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Cardiac Rhythm Management

One of the heart’s most important jobs is to beat at a consistent and regular pace in order to ensure that the body gets the right amount of blood flow. Sometimes the heart has trouble finding its rhythm, causing it to beat too fast or too slow for the body’s needs. This is called arrhythmia.

There are many types of arrhythmias, the most common of which is atrial fibrillation (AFib).

Treatment options

While some arrhythmias can be fixed through electrophysiology, some patients will require more permanent treatments like an implantable pacemaker or minimally invasive procedure to keep their heart’s rhythm in check.

At Saint Agnes, we take a team approach to rhythm management, using the expertise of cardiologists, electrophysiologists, imaging specialists and cardiac surgeons to give you the highest quality, long-lasting results.

Advanced Treatments and Technology

Implantable pacemaker and implantable cardioverter defibrillator (ICD) 
To help your heart beat in a regular rhythm, your electrophysiologist may use a small device called a pacemaker. When your heart beats irregularly, the pacemaker sends little electrical pulses to get it back on track. An ICD works similarly, but it sends a tiny shock to your heart if it’s beating too quickly or out of rhythm.  

To implant a pacemaker or ICD, your doctor makes a small incision in your chest and places the device just underneath your skin. Your EP team will ensure that you’re comfortable throughout the procedure.

MAZE 
Central Valley patients who suffer from atrial fibrillation no longer have to leave the area to benefit from a new treatment option – the Maze procedure – that is now available at Saint Agnes. Atrial fibrillation, an abnormality of the heart’s electrical system that causes the upper chambers of the heart to quiver rapidly, occurs when the heart’s electrical impulse is sidetracked from its normal path. Rather than sending an even signal to trigger the atrium to contract all at once, multiple signals are sent to different regions of the atrium, causing it to contract irregularly. During the Maze procedure, cardiothoracic surgeons make a number of incisions on the left and right atrium to form scar tissue, which disrupts the path of abnormal electrical impulses and prevents erratic electrical signals from recurring. Once the incisions are made, the atrium is sewn back together, resulting in what looks like a maze in which there is only one path for the electrical impulse to take. The Maze procedure is typically performed in conjunction with open-heart surgery and is elemental in keeping patients from returning to the hospital for further atrial fibrillation treatment. 

Micra® Transcatheter Pacing System (TPS) 
In July 2017, Saint Agnes became the first in the Valley to offer the only leadless pacemaker available in the United States – the Micra® Transcatheter Pacing System (TPS). Comparable in size to a large vitamin, the Micra TPS provides patients with the most advanced pacing technology at one-tenth the size of a traditional pacemaker. The Micra is designed for patients who suffer from Bradycardia – a slow or irregular heart rhythm, usually fewer than 60 beats per minute. At this rate, the heart is unable to pump enough blood to the body during normal activity or exercise, causing dizziness, fatigue, shortness of breath or fainting spells. Pacemakers are the most common way to treat bradycardia to help restore the heart’s normal rhythm and relieve symptoms by sending electrical impulses to the heart to increase the heart rate.

Unlike traditional pacemakers, the Micra TPS does not require cardiac wires (leads) or a surgical “pocket” under the skin to deliver a pacing therapy. Instead, a catheter is inserted through the groin and the tiny device is threaded through it and implanted directly into the heart with small tines, providing a safe alternative to conventional pacemakers without the complications associated with leads – all while being cosmetically invisible. 

The entire procedure only takes about 25 minutes and, once implanted, the device begins working immediately to keep the heart in rhythm. 

Revo MRITM SureScan® 
Saint Agnes Medical Center is among a select group of hospitals offering the Revo MRITM SureScan® pacing system, the first pacing system designed, tested and FDA approved for use in the Magnetic Resonance Imaging (MRI) environment under specified conditions for use.

Prior to the Revo MRI SureScan pacing system, MRI procedures were not recommended for patients with implanted pacemakers because of the potential risks. Previously, patients might face serious complications if these two technologies were combined, such as interference with pacemaker operation, damage to system components, lead or pacemaker dislodgement or change in pacing capture threshold.

The addition of this new technology is timely − statistics show that the number of patients with pacemakers is growing while the use of MRI is increasing.

Electrophysiology services include:

  • Electrophysiology studies and ablations − 3-D Mapping with Biosense Webster Carto XP and St. Jude Medical ESI
  • Diagnostic electrophysiology
  • ICD placement
  • Permanent Pacemaker (PPM) placement
  • Radiofrequency (RF) catheter ablation for arrhythmia, including atrial fibrillation (Afib) and ventricular tachycardia (V-tach)