Pacemaker & ablation

PACEMAKERS

What is a pacemaker and how does it work with the heart's electrical system? A pacemaker is a small electronic device that is placed in the chest or abdomen to help control abnormal heart rhythms (as outlined on the Arrhythmia page). This device uses electrical pulses to prompt the heart to beat at a normal rate.

For a complete introduction to a pacemaker's function in cardiac care go to:

CARDIAC ABLATION for ARRHYTHMIA

In cardiac ablation, a form of energy renders a small section of damaged tissue inactive. This puts an end to arrhythmias that originated at the problematic site. Normally, electricity flows throughout the heart in a regular, measured pattern. This normally operating electrical system is the basis for heart muscle contractions.

Sometimes, the electrical flow gets blocked or travels the same pathways repeatedly creating something of a “short circuit”, such as Atrial Flutter,that disturbs normal heart rhythms. Medicine or implanting a pacemaker often helps. In some cases, however, the most effective treatment is to destroy the tissue housing the short circuit. This procedure is called cardiac ablation.

Cardiac ablation is just one of a number of terms used to describe the non-surgical procedure. Other common terms are: cardiac catheter ablation, radiofrequency ablation, cardiac ablation, or simply ablation.

The ablation process: Like many cardiac procedures, ablation no longer requires a full frontal chest opening. Rather, an ablation is a relatively non-invasive procedure that involves inserting catheters – narrow, flexible wires – into a large blood vessel, often through a site in the groin or neck, and winding the wire up into the heart. The journey from entry point to heart muscle is navigated by images created by a fluoroscope, an x-ray-like machine that provides continuous, “live” images of the catheter and tissue.

Once the catheter reaches the heart, electrodes at the tip of the catheter gather data and a variety of electrical measurements are made. The data pinpoints the location of the faulty electrical site. During this “electrical mapping,” the cardiac arrhythmia specialist, an electrophysiologist, may sedate the patient and instigate some of the very arrhythmias that are the crux of the problem. The events are safe, given the range of experts and resources close at hand, and are necessary to ensure the precise location of the problematic tissue.

Once the damaged site is confirmed, energy is used to destroy a small amount of tissue, ending the disturbance of electrical flow through the heart tissue and restoring a healthy heart rhythm. This energy may take the form of radiofrequency energy, which cauterizes the tissue, or intense cold, which freezes, or cryoablates the tissue. Other energy sources are being investigated.

For more information continue to the following links: