the heart. Symptoms of VT include palpitations, shortness of breath, passing out or cardiac arrest. Most cases of ventricular tachycardia are associated with patients who have had a prior heart attack or have preexisting heart disease, such as congestive heart failure (cardiomyopathy). In these cases, ventricular tachycardia may be potentially life threatening and could cause sudden cardiac death. In these patients, placement of an internal cardiac defibrillator (ICD) may be warranted. To prevent future episodes of ventricular tachycardia, antiarrhythmic drugs may be required. However, patients who are intolerant of these medications or have recurrent ventricular arrhythmias despite medications may require VT ablation.
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A cardiac ablation is a minimally invasive procedure performed to cure abnormal heart rhythm disorders called arrhythmias. The most common arrhythmias treated with ablation include supraventricular tachycardia (SVT), atrial fibrillation (Afib), atrial flutter, premature ventricular contractions (PVCs), and ventricular tachycardia (VT). SVT is usually caused either AVNRT, atrial tachycardia or by an accessory pathway. A person with an arrhythmia caused by an accessory pathway has a rhythm disorder called Wolfe-Parkinson-White Syndrome (WPW).
We may recommend an ablation after a patient fails medical therapy but we may also recommend it as first-line therapy in patients who do not want to be on medications long term. We typically perform the procedure with sedation performed by an anesthesiologist. The minimally invasive procedure will be performed from small IV’s placed in the femoral veins that allow entry to the heart. We position catheters into the heart and we perform an electrical study. Once the abnormal rhythm is triggered, a 3D mapping system will localize the abnormal rhythm. Once we localize the abnormal rhythm, we use an ablation catheter to deliver radiofrequency energy to eliminate the abnormal tissue causing the rhythm disorder. The procedure typically ranges from 1 to 4 hours. After the procedure, the patient may spend one night in the hospital or be given the option to be discharged after 4 hours of bed rest.
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