Tests for Cardiac Arrhythmia

Cardiac Assessment
Cardiac enzymes 
Chest X-Ray
Echocardiogram
EKG
Electrophysiology study
Event Monitor
Holter Monitors
Signal Average EKG
Tilt table
Transesophageal Echocardiogram (TEE)

Treatments for Cardiac Arrhythmia

Treatment is aimed at “converting” the rhythm of the heart to a normal rate. This may be accomplished with medications, electrical cardioversion, pacemaker or implantable cardioverter-defibrillator and in some cases surgery.

Medication Management

Medications can be used to convert the irregular heart rhythm to normal sinus rhythm or to prevent cardiac arrhythmias.

Cardioversion

In patients with persistent arrhythmias (such as atrial fibrillation), a normal rhythm may not be achieved with drug therapy alone. Your physician may recommend a cardioversion. A cardioversion is a process by which the heart is shocked to convert it from an irregular rhythm back into a normal sinus rhythm.

Cardiac Ablation

Sometimes the rhythm can be treated with an ablation of the heart. Ablation involves inserting catheters - narrow, flexible wires - into a blood vessel, often through a site in the groin or neck, and winding the wire up into the heart. Once the catheter reaches the heart, electrodes at the tip of the catheter gather data and a variety of electrical measurements are made.

The data pinpoints the location of the faulty electrical site. Once the damaged site is confirmed, energy is used to destroy a small amount of tissue, ending the disturbance of electrical flow through the heart and restoring a healthy heart rhythm.

This procedure is performed by an Electrophysiologist. It is a widely used procedure, proven to be safe, effective, and long lasting, although some arrhythmias are more easily treated with catheter ablation than others.

What Happens Next?

You will be required to lie flat for 4 to 6 hours following your study. Your blood pressure, heart rate, and areas where the catheters were inserted will be checked frequently. Notify your nurse immediately if you should develop any numbness or tingling in your arm or leg, bleeding from the insertion site, or if you have chills or fever.

What are the Risks?

This is called an invasive procedure because a catheter is inserted into the body. As with any procedure of this type, there can be some risk involved. Your physician will discuss the risks of your particular case in detail with you.

Implantable Devices

Permanent Pacemaker - A pacemaker is a small device (about the size of two silver dollars stuck together) placed under the skin of your chest just below the collar bone. A pacemaker helps to regulate your heart rhythm. The pacemaker runs on batteries and sends out electrical impulses that keep the heart beating at its proper speed. 

Implantable Cardioverter Defibrillator - An ICD (implantable cardioverter defibrillator), or defibrillator, helps stop dangerously fast heart rhythms in the ventricles (the heart's lower chambers). Click on link for more information.

Surgical Treatment

Patients with arrhythmias not relieved by medication or procedures, or patients who have other conditions requiring heart surgery, may be candidates for surgical treatment of AF.

Maze Surgical Ablation

Maze Surgical Ablation is an open-heart surgery that uses an energy source to scar tissue on or near the pulmonary vein. The alternative energy sources used during the procedure include: radiofrequency, cryotherapy, microwave and laser. The goal of all four energy sources is to produce lesions and ultimately scar tissue to block the abnormal electrical impulses from being conducted through the heart and promote the normal conduction of impulses through the proper pathway. It is generally done in patients needing a valve replacement or coronary artery bypass (CABG) surgery, but may also be done on "lone atrial fibrillation."

Mini-Maze Surgical Ablation

A mini-maze surgical ablation is a new minimally-invasive variation of Maze surgical ablation. Since it doesn't require opening the chest, it is typically done on patients with "lone afib", often after a failed catheter ablation. It is much easier on the body and involves much less recovery time than open-chest surgeries, and success rates appear similar.