FAQ Cardiac Arrhythmia


FAQ Cardiac Arrhythmia

What is a heart arrhythmia / cardiac arrhythmia?

The heart has an electrical system similar to machines you are familiar with.  In the case of the heart, the electrical system stimulates the heart to beat on a regular basis, with a regular rhythm.  When the heart rhythm is not normal, too fast or too slow, or irregular, this is known as an arrhythmia.  There are many types of arrhythmias that we can help you diagnose and treat at our Center.

 What is a pacemaker?

A pacemaker is an implantable machine that tells your heart to beat by using a computer attached to some wires that give a small electrical charge to the heart.  You do not feel this electrical charge as a shock as it is too low of a voltage.  It is used to treat people with heartbeats that are too slow or that stop suddenly.  It is an outpatient surgical procedure usually involving an overnight hospital stay postoperatively with very little recovery time.

What is an implantable cardiac defibrillator (ICD)?

This is an advanced device similar to a pacemaker that can “restart” the heart if you have a sudden dangerous cardiac arrhythmia known as ventricular tachycardia or ventricular fibrillation (VT or VF).  VT and VF are the leading causes of “sudden death” from the heart and ICDs are the only treatment than can prevent dying from sudden cardiac death.  Defibrillators are given to selected patients who have had dangerous arrhythmia or are at very high risk for arrhythmia because of congestive heart failure.

What is congestive heart failure?

Congestive heart failure (CHF) is a condition where usually the heart has become weak and cannot effectively pump blood to the body, as a result of coronary artery disease or other heart diseases.  Some people with CHF have an increased risk of deadly cardiac arrhythmia and they are often treated with an ICD (defibrillator) implant.  Other types of congestive heart failure may not be associated with arrhythmia, so it is important to discuss this with us at your visit.

What is a cardiac resynchronization device?

A newer type of pacemaker or ICD that can help the heart pump better is known as a cardiac resynchronization device, or CRT.  It is a complex pacemaker or ICD that involves wires placed in usually three different areas of the heart and is designed to keep the right and left sides of the heart beating in synchrony for certain people who are “out of synch.”

How to you check pacemakers or ICDs once they are placed?

Pacemakers and ICDs are easily checked painlessly and from the outside using a special wireless computer that can read data on the device including looking at and changing programming settings, and retrieving stored images of the heartbeat and arrhythmia that are recorded by the device.

 When I have a pacemaker or ICD, do I need to stay away from electrical devices?

In general, you can use most household appliances and electronics normally, as well as travel normally.  There may be a few restrictions on these activities in certain situations that we will discuss with you.

 What is an electrophysiology study (EP study) and cardiac ablation?

This is a special type of cardiac catheterization that involves threading wires up through the veins or arteries of the leg and running detailed tests of the electrical system of the heart.  This is a way to find many arrhythmia problems that are not apparent from other testing, and it may be a way to discover the cause of palpitations or episodes of passing out.  Sometimes an arrhythmia found can be treated with cadiac ablation, which is a special cauterization of abnormal electrical tissue in the heart, all done with the catheters in the leg veins and not involving any cutting or open-heart type surgery.  The wires are all removed at the end of the study.  Sometimes the result of the test will lead to recommending a permanent pacemaker or ICD implant instead.

What is atrial fibrillation?

Atrial fibrillation is one of the most common arrhythmia disorders and usually presents as an irregular heartbeat that is too fast or sometimes too slow.  Although it is not life threatening, it can worsen your quality of life and put you at risk for having a stroke.  The treatment of atrial fibrillation is very varied and can involve medications, catheter or surgical procedures and device implants (defibrillators, pacemakers) depending on your individual case.  To this day, there is not a “cure” but there are many treatments available to help reduce your risk of complications from it and to reduce your symptoms.

 I heard pacemakers and defibrillators malfunction frequently.  Is this true?

No. Although they are given negative press and publicity, true device malfunctions are not common, and are on the order of 1% depending on the severity of the malfunction.  In some patients the less severe malfunctions can be as high as 6%.  Compared to the benefit pacemakers and defribrillators provide, their risk of malfunction is very small.  Malfunctions can include failure of the device to perform, disruption of the computer or the wires either microscopically or physically, infection of the device, or simply the device needing to be reprogrammed because it is giving unnecessary treatments or not giving enough treatments.  Correcting malfunctions usually involves simple computer programming changes wirelessly, but certain malfunctions do require replacement or removal of the wires and/or the computer.