Almost everyone experiences an episode of arrhythmia-abnormal heart rhythm-at some time in their lives. Mild, isolated arrhythmias are common and are usually considered harmless. But for other types of arrhythmias, such as atrial fibrillation (AFib) and ventricular tachycardia (v-tach), treatment is crucial to prevent serious consequences, such as heart failure, stroke, and even death. Several recent technological advances are making it easier for doctors to return the heart to a normal rhythm with catheter ablation, a procedure that entails threading a catheter (a thin, flexible tube) through a blood vessel into the heart and correcting the irregularity. A key element of an ablation procedure is guiding the catheter to the areas in the heart where the irregular rhythms originate. "Performing an ablation procedure with robotics or magnetic navigation allows the physician to get to places that might be hard to reach manually, which should improve accuracy, safety and effectiveness," says cardiologist Walid Saliba, MD, Director of the Electrophysiology Lab in the Department of Cardiovascular Medicine at Cleveland Clinic.
Checking your blood pressure at home a few times a week can help you keep your numbers under control and spot unhealthy trends before your condition worsens. And with improvements in technology, you can quickly provide your blood pressure information to your healthcare team for improved care. This was illustrated in a study published in the June 25 issue of the Journal of the American Medical Association (JAMA), which showed that hypertensive patients who used a Web-based program to share information and receive services and advice from a pharmacist had better blood pressure control than patients who did not participate in the program. Home blood pressure monitors typically cost between $50 and $150 and are easy to operate. Cleveland Clinic cardiologist Donald Vidt, MD, says the devices are worth the investment. He recommends checking your blood pressure three times a week, especially if youre taking medication to control hypertension.
Heart failure patients often need surgery to survive-but the fact that theyre at high risk makes them especially vulnerable to complications. In such cases, a newer type of ventricular assist device (VAD) called TandemHeart can be lifesaving, says Eric Roselli, MD, a staff surgeon in Cleveland Clinics Department of Thoracic and Cardiovascular Surgery. Like other VADs, which were designed to keep patients alive while they wait for a heart transplant, the TandemHeart takes over the hearts pumping function, allowing the weakened muscle to rest. However, while traditional VADs are surgically implanted in the abdomen, a percutaneous VAD (pVAD) such as TandemHeart is introduced into the circulatory system without invasive surgery (see illustration). "TandemHeart can get patients to some level of recovery, so they can better tolerate a more invasive procedure," says Dr. Roselli. "Its small size and ease of placement make it ideal for patients whose heart failure has progressed rapidly."
If youre at high risk of a heart attack, you might feel better having a home version of the automatic external defibrillator (AED) used by hospitals and paramedics. The American Heart Association says they can be a good investment, especially if you live in an area where swift emergency response is unlikely. However, theyre also expensive-and they may not work in every case, cautions Bruce Wilkoff, MD, director of Cardiac Pacing and Tachyarrhythmia Devices at Cleveland Clinic. "An AED works for a specific issue-sudden cardiac arrest by ventricular tachycardia or fibrillation-which can be confused with other devastating events, such as a heart attack, stroke or aneurysm," he explains.
If you received an implantable cardioverter defibrillator (ICD) after a major heart attack and youve started getting frequent jolts to your heart to get it back in rhythm, a cardiologist may recommend radiofrequency ablation in the hope of quieting the troublesome electrical pathway. But a recent study, published in the Dec. 26 issue of the New England Journal of Medicine (NEJM), suggests that performing ablation soon after ICD implantation greatly reduces the number of shocks the ICD will have to administer in subsequent months. The study followed 128 post-heart attack patients with ventricular tachycardia or ventricular fibrillation (abnormal heart rhythms) and showed that the number of discharges from the ICDs decreased by two-thirds if the patients underwent ablation.
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