Pacemaker implantation: This is a procedure to put a small battery-operated device called a pacemaker into your chest. The pacemaker sends regular electrical pulses to help keep your heart beating regularly. Pacemakers work on demand and they can be programmed to in response to your body's needs. If the pacemaker senses that your heart has missed a beat or is beating too slowly, it sends signals at a steady rate. If it senses that your heart is beating normally by itself, it does not send out any signals.
Defibrillator (ICD) implantation: An ICD (implantable cardioverter defibrillator) is an electronic device that constantly monitors your heart rhythm. When it detects a very fast, abnormal heart rhythm, it delivers energy to the heart muscle, causing it to again beat in a normal rhythm. The physician surgically implants the defibrillator under the skin, usually below the left collarbone. A wire threaded through a large vein connects the device to the heart. If you have had a serious episode of an abnormally fast heart rhythm or are at high risk for having one, you may need an ICD.
Cardiac resynchronization therapy: Many patients with weak heart muscle have disorganized muscle function. This further degrades the performance of the heart, resulting in shortness of breath and fatigue. This therapy is commonly performed in conjunction with defibrillator implantation (link to defibrillator implantation description). Additional pacing leads are threaded to the heart to help make it beat in an organized and more efficient way.
Catheter ablation: This procedure is used to treat heart rhythm disturbances. It is typically performed in conjunction with an electrophysiologic study (link to electrophysioloic study description) and frequently with intra-cardiac echocardiography (link to intra-cardiac echocardiography description). One of the catheter tips is heated or cooled next to the area that is responsible for the heart rhythm disturbance. This eliminates its activity and helps restore normal rhythm.
Implantable loop recorders: This is a small, insertable cardiac monitor that is implanted just under the skin of the chest to record the heart's electrical activity. It is a useful diagnostic tool when patients regularly experience symptoms such as fainting, seizures, rapid heartbeat, lightheadedness, or dizziness, but not often enough to be captured by a 24-hour or 30-day external monitor. An ILR can be used for 2 to 3 years, if necessary.
Electrophysiologic study: This testing investigates the condition of the electrical system of the heart and its propensity for rhythm disturbances. If a rhythm disturbance is found, it can be “mapped” to a certain location in the heart, which will help guide therapy. Catheters are inserted into the groin and sometimes the neck to reach the heart and record its electrical activity. The heart can also be stimulated or “paced” using the same catheters.