Abnormal Heart Rhythm Treatments

Every year, Overlake’s heart rhythm doctors (electrophysiologists) perform hundreds of complex procedures like ablations and the placement of heart rhythm devices in our state-of-the-art electrophysiology (EP) labs.

Arrhythmia Treatments

We expertly treat all heart arrhythmias, from atrial fibrillation (AFib) to long QT syndrome and other less common types. You receive compassionate, high-level care at the Bob and Patty Edwards Arrhythmia Center at Overlake.

Heart arrhythmia treatments at Overlake

Some types of arrhythmias respond well to medications, while others require complex surgical treatments. Our doctors take the time to understand your unique symptoms and diagnosis and create a custom care plan using the least invasive treatment possible.  Heart arrhythmia treatments at Overlake include:

Medications

Certain medicines can help your heart maintain a healthy rhythm, as well as lower your risk of stroke-causing blood clots and coronary artery disease (narrowed arteries). Our doctors select the most effective medication plan based on your unique anatomy and diagnosis.

Medications to treat arrhythmias include:

• Antiarrhythmic drugs to treat atrial fibrillation (AFib), fast heart rates (tachycardia) and premature contractions.
• Beta blockers or calcium channel blockers to slow a fast heart rate and decrease the strength of heart contractions.
• Blood thinners (anticoagulants) to prevent blood clots and lower stroke risk, particularly in people who have AFib.

Electrical cardioversion

Our doctors use electrical cardioversion to safely deliver an electric shock to the heart and restore a normal heart rhythm. This procedure takes place in one of our advanced EP labs. A machine sends an electric current to electrode patches placed on the chest. The current travels to the heart, disrupting the electrical signals responsible for the arrhythmia.

Electrical cardioversion treats persistent arrhythmias that don’t respond to medications, as well as severe symptoms of AFib, atrial flutter, and tachycardia.

Defibrillation takes place in emergency situations. It sends a stronger electric shock to stop life-threatening arrhythmias that can cause sudden death.

Catheter ablation

Our doctors use extreme heat (radiofrequency ablation) or cold (cryoablation) to destroy small sections of heart tissue where the arrhythmia originates. The resulting tissue damage creates a disconnect in the pathway that carries the electrical signals causing the arrhythmia.

In our advanced EP lab, doctors thread a catheter (thin tube) with electrodes at the tip through blood vessels to reach the heart. The electrodes deliver hot or cold energy to the targeted treatment area.

Our electrophysiologists have deep expertise performing complex ablation procedures for difficult-to-treat arrhythmias. We specialize in:

• Ventricular tachycardia ablation to target tissue inside the heart's lower chambers through the use of electrode catheters threaded through a vein.
• Epicardial ablation to directly treat ventricular tachycardia that originates in the heart’s outer tissue. We thread the electrode catheters through a sheath (hollow tube) directly inserted into the chest.

Heart rhythm devices

If other treatments don’t help, you may need a medical device to regulate your heart rhythm. These devices send mild electrical impulses to slow down or speed up the heart as needed. Overlake patients have access to a cardiac monitoring device clinic staffed by dedicated and specially trained nurses and technicians.

Our device clinic provides remote heart rate monitoring with 24/7 alerts,  allowing us to quickly detect problems and make treatment changes that lower the risk of life-threatening complications and hospitalization.

Our doctors implant hundreds of heart rhythm devices every year. These devices include:

• Pacemaker: Pacemakers treat slow heart rates known as bradycardia. The device sits underneath the skin in the chest and connects to wires (leads) that travel to the heart. When the device detects a heart rate that is too slow, it sends electrical signals through the wires to restore a normal heart rhythm. We offer MRI-compatible pacemakers so you can safely get imaging scans. 
• Leadless pacemaker: A leadless pacemaker sits directly inside the heart’s lower right chamber (ventricle) to regulate a slow heart rate. There are no leads (wires) connecting to the heart. Our doctors place this device using catheters threaded through a blood vessel.
• Implantable cardioverter defibrillator (ICD): An ICD treats life-threatening fast heart rates that occur in the heart’s lower chambers. Your doctor places a small electric pulse-generating device underneath the skin in your chest and threads wires (leads) through the blood vessels from the device to the heart. An ICD can also send an electric shock to stop a dangerously fast heart rate or restart a heart that stops.
• Subcutaneous ICD (S-ICD): This device sits underneath the skin at the side of the chest below the armpit. It sends electrical impulses to an electrode placed near the heart. There are no wires connecting to the heart. An S-ICD treats fast heart rates and can shock the heart into a healthy pumping action. However, the device doesn’t have a pacemaker function for slow heart rates.
• Cardiac resynchronization therapy pacemaker (CRT-P): This type of pacemaker helps people who have heart failure. It sends electrical impulses to both of the lower heart chambers (ventricles), causing them to contract together and to help your heart pump blood more efficiently. This is also known as a biventricular pacemaker.
• Cardiac resynchronization therapy defibrillator (CRT-D): This CRT device has a pacemaker and a defibrillator. The defibrillator shocks the heart when the device detects a dangerously fast arrhythmia that can cause cardiac arrest.
• His bundle pacing: Electrophysiologists place pacemaker leads into the bundle of His, an area in the heart that carries electrical impulses from the heart’s upper chambers to the lower chambers. Pacemaker impulses cause the lower chambers to contract at the same time. Placing a lead into the His bundle instead of the right lower chamber lowers the risk of heart muscle damage.

Pacemaker and ICD lead extractions

Pacemaker and ICD leads are meant to stay in place for life. However, there are rare instances when leads need to be removed and replaced. Lead replacement is challenging because the wires connect to the heart and can attach to blood vessels. Our doctors are experts at safely removing leads and placing new ones.

Our electrophysiologists and cardiothoracic surgeons work as a team in our advanced hybrid operating room. They remove leads via minimally invasive, catheter-based procedures. If a lead is difficult to remove, the hybrid operating room quickly converts from a catheter lab to a surgical suite.

Reasons for performing a lead extraction include:

• Device upgrade.
• Infection.
• Lead damage, electrical malfunction or recall.

Pacemaker and ICD battery replacements

Our doctors also replace pacemaker and ICD batteries, which typically last five to 15 years, depending on the device. Because the pacemaker or ICD sits just under the skin, replacing the entire device (if needed) or putting in a new battery is a simpler procedure than lead extraction.

This is an outpatient procedure that requires numbing the skin with a local anesthetic. You also receive an IV sedative to help you relax. You go home the same day.

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