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Electrophysiology
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A Tradition of Experience in Repairing Hearts.
Alta Bates Summit Medical Center is the East Bay’s electrophysiology pioneer, leading the way to cutting-edge heart treatments and procedures since 1980. With the remarkable advancements in the field of electrophysiology, we are continually adopting new ways to repair hearts. Alta Bates Summit Medical Center offers the latest treatments that weren’t available even five years ago and is committed to electrophysiology as a means of saving patients’ lives.
Our experienced team of electrophysiologists treats patients for nearly every condition affecting their heart’s electrical system, with the majority of our patients suffering from Sudden Cardiac Death, Congestive Heart Failure, Atrial Fibrillation, and Supraventricular Tachycardia.
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Electrophysiology Glossary
Sudden Cardiac Death (Cardiac Arrest)
Congestive Heart Failure
Atrial Fibrillation
Supraventricular Tachycardia
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Electrophysiology Glossary
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* Arrhythmia: Any abnormal heartbeat or rhythm
* Biventricular Pacing: Works like a pacemaker to synchronize several actions of the heart, coordinating the contractions of the left and right ventricles.
* Defibrillation: Stops fibrillation of the heart by use of electric current.
* Electrophysiologist: A cardiologist who has additional education and training in the diagnosis and treatment of abnormal heart rhythms.
* Fibrillation: A rapid, uncoordinated series of contractions of some portion of the heart muscle, causing irregular heartbeats and ineffective pumping of blood.
* Implantable Cardioverter Defibrillator (ICD): An implantable device used to treat heart rhythms that are abnormally fast and life threatening.
* Ventricular Arrhythmia: Any ventricular irregularity in the heart’s rhythm. The ventricles are the lower chambers of the heart.
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Sudden Cardiac Death (Cardiac Arrest)
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Sudden Cardiac Death (SCD) claims the lives of 225,000 Americans every year. In SCD, the heart stops abruptly, without warning, killing its victim within minutes. Adding to the shock of sudden death is that it often strikes seemingly healthy people who have no known heart disease. SCD is different from a heart attack, during which clogged or blocked blood vessels stop the supply of blood to the heart.
Most SCD patients suffer from a heart rhythm disorder called ventricular fibrillation (VF). Under normal conditions, the heart’s electrical system regulates the pumping action of the ventricles, or lower chambers of the heart. But in VF, the heart’s electrical system goes haywire and sends the wrong signals to the chambers. This causes the heart to beat rapidly and irregularly and the ventricles to stop contracting. The only way to restore the heart’s normal rhythm and its ability to pump blood is to immediately deliver an electric shock from an external defibrillator, or sudden death occurs.
Common risk factors for the development of arrhythmias and specifically SCD are the usual heart disease danger signs such as high cholesterol, hypertension, smoking, and diabetes. The best way to determine if you are at risk for SCD is to have an echocardiogram screening. If you have SCD risk factors or have had a heart attack, ask your doctor if you should have this important screening test. Early detection can save your life.
You can lower your risk of SCD by incorporating a “heart healthy" lifestyle that includes exercising regularly, eating nutritious foods, maintaining a desirable weight, and stopping or avoiding smoking. If you have high blood pressure, high cholesterol, diabetes, or ventricular arrhythmias, be sure to receive treatment for these conditions as they can contribute to SCD.
For patients who require treatment for SCD, we give them an Implantable Cardioverter-Defibrillator (ICD). ICDs are pacemaker-like devices that are implanted near the heart, continually monitoring the heart and automatically delivering an electric shock if it detects a rapid heartbeat in the ventricles. With a 99 percent effective rate in stopping life-threatening heart rhythms, ICDs have been the most successful therapy to prevent sudden cardiac death in certain high-risk patients. If you think you might be at risk for SCD, please talk with your physician today about your concerns and be sure to have an echocardiogram, if appropriate.
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Congestive Heart Failure
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If you are one of the five million Americans with Congestive Heart Failure (CHF), you know how debilitating and frightening it is to live with a weak heart. As the condition progresses, your heart muscle weakens even further, often becoming enlarged as it is forced to work harder to supply blood to the body. It is then that your heart can develop ventricular arrhythmias, further reducing heart output and aggravating your symptoms.
While there is no cure for CHF, there is hope for a return to an active and fulfilling life. Alta Bates Summit Medical Center offers patients the latest in cutting-edge treatment options that not only alleviate symptoms but also help strengthen the heart and slow the progression of the disease.
One of the most successful means of controlling CHF is Cardiac Resynchronization Therapy (CRT) combined with an Implantable Cardioverter Defibrillator (ICD). The CRT device paces both the left and right ventricles simultaneously to resynchronize the muscle contraction and improve the efficiency of the weakened heart. This, in conjunction with the ICD’s ability to deliver an electrical impulse to the heart to restore its normal rhythm, treats fibrillation and the lack of synchronization in the two ventricles. Now there is finally a successful treatment for congestive heart failure, eliminating the need for a heart transplant in some patients.
We implant a lot of CRTs, finding many a success story in their use. One such case is Grace Jimenez, a 57-year old Piedmont resident who, at 53, was diagnosed with CHF along with several other severe heart conditions. When we prescribed a regimen of medication and implanted a CRT, she survived her condition and was able to maintain a much better quality of life than before treatment. Her damaged heart, however, precluded her from undergoing badly needed coronary bypass artery surgery. Two years later tests showed that the CRT had, in essence, "exercised" her heart, reducing its size and strengthening the remaining muscle so that she was able to have a successful six-way bypass. "I doubt that without the treatment I received -- especially the CRT -- I would not have lived and certainly would not have the quality of life I now enjoy. Within the last year I attended the weddings of both my children and look forward to the birth of my first grandchild in November. I could have missed so much," said Grace.
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Atrial Fibrillation
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More than two million Americans suffer from Atrial Fibrillation (AF), a rapid, irregular heart rhythm caused by abnormal electrical signals from the atria (upper chambers of the heart). Normally, a steady rhythm of electrical signals makes the heart beat anywhere from 60-100 times per minute. In AF, the heart beats anywhere from 300-600 times per minute. As a result, the atria are unable to contract normally, causing the ventricles to also beat irregularly. AF’s heart-racing and inefficient pumping can prevent your heart from delivering adequate blood and oxygen to your body.
Although not life threatening, Atrial Fibrillation can lead to stroke or heart muscle damage. If you have AF, you are five times more likely than the general population to have a stroke.
AF’s electrical impulses typically come from the four pulmonary veins in the heart. Removing the erroneous electrical triggers eliminates or greatly reduces AF. At Alta Bates Summit Medical Center, we use catheter ablation techniques in the pulmonary veins to stop AF. This new and exciting advance allows us to pinpoint the cause of AF, and then use radiofrequency energy to electrically disconnect the problem area from the heart. After the procedure is completed, the pulmonary veins continue to distribute oxygenated blood to the left atrium but no longer generate electrical impulses.
To find AF in the pulmonary veins, we use a lasso catheter, the first circular catheter capable of tracking the pulmonary veins’ circumference along with intracardiac ultrasound to guide the catheter and measure blood flow to veins. This equipment allows us to view the interior of the heart, and identify, diagnose, and assist in the treatment AF and other heart abnormalities and conditions.
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Supraventricular Tachycardia
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Supraventricular Tachycardia (SVT) is a fast, regular heart beat that begins and ends suddenly. Although not life-threatening, SVT causes uncomfortable palpitations, dizziness, and feelings of anxiety. It usually afflicts young people and infants and can hamper an active lifestyle. SVT can start in the upper chambers of the heart making it difficult to find its source.
At Alta Bates Summit, we have the latest means of SVT diagnostics: CARTO and ESI Mapping. Very few medical centers in Northern California offer both of these state-of-the-art mapping systems that enable electrophysiologists to locate an SVT or other arrhythmia.
The CARTO™ XP EP Navigation and Ablation System provide views into the electrical activity of the heart through three-dimensional, color-coded cardiac maps. In addition, the system tracks catheter location and diagnosis. We can now quickly diagnose SVTs based on color-coded, 3-D electroanatomical maps.
The ESI non-contact mapping system uses a catheter that sits inside heart without touching it. The system tracks 3,000 points of electrical activity to locate the irregularity in just one heartbeat. Once an arrhythmia is located, the non-contact system guides a conventional catheter to the location.
We then perform catheter ablation on the site to eliminate the SVT. Usually, with just one treatment, the SVT is cured and we never need to treat the patient again.
As technology advances in the field of electrophysiology, we’ll be there at the forefront, making sure that latest techniques are available for you. To find out more about our program, contact your doctor and they can make the appropriate referral.
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