Setting the Pace in Innovative Cardiac Specialization
With nearly 300 electrophysiology inpatient procedures performed annually, the heart rhythm specialists of Providence Saint Joseph Medical Center lead the San Fernando Valley in the treatment of arrhythmias, a heart condition that, without medical therapy or intervention, may diminish a patient’s quality-of-life or result in sudden cardiac death. Providence Saint Joseph’s electrophysiologists represent part of a distinguished team of heart specialists – which also includes medical and interventional cardiologists and cardiac surgeons – that consistently receives outstanding recognition for the diagnosis and treatment of more than 2,000 cardiac patients each year.
- The California Office of State Health Planning and Development consistently reports that Providence Saint Joseph produces better than average survival rates for the treatment of heart attack and for coronary artery bypass surgery.
- Healthcare quality valuation agency Health Grades rates Providence Saint Joseph as a five-star medical provider in the categories of heart attack and heart failure treatment.
- Patients rank Providence Saint Joseph among the top five heart programs in the Los Angeles area, according to a preference survey conducted by the National Research Corporation.
Proudly providing an impressive range of state-of-the-art services and programs, Providence Saint Joseph heart specialists continue to innovate and refine world-class cardiovascular care in the heart of Burbank.
Providing State-of-the-Art Service and Technology
Providence Saint Joseph Medical Center includes a state-of-the-art cardiovascular laboratory fully equipped to facilitate invasive electrophysiology studies as well as pacemaker and implantable cardioverter defibrillator (ICD) implants. Our board-certifiedelectrophysiologists perform inpatient arrhythmia procedures, provide inpatient consultation in the telemetry and coronary care units, and provide outpatient diagnostic and consultation services. From diagnosis to treatment to follow-up, the heart rhythm specialists of Providence Saint Joseph work collaboratively with each patient’s primary care physician, cardiologist, and other specialists to ensure appropriate, effective diagnosis and treatment.
Diagnostic Electrophysiologic Studies
- Electrocardiogram (ECG). Sensors, or electrodes, detect the electrical activity of the heart by measuring the timing andduration of each electrical phase in the heartbeat.
- Holter monitor. A portable ECG device worn for a day or more records the heart's activity during the normal daily routine.
- Event monitor. For sporadic arrhythmias, a portable ECG device is attached to the body and activated only when the patient experiences symptoms of an arrhythmia. An ECG strip of the preceding few minutes and following few minutes is recorded.
- Echocardiogram. A hand-held device (transducer) placed on the chest uses sound waves to produce images of the heart's size, structure and motion.
- Stress test. To determine if the arrhythmia is triggered or worsened by exercise, heart activity is monitored by an ECG during a work-out on a treadmill or stationary bicycle. For patients who find it difficult to exercise, drugs may also be used to stimulate the heart in a way that is similar to exercise.
- Tilt table test. For patients with recurrent fainting spells, the heart rate and blood pressure are monitored as the patient is positioned flat on a table. While the table is tilted as if the patient were standing up, the doctor observes how the heart — and the nervous system that controls the heart — respond to the change in angle.
- Electrophysiologic testing and mapping. Thin, flexible tubes, or catheters, tipped with electrodes are threaded through the blood vessels to a variety of spots within the heart. The electrodes precisely map the spread of electrical impulses through the heart, or may be used to stimulate the heart to beat at rates that may trigger — or halt — an arrhythmia. The ability to start and stop the arrhythmia is used to observe the location of the arrhythmia and the mechanisms that may be causing it or to test various treatment methods for effectiveness.
Arrhythmia Treatments
- Radiofrequency Catheter Ablation. Generally considered the preferred first-treatment method for many types of arrhythmias difficult to treat with medications, catheter ablation causes little discomfort and is performed under mildsedation with local anesthesia. One or more catheters are threaded through the blood vessels to the inner heart, positioned along electrical pathways suspected of causing the arrhythmia. Electrodes at the catheter tips are heated with radiofrequency energy, which destroys (ablates) a small spot of heart tissue and creates an electrical block along the pathway causing your
arrhythmia. Radiofrequency catheter ablation is most commonly used to treat
• AV nodal reentry tachycardia • Accessory pathways
• Atrial fibrillation and atrial flutter • Ventricular tachycardia
- Implantable Cardioverter Defibrillator (ICD). An electronic device that constantly monitors the heart rate and rhythm,and ICD delivers energy to the heart muscle when it detects a very fast, abnormal heart rhythm, causing the heart to beat in a normal rhythm again. Primary candidates for ICDs include patients with previous episodes of sudden cardiac death or ventricular fibrillation; previous heart attack victims at high risk for sudden cardiac death; patients with hypertrophic cardiomyopathy; or patients with at least one episode of ventricular tachycardia. The ICD is programmed to include one orall of the following functions:
• Anti-tachycardia pacing • Cardioversion • Defibrillation • Bradycardia pacing
- Pacemaker. Using a small, battery-powered generator to deliver timed, electrical impulses to the heart muscle through tinywire leads, a pacemaker helps a patient’s heart beat in a regular rhythm. Traditional pacemakers may have one lead, pacingonly the ventricles or the atria, or two leads, pacing both chambers. A more recent innovation in the treatment ofarrhythmias, a biventricular pacemaker uses three leads to treat the delay in heart ventricle contractions. This new therapyimproves the symptoms of heart failure (fatigue, shortness of breath and exercise intolerance) and the person's overall qualityof life. Primary uses for pacemakers include the treatment of:
•Bradycardia • Heart failure • Hypertrophic cardiomyopathy
- Modified MAZE Procedure: An effective and less invasive technique to restore sinus rhythm in patients with chronic atrial fibrillation (AF), the modified MAZE procedure uses a radiofrequency device to ablate targeted tissues and create electrophysiology barriers that interrupt the multiple wavelength re–entry circuits of AF. Most patients experience an organized heart rhythm immediately, and medication eventually may be discontinued.
For more information or evaluation of a patient with a heart rhythm disorder, please contact one of our arrhythmia specialists by calling 1-888-HEALING (1-888-432-5464).
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