Electrophysiology and Heart Rhythm Disorders

The heart’s electrical system is responsible for keeping your heart beating in rhythm. All day long, electrical signals run from the top to the bottom of your heart. Every time this happens, the heart contracts, causing blood to pump out of the heart. From there, blood travels throughout your body through arteries and blood vessels.

When something goes wrong with the electrical activity in your heart, you wind up with an arrhythmia, also known as an abnormal heart rhythm. Some of the most common arrhythmias treated through Ochsner’s electrophysiology and heart rhythm care include:

• Atrial fibrillation — irregular heart rhythm that may be faster than usual

• Atrial flutter — symptoms similar to atrial fibrillation but may be more regular

• Bradycardia — heart rate is excessively slow

• Heart failure — the heart doesn’t pump enough blood to the body’s organs

• Sudden cardiac arrest — an electrical malfunction causes the heart to stop pumping blood and requires immediate attention

• Supraventricular tachycardia — upper chambers of the heart beat abnormally fast

• Syncope — you pass out, which may be due to an arrhythmia

• Ventricular tachycardia — lower heart chambers beat abnormally fast

Symptoms vary based on the type and severity of arrhythmia. A few symptoms you may experience include:

• Ability to feel your heart alternate between rapid and slow rhythm

• Experiencing anxiety or shortness of breath

• Feeling faint, weak, dizzy or lightheaded

• Sweating and/or chest pain or pressure

• Unexplainable loss of consciousness

An electrophysiological study helps determine the cause of your arrhythmia. During the test, an electrophysiologist guides a thin, flexible tube called a catheter to your heart. The electrophysiologist then attaches small, electrical wire electrodes to your heart to record your heart’s electrical activity.

A blood pressure cuff tracks your blood pressure during the procedure. Medication given intravenously (through an IV line in your hand or arm) helps reduce anxiety and pain.

Information from your test guides your electrophysiology and heart rhythm team as they develop a treatment plan.

The goal of treatment is to prevent future complications and bring relief for symptoms. Treatment options available at Ochsner include:

• Cardiac ablation. If part of your heart is causing heart rhythm issues, ablation controls the pace by neutralizing the portion of the heart that is not functioning properly. Radiofrequency ablation uses heat to destroy the problematic area. Cryoablation uses cold to do the same thing. These therapies treat atrial fibrillation, ventricular tachycardia and more.

• Device therapy. Sometimes, your heart needs help staying in rhythm. Pacemakers and defibrillators do this. When implanted in your chest, a pacemaker helps keep your heart rate from dropping. Your doctor places this small electrical device directly inside the heart’s right ventricle. A defibrillator, on the other hand, monitors your heart rhythm. When an abnormality occurs, the device shocks the heart back into rhythm.

• Laser extractions. Old pacemakers and other devices are removed with laser technology. This technique is faster than previous techniques and has excellent results.

• Long-term monitoring. If your arrhythmia only occurs occasionally, a loop recorder can detect the problem. A doctor implants this small device into the chest to track your heart rhythm for a year or longer.

• Left atrial appendage occlusion. Atrial fibrillation can cause blood clots to form in the left atrial appendage. If these clots leave the heart, they can cause a stroke. Medication can prevent clot formation, but you must take this medicine your entire life. WATCHMAN and AMULET are small devices that keep the clots in the left atrial appendage to prevent stroke-causing clots — no medication necessary. Ochsner was one of the first programs in the country to offer this treatment.

At Ochsner, a team approach helps bring your heart back in rhythm. Along with electrophysiologists, your team may include the following:

• Cardiovascular anesthesiologists

• Cardiothoracic surgeons

• Congenital heart surgeons

• Heart failure specialists

• Transplant team

• Nurse practitioners

• Pediatric cardiothoracic surgeons

The field of electrophysiology and heart rhythm disorders continues to advance, and the Ochsner team is helping push it ahead. When a new technology hits the market, we scrutinize it carefully. As soon as it proves effective, we bring it here for the good of our patients.

We also participate in clinical research and various clinical trials in cooperation with other electrophysiology centers across the country. This engagement ensures better therapies for the future so more people benefit from improved management of their arrhythmias.

If you’re a candidate for a clinical trial, your team will explain the trial’s goals and limitations. Then you decide whether the trial is a good fit for you.