BHI Arrhythmia Services provides comprehensive service for the diagnosis and treatment of arrhythmias and congestive heart failure. Heart rhythm disorders and arrhythmias are problems related to the heart's electrical system. A cardiac electrophysiologist (EP) is a specialist who investigates and corrects heart rhythms for patients with these problems. Dr. Andrew Merliss, electrophysiologist, is the director of BHI’s Arrhythmia Services. We participate in national studies and protocols in congestive heart failure and arrhythmia management. We utilize leading technology and treatments for our patients. Our range of Arrhythmia Services includes electrophysiology studies, ablation procedures, permanent pacemaker and defibrillator implants, heart rhythm monitoring and devices for congestive heart failure management.
Electrophysiology Study
An electrophysiology study, or EP study, is a procedure in which a thin tube called a catheter is inserted into a vein or artery, typically in the groin. The catheter moves through the vein to the heart, where it can perform specific measurements of the heart's electrical activity and pathways. These measurements are helpful in the diagnosis of abnormal heart rhythms. Abnormally fast rhythm is called tachycardia and abnormally slow heart rhythm is called bradycardia.
The results of an EP study may lead to further treatment, such as the implantation of a pacemaker or implantable cardioverter defibrillator (ICD), or a prescription for antiarrhythmic medications.
Pacemaker Insertion
A pacemaker is an electronic device that is implanted in the chest to artificially regulate the heart's rhythms. Pacemakers correct abnormal heart rhythms by sending electrical impulses to one or more chambers of the heart. These signals make the heart beat in a more regular rhythm. A pacemaker continuously monitors the heart's electrical activity and is programmed to fit the needs of the individual patient. The device is sensitive to activity level and breathing patterns of the patient and when abnormal rhythms are detected, the pacemaker will send electrical impulses until it senses that the heart has returned to a normal rate.
A pacemaker is implanted into a patient's chest during a minor surgical procedure. Once the pacemaker is in place, it runs on batteries that last between five to ten years. Pacemaker batteries will not run out unexpectedly and physicians can detect when a battery is running low or needs to be replaced during a routine office visit or phone call.
Implantable Cardioverter Defibrillator
A defibrillator is a device that is implanted in the chest to monitor a patient's heart rhythm and may, if necessary, deliver specialized therapy to protect the patient from arrhythmias or irregular rhythms. If a heartbeat gets too fast, called ventricular tachycardia, the ICD will stimulate the heart to restore a normal rhythm. In some cases where the heartbeat is so rapid that a person may die, called ventricular fibrillation, the ICD will also give an electric shock called defibrillation, to restore the heartbeat to a normal rhythm.
Once the ICD is in place, it runs on batteries for about four to seven years, depending on how often an electric shock is discharged. ICD batteries will not run out unexpectedly and physicians can detect when a battery is running low or needs to be replaced during a routine office visit.
Cardiac Resynchronization Therapy (Bi-Ventricular pacemaker and Bi-Ventricular ICD)
Cardiac resynchronization therapy is designed for patients with congestive heart failure, in combination with established medical treatments and medications. Congestive heart failure causes the heart to pump blood ineffectively to vital organs. A special pacemaker for these patients has up to three leads and helps coordinate and strengthen the pumping function of the main lower chambers of the heart. A patient may require a defibrillator along with cardiac resynchronization therapy under certain circumstances. Dr. Andrew Merliss is one of the leading implanters of these devices in the United States and Europe.
Ablation
An ablation is a procedure which is used to correct irregular heart rhythms called arrhythmias. During an ablation, the very small, carefully selected parts of the heart that are causing the irregular rhythms are destroyed and the heart returns to a normal rhythm. The most common method of ablation involves a thin tube called a catheter, which is inserted through a blood vessel up to the heart. At the tip of the catheter is a small wire, which delivers radiofrequency energy used to burn away the abnormal areas of the heart. Depending on the arrhythmia, medications may still be used following an ablation to ensure normal rhythms.
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