Heart Rhythm Treatments

Swedish is on the forefront of electrophysiology, which focuses on electrical activity in the heart. Patients suffering from heart-rhythm problems are at risk of sudden cardiac arrest. In the past, many of these disorders were considered untreatable.

Our leading-edge electrophysiology program features physicians, nurses and staff highly trained in the diagnosis and treatment of potentially fatal rhythm disorders. Swedish has also pioneered many of these treatment approaches. In fact, we were the first on the West Coast to perform hybrid surgery on patients with persistent, long-lasting atrial fibrillation.

Cardiac pacemakers

A battery-powered cardiac pacemaker is surgically implanted under a patient’s skin to correct electrical abnormalities that result in a slow heart rate. The device has two or three leads (wires) that are positioned in the heart to help it beat in a more balanced way. If the patient’s heart rate tries to drop below the rate programmed by his or her physician, the pacemaker generates electrical impulses that pass through the leads to the heart muscle. These impulses make the upper and/or lower chambers of the heart beat to keep the pulse rate from slowing.

Implantable defibrillators

An implantable cardioverter defibrillator (ICD), like a pacemaker, is placed below the skin and connected to the heart with electrodes (leads). In contrast to a pacemaker, which corrects slow heart rhythms, an ICD uses electrical shocks to slow down an overly rapid heartbeat. ICDs also incorporate pacemaker functions for those patients who require both.

Biventricular pacemaker and defibrillators

With heart failure, the heart’s ability to pump is weaker than normal and problems can develop in the ventricles (lower chambers) of the heart. A delay between the contraction of the right ventricle and the left ventricle often occurs. When this happens, the walls of the left ventricle are unable to contract at the same time. A biventricular pacemaker, which is designed to treat the delay in heart-ventricle contractions, can be used as a treatment option. This new therapy has been shown to improve symptoms of heart failure, such as fatigue, shortness of breath and exercise intolerance.

Diagnostic electrophysiology (testing and mapping)

An EP study is a recording of the electrical activity of a patient’s heart that is used to help physicians find the cause of a rhythm disturbance and determine the best treatment. Multi-electrode catheters are inserted through the groin (and occasionally the neck or collarbone area) and placed in the heart to determine the electrical patterns. As part of the study, physicians may reproduce an arrhythmia (irregular heartbeat), give intravenous medications, and map the arrhythmia in preparation for correcting the problem.

EnSite™ and Carto™ mapping systems

These navigation systems are specialized three-dimensional mapping techniques used to locate the source of particularly complex rhythm problems in the heart. The 3-D mapping involves a catheter and a powerful computer. The computer processes signals picked up in the heart by the catheter, then displays the information on a 3-D map of the heart chamber. This allows physicians to identify the exact source, or sources, of the irregular heartbeat.

Radiofrequency ablation

This is a modification of the surgical Cox-Maze procedure, which is a relatively long operation that involves extensive incisions and suturing of the atria (upper chambers of the heart) to prevent atrial fibrillation (rapid and disorganized heartbeat). In radiofrequency ablation, only one incision is needed. Physicians guide a catheter with an electrode at the tip into the heart. The electrode helps pinpoint the site of the electrical problem. A mild, painless radiofrequency pulse is then used to destroy a small amount of tissue, which stops the faulty electrical flow and creates a healthy heart rhythm.

Cryoablation

Cryoablation – or the use of very cold temperatures to create lesions within the heart – is often used during a modified Maze procedure, which is a minimally invasive procedure to correct an irregular heart rhythm by blocking the abnormal electrical impulses that are causing the problem. The Maze procedure itself uses a series of incisions in the right and left atria to interrupt the impulses. With the modified Maze procedure, alternated energy sources – including Cryoablation – are used in place of incisions to create the lesions, and eventually the scar tissue, that will block the abnormal electrical impulses from being conducted through the heart.

Stereotaxis magnetic guidance

The Stereotaxis Navigation System is an exciting addition to Swedish’s catheterization offerings. The system uses magnets to guide catheters through the body and is designed to improve many catheter-based cardiac procedures, including those used to treat both coronary artery disease and rhythm disorders. Swedish was one of the first places in the world to offer this advanced technology.

Atrial fibrillation ablation

This is a descendant of the surgical Cox-Maze procedure, which involves extensive incisions and suturing of the atria – and a relatively long operation – to treat atrial fibrillation. In many patients with atrial fibrillation, creating additional lesions within the left atrium will interrupt the electrical impulses that are causing the problem. Radiofrequency ablation is the most common approach and is used to create a specific set of lesions for this procedure.