Devices and Surgical Procedures to Treat Heart Failure Devices and Surgical Procedures to Treat Heart Failure Updated:Oct 11,2016 Implantable Cardioverter-Defibrillator (ICD) Some people who have severe heart failure or serious arrhythmias (irregular heartbeats) are candidates for implantable defibrillators. These devices are surgically placed and deliver pacing, or an electric countershock, to the heart when a life-threatening abnormal rhythm is detected. They have saved millions of lives, but may not be for everyone. This is a shared decision by the patient and physician. Learn more about implantable devices . Cardiac Resynchronization Therapy (CRT) Some people with heart failure develop abnormal conduction of the heart’s electrical system that changes how efficiently the heart beats. Cardiac resynchronization therapy, also known as biventricular pacing, may be needed. In this procedure, a special pacemaker is used to make the ventricles contract more like normal and in synchrony. This therapy can improve heart function, reduce hospitalization risk, and improve survival. Learn more about cardiac resynchronization therapy . Left ventricular assist device (LVAD) What is a left ventricular assist device (LVAD)?

The left ventricle is the large, muscular chamber of the heart that pumps blood out to the body. A left ventricular assist device (LVAD) is a battery-operated, mechanical pump-type device that's surgically implanted. It helps maintain the pumping ability of a heart that can't effectively work on its own. These devices are available in most heart transplant centers. When is an LVAD used? This device is sometimes called a "bridge to transplant," but is now used in longer-term therapy. People awaiting a heart transplant often must wait a long time before a suitable heart becomes available. During this wait, the patient's already-weakened heart may deteriorate and become unable to pump enough blood to sustain life. An LVAD can help a weak heart and "buy time" for the patient or eliminate the need for a heart transplant. Most recently, LVADs are being used longer-term as ‘destination therapy’ in end-stage heart failure patients when heart transplantation is not an option. How does an LVAD work? A common type of LVAD has a tube that pulls blood from the left ventricle into a pump. The pump then sends blood into the aorta (the large blood vessel leaving the left ventricle).

This effectively helps the weakened ventricle. The pump is placed in the upper part of the abdomen. Another tube attached to the pump is brought out of the abdominal wall to the outside of the body and attached to the pump's battery and control system. LVADs are now portable and are often used for weeks to months. Patients with LVADs can be discharged from the hospital and have an acceptable quality of life while waiting for a donor heart to become available. Heart transplantation Some people have severe, progressive heart failure that can't be helped by medications and dietary and lifestyle changes. In such cases a heart transplant may be the only effective treatment option. Surgeons replace the damaged heart with a healthy one taken from a donor who has been declared brain dead. It can take several months to find a donor heart that closely matches the tissues of the person receiving the transplant. But this matching process increases the likelihood that the recipient's body will accept the heart. In some cases surgeons will implant a left ventricular assist device to help the heart function during this waiting period. This mechanical pump helps the left ventricle (lower left chamber) to pump.

During a transplant procedure, the surgeon connects the patient to a heart-lung machine, which takes over the functions of the heart and lungs. The surgeon then removes the diseased heart and replaces it with the donor heart. Finally, the major blood vessels are reconnected and the new heart is ready to work. The outlook for people with heart transplants is good during the first few years after the transplant. In fact, about 90 percent of patients live for more than a year after their operations. However, the number of patients who receive heart transplants is still relatively low (around 2,500 each year). Read more about heart transplants . Surgery isn't frequently used to treat heart failure. However, it's recommended when the doctor can identify a correctable problem that's causing heart failure – such as a defect (such as a heart valve) or a blocked coronary artery. Surgery also may be needed when the heart failure is so severe that it can't be helped with medications or dietary and lifestyle changes. View an illustration of coronary arteries . Percutaneous coronary intervention (PCI) (also referred to as angioplasty) Heart failure can develop when blockages in the coronary arteries restrict the blood supply to the heart muscle.

Removing these blockages can improve overall heart function, which may improve or resolve heart failure symptoms. PCI is one type of procedure to reopen blocked vessels. The procedure is usually performed in the cardiac catheterization lab. A small tube – a catheter – with a tiny deflated balloon on the end is inserted through an incision in the groin (or other artery) area and pushed through to the diseased artery. Then the balloon is inflated to push open the artery. The balloon is removed once the artery has been fully opened. A stent may be placed during the procedure to keep the blood vessel open. Although there's a slight risk of damage to the artery during this procedure, PCI usually improves the patient's condition. Watch an animation of PCI . Coronary artery bypass Coronary artery bypass surgery reroutes the blood supply around a blocked section of the artery. During this procedure, surgeons remove healthy blood vessels from another part of the body, such as a leg or the chest wall. They then surgically attach the vessels to the diseased artery in such a way that the blood can flow around the blocked section.

After a bypass operation, it's especially important for you to watch your diet and reduce the amount of fat and cholesterol you eat, since these substances cause the arteries to clog. Doctors also recommend following a routine of increased physical activity to strengthen the heart muscles. View an illustration of coronary artery bypass . Valve replacement Heart failure is sometimes caused by a defective or diseased heart valve. Heart valves regulate the flow of blood inside the heart. When they don't work properly, this puts extra strain on the heart and can lead to heart failure. For some valve problems, medical management is the first step in treatment. Correcting the problem surgically can often improve or resolve the condition. A variety of different replacement valves can be used: a mechanical valve made from metal and plastic, one made from human or animal tissue. During the surgery, the patient is connected to a heart-lung machine that supplies blood to the brain and body. The bad valve is removed and replaced. After the operation and depending on the type of replacement heart valve used, patients may take medicines to prevent blood clots from forming around the new heart valve. This treatment is often long-term to ensure the new valve works properly.

Most heart valve surgeries are a success, but the operation is only considered as an option when a defective or diseased valve threatens someone's life. In some patients, heart valve replacement may occur without surgery but candidacy for this kind of procedure is highly individualized. Read more about heart valve surgery . This content was last reviewed Oct 2015. Heart Diseases & Disorders Heart Diseases & Disorders Back to Patient Resources Heart Diseases & Disorders Millions of people experience irregular heartbeats, called arrhythmias, at some point in their lives. Most of the time, they are harmless and happen in healthy people free of heart disease. However, some abnormal heart rhythms can be serious or even deadly. Having other types of heart disease can also increase the risk of arrhythmias. Disease Categories Electrical : Abnormal heart rhythms (arrhythmias) are caused by problems with the electrical system that regulates the steady heartbeat. The heart rate may be too slow or too fast; it may stay steady or become chaotic (irregular and disorganized). Some arrhythmias are very dangerous and cause sudden cardiac death, while others may be bothersome but not life threatening.

Circulatory : High Blood Pressure and coronary artery disease (blockage in the pipes of the heart) are the main causes of blood vessel disorders. The results, such as stroke or heart attack, can be devastating. Fortunately, there are many treatment options. Structural : Heart muscle disease (cardiomyopathy) and congenital abnormalities (problems present from birth) are two problems that can damage the heart muscle or valves. Atrial Fibrillation (AF or AFib ) More than 2 million people in the U.S. have atrial fibrillation. In AFib , the heartbeat is irregular and rapid due to disorganized signals from the heart’s electrical system. The upper chamber of the heart may beat as often as 300 times a minute, about four times faster than normal. Though AFib isn't life threatening, it can lead to other rhythm problems, feeling tired all the time, and heart failure (with symptoms such as filling up with fluid, swelling in hands, legs and feet, shortness of breath). People with AFib are five times more likely to have a stroke compared to people without the condition. Doctors often prescribe blood thinners (anticoagulants) to patients with AFib to reduce this higher risk of stroke.

Atrial Flutter ( AFL ) Atrial flutter is similar to AFib because it also causes a fast beat in the atrium. However, AFL is caused by a single electrical wave that circulates very rapidly in the atrium, about 300 times a minute. This leads to a very fast, but steady, heartbeat. Sick Sinus Syndrome ( SSS ) Sick sinus syndrome is not a disease, but a group of signs or symptoms that show the heart’s natural electrical pacemaker, the sinus node, is not working properly. In SSS , the heart rate can alternate between slow (bradycardia) and fast (tachycardia). Treatment for SSS is usually an artificial pacemaker, along with medication. Sinus Tachycardia A harmless faster rhythm, sinus tachycardia is a normal increase in heart rate that happens with fever, excitement, and exercise. There is no need for treatment, except in rare cases when it is caused by an underlying problem, such as anemia (low blood count) or hyperthyroidism (overactive thyroid gland).

Arrhythmias that originate in the heart’s lower chambers, the ventricles, include: Ventricular Tachycardia ( VT ) A life-threatening arrhythmia, ventricular tachycardia is usually seen along with other serious heart disease but sometimes happens in people with normal hearts. Because VT can lead to ventricular fibrillation (a dangerously fast and disorganized heartbeat), it is a serious condition that needs aggressive treatment and follow up. Treatment options are surgery, radiofrequency ablation (scarring or burning the area of heart tissue that triggers the abnormal rhythm), and/or medication. People with VT are often protected by a defibrillator (a device that can shock the heart out of the dangerous heartbeat) that is implanted in the body. Ventricular Fibrillation ( VF ) Sudden cardiac arrest caused by ventricular fibrillation is the cause of half of all cardiac deaths. In VF , the heartbeat is fast and chaotic, causing the lower heart chambers, or ventricles, to spasm. Sometimes, a heart attack (blockage of the heart pipes/arteries) can lead to VF . VF is sudden, happens without warning, and stops the heart from working.

The lack of oxygen to the body, especially to the brain, is deadly. Sudden cardiac arrest is caused by an electrical problem. It is not the same as a heart attack (myocardial infarction), which is a circulatory (plumbing) problem caused by clogged blood vessels that cut off the supply of blood to the heart. Though CPR may help, the only truly effective VF treatment is defibrillation, which uses paddles or electrodes to “shock” the heart back to normal rhythm. Without treatment, the person with VF will pass out suddenly and die. Other arrhythmias include: Premature Contractions Extra, early, or “skipped” beats are the most common cause of irregular heart rhythms. These can start in the upper or lower chambers of the heart. Long QT Syndrome ( LQTS ) Long QT Syndrome is a disorder of the electrical system. It can be inherited, brought on by taking certain medications, or caused by a combination of both. People with LQTS are at risk for VF , the most dangerous heart rhythm that causes sudden death. When electrical signals from the upper chambers of the heart (atria) cannot travel to the lower chambers (ventricles), heart block happens.

The heart then beats too slowly, decreasing the amount of oxygen that gets to the body and brain. Syncope ( Fainting ) Fainting , or feeling as if one might pass out, can be caused by serious heart rhythm disorders and needs to be evaluated carefully. Sometimes the cause is not heart related, as in cases of low blood sugar, but it can still be dangerous due to the risk of injuries from falling. Circulatory Disorders Heart Attack (Myocardial Infarction) When arteries become so clogged that the flow of blood to the heart is reduced or stopped, the lack of oxygen can damage or kill the heart muscle, causing a heart attack. Knowing the symptoms of a heart attack and getting immediate emergency treatment can limit or prevent heart muscle damage. Stroke Strokes (brain attacks), although not true heart disorders, are caused by blockage or reduced blood flow to the brain. While some strokes occur when a blood vessel bursts, most happen due to clogged or blocked vessels to the brain, in the same way clogged vessels in the heart can cause a heart attack. Abnormal heart rhythms such as atrial fibrillation and atrial flutter can lead to the formation of blood clots in the heart.

When dislodged, a blood clot can travel to the brain, block a vessel and cause a stroke. All strokes pose serious health threats. Structural Disorders When the heart muscle is too weak to effectively pump blood through the body, heart failure, or cardiomyopathy, sets in. Early diagnosis and treatment can stop or slow down the worsening of heart failure. Heart Valve Problems Heart valve problems can be inherited or develop on their own, affecting the heart’s ability to push blood from chamber to chamber. Medication and surgery are treatment options. Share: Diagnosing and Treating Heart Rhythm Problems | Sarver Heart Center Home › Diagnosing and Treating Heart Rhythm Problems Diagnosing and Treating Heart Rhythm Problems By Julia H. Indik, MD, PhD, associate professor of medicine, University of Arizona Sarver Heart Center The normal heart beat begins in the sinus node, located near the top of the right atrium. (See Figure below.) This electrical impulse spreads over the atrium, causing the atria to contract to pump the blood into the ventricles. But for the atrial impulse to get to the ventricles, it must go through the AV node and the His Bundle.

The electrical impulse then travels down the bundle branches to the ventricular muscles, causing them to contract, producing a heartbeat that pumps the blood to the body. The normal heart rate is between 60 and 100 beats per minute. If the sinus node is without nerves (for example a transplanted heart) the heart rate is about 80 beats per minute. Two types of nerves regulate the heart rate. The sympathetic nerve speeds up the heart rate with exertion or excitement. The vagal nerves slow the heart rate. Many athletes have a slow heart rate due to increased vagal tone. In non-athletes a slow heart rate can be a sign of a defective AV node. The heart rate also can be increased by adrenalin from the adrenal glands, due to exercise or excitement. Normal conduction from the atrium to the ventricles The electrical heart. Each heart beat is started electrically at the sinus node. Then the electrical impulse is carried to the AV node and relayed to the ventricles over the left and right bundle branches to the heart muscle.

Slow Heart Beat (Bradycardia) An abnormally slow sinus heart rate is called the “sick sinus syndrome” and, if severe, results in symptoms of fatigue. In some such cases a permanent pacemaker is needed to be implanted to generate a normal heart rate. Many people with sick sinus syndrome also develop atrial fibrillation. These individuals have intermittent heart rates that are often either too fast or too slow. From the atrium, the electrical impulse is carried through the AV node, which sits as an electrical “relay” between the upper chambers (atria) and lower chambers (ventricles). Slowdown in the AV node can be another cause for bradycardia, in which not all the sinus node discharges can make it through to the ventricle, a form of heart block. Sometimes the AV node slows down due to medications, which need to be adjusted. After the AV node, comes the left and right bundle branches, very important electrical relays that are the final pathways to signal the ventricles to beat.

A slowdown or block in this part of the conduction system may be serious and require a pacemaker as some patients can develop “complete heart block.” In complete heart block, no signals from the sinus node can penetrate to the ventricles, and the patient can have a dangerously slow pulse. Adjusting medications cannot fix this type of complete heart block; a pacemaker is needed. Treating Slow Heart Rhythms Sometimes a slow heart beat can be improved by adjusting medications. This may be the case with “sick sinus syndrome,” for example. When the slow heart beat cannot be improved by medication adjustments, a pacemaker is needed. Pacemakers also are needed when signals from the atrium are not conducted to the atrium; this is known as “complete heart block.” Placing a pacemaker: Pacing leads (one to three) are positioned through the vein under the collarbone (subclavian vein) into the heart chambers and affixed to the heart muscle. These leads then are connected to the pacemaker generator, which is placed under the skin in the front chest region just below the collarbone. This procedure is performed in the electrophysiology laboratory and typically takes about one to two hours.

If a third lead is needed for what is called “biventricular pacing” for heart failure, the procedure may take up to three hours. Follow up and monitoring: The patient will have future follow-up appointments in the pacemaker clinic and can be followed remotely with a home monitoring unit. Very little in the typical environment interferes with a pacemaker. It is fine to use microwaves and cell phones, but not placing the cell phone directly over the device. A patient with a pacemaker cannot get an MRI, but a CT scan is all right. At the airport, the device will set off the metal detectors, so inform security that you have a pacemaker. At stores with anti-theft devices at the door, patients should simply walk through and not linger by the door. Fast Heart Rhythms – Tachycardia Tachycardia refers to a situation where the pulse is faster than 100 beats per minute (bpm). Sometimes this is absolutely normal. For instance, with exercise it is entirely appropriate for the pulse to rise above 100 bpm. However, when tachycardia occurs at rest, a cardiologist needs to determine the specific cause.

The first question is whether the tachycardia is originating from the upper chambers (“atria”) or the lower chambers (“ventricles”). Ventricular tachycardia refers to a fast heart beat that originates from the ventricles and can be potentially dangerous. If tachycardia originates from the upper chambers, it will be one of three types: 1) Atrial fibrillation Heart-Encyclopedia - A abdominal aortic aneurysm An abdominal aortic aneurysm, also called aortic aneurysm, occurs when the large blood vessel (the aorta) that supplies blood to the abdomen, pelvis and legs becomes abnormally large or balloons outward. This type of aneurysm is most often found in men over age 60 who have at least one or more risk factor, including emphysema, family history, high blood pressure, high cholesterol, obesity and smoking. ablation Ablation, or cardiac ablation, is a therapeutic method used to destroy a small section of heart tissue causing abnormal electrical activity or irregular heartbeat.

Ablation is done using electrodes that help identify the site of abnormal activity, then deliver either radiofrequency energy (RF ablation) or intense cold (cryoablation) to destroy the tissue. abnormal glucose tolerance Abnormal glucose tolerance is when the body is unable to break down, or metabolize, sugar adequately. The body uses a type of sugar called glucose for energy. People with abnormal glucose tolerance, also called impaired glucose tolerance, are considered prediabetics. They are at increased risk for developing type 2 diabetes , which is an important risk factor for heart disease and stroke . ACE inhibitors ACE inhibitors, also called angiotensin-converting enzyme inhibitors, are drugs used to treat high blood pressure and heart failure. ACE inhibitors s alters the body's ability to produce angiotensin II, a hormone that causes the arteries to narrow. By blocking the making of angiotensin, these drugs help the blood vessels relax and widen, which lowers blood pressure, increases blood flow to the heart and reduces the heart's workload. actin Actin is a protein that helps make up the structure of muscles in the heart. As muscle cells die during a heart attack, actin is released into the blood.

A blood test to measure actin can help confirm a heart attack and determine the extent of heart damage. acute coronary syndrome Acute coronary syndrome is an umbrella term for when blood supplied to the heart muscle is decreased or blocked, leading to a heart attack . The common signs of acute coronary syndrome are chest pain or discomfort, which may involve pressure, tightness or fullness; pain or discomfort in one or both arms, the jaw, neck, back or stomach; shortness of breath; feeling dizzy or lightheaded; nausea; or sweating. Adams-Stokes Disease Adams-Stokes disease, also called Stokes-Adams disease, is a condition that leads to fainting ( syncope ) and sometimes convulsions. It happens when the electrical signals traveling from the upper to lower chambers of the heart are interrupted. This results in inadequate blood flow to the brain because the heart is beating too slowly (an arrhythmia called bradycardia ). adenosine Adenosine is a substance produced by the body that plays a role in important biochemical processes. It causes increased blood flow to the heart muscle by relaxing the coronary arteries and other blood vessels in the body and regulates heart rhythm.

Adenosine is also s a drug used to treat some types of arrhythmias (irregular heartbeats), specifically those that cause a fast heartbeat. AED An automated external defibrillator is a computerized medical device that can check a person’s heart as well as shock it back to a normal rhythm. It can help save the life of someone who has suffered sudden cardiac arrest, the abrupt loss of heart function. The AED uses voice prompts, lights and text messages to tell the rescuer the steps to take. AEDs are very accurate and easy to use. With a few hours of training, anyone can learn to operate an AED safely. air pollution and cardiovascular diseases Air pollution increases the risk for heart attack, stroke, heart failure, irregular heartbeats (arrhythmias) and cardiovascular death. Once inhaled, particulate matter can cause inflammation and irritate nerves in the lungs, starting a cascade of changes that adversely affect the rest of the body, including the heart. The elderly and people with existing heart diseases may be at higher risk from short-term exposure (hours or weeks). Long-term exposure further increases cardiovascular risk and reduces life expectancy, probably by several months to a few years.

The American Heart Association recommends people, particularly those at high cardiovascular risk, limit their air pollution exposure. alcohol and heart disease Drinking large amounts of alcohol can increase the levels of some fats in the blood known as triglycerides and can lead to high blood pressure, heart failure and obesity. Excessive drinking and binge drinking can lead to stroke and sudden cardiac arrest. For those who consume alcohol, the American Heart Association recommends no more than two drinks per day for men and no more than one a day for women. alcohol and stroke Alcohol abuse can lead to multiple medical complications, including stroke. Based on research examining alcohol and stroke risk, the American Heart Association recommends no more than two drinks per day for men and no more than one drink per day for non-pregnant women. aldosterone Aldosterone is a hormone produced by the adrenal glands. It regulates the balance of salt and water in the body by helping the kidneys retain sodium and excrete potassium. Aldosterone also acts on the central nervous system to increase a person’s appetite for salt and to make them thirsty. These effects directly control blood pressure and the balance of fluids in the blood.

aldosterone antagonists Also called aldosterone receptor blockers, aldosterone antagonists block the body’s response to the hormone aldosterone, which normally causes the body to retain sodium and get rid of potassium. Aldosterone antagonists increase urination, thus reducing water and salt while retaining potassium. They help lower blood pressure, increase the heart’s pumping ability and help protect the heart in heart failure. aldosterone receptor blockers Also called aldosterone antagonists, aldosterone receptor blockers hinder the body’s response to the hormone aldosterone, which normally causes the body to retain sodium and get rid of potassium. Aldosterone receptor blockers increase urination, thus reducing water and salt while retaining potassium. They help lower blood pressure, increase the heart’s pumping ability and help protect the heart in heart failure. alpha adrenergic antagonists Alpha-adrenergic antagonists are drugs used to lower blood pressure. They work by relaxing the muscles in the walls of blood vessels. With blood vessels open and relaxed, blood flow improves and blood pressure lowers. Alpha-adrenergic antagonists also lower blood pressure and reduce stress on the heart by slowing the heart rhythm and lessening the force of the heartbeat.

These drugs are also called alpha blockers, alpha-adrenergic blocking agents and alpha-adrenergic blockers. alpha adrenergic blockers Alpha-adrenergic blockers are drugs used to lower blood pressure. They work by relaxing the muscles in the walls of blood vessels. With blood vessels open and relaxed, blood flow improves and blood pressure lowers. Alpha-adrenergic blockers also lower blood pressure and reduce stress on the heart by slowing the heart rhythm and lessening the force of the heartbeat. These drugs are also called alpha blockers, alpha-adrenergic antagonists and alpha-adrenergic blocking agents. alpha adrenergic blocking agents Alpha-adrenergic blocking agents are drugs used to lower blood pressure. They work by relaxing the muscles in the walls of blood vessels. With blood vessels open and relaxed, blood flow improves and blood pressure lowers. Alpha-adrenergic blocking agents also lower blood pressure and reduce stress on the heart by slowing the heart rhythm and lessening the force of the heartbeat. These drugs are also called alpha blockers, alpha-adrenergic antagonists and alpha-adrenergic blockers. alpha blockers Alpha blockers are drugs used to lower blood pressure. They work by relaxing the muscles in the walls of blood vessels.

With blood vessels open and relaxed, blood flow improves and blood pressure lowers. Alpha blockers also lower blood pressure and reduce stress on the heart by slowing the heart rhythm and lessening the force of the heartbeat. These drugs are also called alpha-adrenergic antagonists, alpha-adrenergic blocking agents and alpha-adrenergic blockers. ambulatory ECG Ambulatory ECG, also called ambulatory electrocardiography, ambulatory EKG, or a Holter monitor, is a battery-operated, portable device that measures and tape-records the heart's electrical activity (ECG) continuously, usually for a period of 24 to 48 hours so that any irregular heart activity can be correlated with a person's activity. The device uses electrodes or small conducting patches placed on the chest and attached to a small recording monitor that is carried in a pocket or in a small pouch worn around the neck.

ambulatory EKG Ambulatory EKG, also called ambulatory ECG, ambulatory electrocardiography, or a Holter monitor, is a battery-operated, portable device that measures and tape-records the heart's electrical activity (ECG) continuously, usually for a period of 24 to 48 hours so that any irregular heart activity can be correlated with a person's activity. The device uses electrodes or small conducting patches placed on the chest and attached to a small recording monitor that is carried in a pocket or in a small pouch worn around the neck. ambulatory electrocardiography Ambulatory electrocardiography, also called ambulatory ECG, ambulatory EKG, or a Holter monitor, is a battery-operated, portable device that measures and tape-records the heart's electrical activity (ECG) continuously, usually for a period of 24 to 48 hours so that any irregular heart activity can be correlated with a person's activity. The device uses electrodes or small conducting patches placed on the chest and attached to a small recording monitor that is carried in a pocket or in a small pouch worn around the neck.

amiodarone Amiodarone is a drug used to slow the heart rate and help keep it in a regular rhythm. It is used to treat fast or other irregular heartbeats, called arrhythmias, including atrial fibrillation, ventricular tachycardia and ventricular fibrillation. Amiodarone belongs to a class of drugs called antiarrhythmics. Side effects are usually dose-related and regular follow-up is necessary to evaluate kidney, liver and lung function. aneurysm An aneurysm is an abnormal weakening or ballooning-out of a vessel wall of an artery. Weakening of the blood vessel wall may be due to disease, injury or an abnormality present at birth. Some common locations for aneurysms include the aorta (the major artery leading away from the heart), the brain (called a cerebral aneurysm), leg, intestine and splenic artery (which supplies blood to the spleen). angina Angina is chest pain or discomfort due to coronary heart disease. It occurs when the heart muscle doesn’t get as much blood as it needs. This usually happens because one or more of the heart’s arteries is narrowed or blocked, also called ischemia.

Stable angina refers to “predictable” chest discomfort associated with exertion or stress. Unstable angina refers to unexpected chest pain and usually occurs at rest. It is typically more severe and prolonged. Unstable angina should be treated as an emergency. angina inversa Prinzmetal angina can also be called, variant angina, Prinzmetal's variant angina, angina inversa. Unlike typical angina – which is often triggered by exertion or emotional stress - Prinzmetal’s angina almost always occurs when a person is at rest, usually between midnight and early morning. These attacks can be very painful. The pain from variant angina is caused by a spasm in the coronary arteries (which supply blood to the heart muscle). The spasms tend to come in cycles – appearing for a time, then going away. After six to 12 months of treatment, doctors may gradually reduce the medication. angina pectoris Also called angina, angina pectoris is the medical term for chest pain or discomfort due to coronary heart disease. Angina pectoris occurs when the heart muscle doesn’t get as much blood as it needs.

This usually happens because one or more of the heart’s arteries is narrowed or blocked, also called ischemia. Stable angina refers to “predictable” chest discomfort associated with physical exertion or mental or emotional stress. Unstable angina refers to unexpected chest pain and usually occurs at rest. It is typically more severe and prolonged. Unstable angina should be treated as an emergency. angiotensin converting enzyme inhibitors Angiotensin-converting enzyme inhibitors, also called ACE inhibitors, are drugs used to treat high blood pressure and heart failure. ACE inhibitors s alters the body's ability to produce angiotensin II, a hormone that causes the arteries to narrow. By blocking the making of angiotensin, these drugs help the blood vessels relax and widen, which lowers blood pressure, increases blood flow to the heart and reduces the heart's workload. angiotensin II receptor blockers Angiotensin II receptor blockers, also known as ARB blockers or angiotensin 2 receptor blockers, are drugs used to treat high blood pressure and heart failure. They do not interfere with the body's�production�of angiotensin.

Instead, they block the�effects�of angiotensin, preventing the hormone from narrowing the blood vessels. By relaxing the coronary arteries, blood flow to the heart increases, blood pressure goes down and the heart's workload is reduced. Angiotensin II receptor blockers are often used in patients who cannot tolerate a common type of drugs known as ACE inhibitors. ankle brachial index test The ankle-brachial index test is a painless exam that compares the blood pressure in the feet to the blood pressure in the arms to determine how well blood is flowing. This test is used to diagnose peripheral artery disease, or PAD, a condition that most often affects blood flow to the legs. The ankle-brachial index test takes only a few minutes and can be performed by a healthcare professional as part of a routine exam. antiarrhythmic medication Antiarrhythmic medication helps control and slow the heart rate. Antiarrhythmics work by either slowing the activity of tissue that is initiating electrical impulses too quickly in the heart's natural pacemaker or by slowing the transmission of fast electrical impulses that cause the heart to beat. Antiarrhythmics include several classes of drugs, such as sodium channel blockers, beta-blockers, potassium channel blockers and calcium channel blockers.

Other medications used to control heart rate include adenosine and digitalis (also called digoxin and digitoxin). The type of arrhythmia you have determines which medication is prescribed. antibiotic prophylaxis Antibiotic prophylaxis refers to the use of antibiotics before certain dental and medical procedures to prevent endocarditis, an infection caused by bacteria that enters the bloodstream and settles in the heart lining, a heart valve or a blood vessel. The American Heart Association recommends antibiotic prophylaxis only for patients at the highest risk for endocarditis. anticoagulants Anticoagulants are drugs that decrease the ability of the blood to clot, or coagulate. Also called blood thinners, they are used to treat certain blood vessel, and heart and lung conditions. They are also given to some people at high risk for blood clots, including those with atrial fibrillation or artificial heart valves. Anticoagulants do not dissolve clots but may prevent existing clots from becoming larger and causing more serious problems. They are often prescribed to prevent first or recurrent heart attack or stroke. Common anticoagulant drugs are heparin and warfarin.

antihypertensive drugs Antihypertensive drugs are commonly prescribed to help lower blood pressure in conjunction with a heart-healthy diet and regular physical activity. Blood pressure-lowering drugs include diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, vasodilators, alpha blockers, beta-blockers, calcium channel blockers and central agonists. Many patients may require more than one drug to control high blood pressure. Some drugs used in hypertensive people may also be prescribed for heart failure and arrhythmia patients. antioxidants Antioxidants are natural substances found vitamins and minerals that are believed to help prevent disease by fighting free radicals, which are substances that can harm the body. Examples of free radicals are environmental contaminants such as cigarette smoke. Without adequate amounts of antioxidants, these free radicals can damage cells which can lead to the development of heart disease. antiplatelet agents Antiplatelet agents are drugs used to prevent blood platelets from sticking together and forming blood clots. The drugs prevent clotting in patients who have had a heart attack, unstable angina, ischemic stroke, transient ischemic attack (also known as a warning stroke) or other form of cardiovascular disease.

Common antiplatelet agents include aspirin, ticlopidine and clopidogrel. aortic aneurysm An aortic aneurysm, also called abdominal aortic aneurysm, occurs when the large blood vessel (the aorta) that supplies blood to the abdomen, pelvis and legs becomes abnormally large or balloons outward. This type of aneurysm is most often found in men over age 60 who have at least one or more risk factor, including emphysema, family history, high blood pressure, high cholesterol, obesity and smoking. aortic dissection Aortic dissection is a life-threatening condition that occurs when blood leaks from the aorta, the major artery that carries blood from the heart to the body. The leak is often caused by a tear in the inside wall of the aorta. The most common symptom of aortic dissection is sudden and severe chest pain or upper back pain. aortic regurgitation Also called aortic valve regurgitation, aortic regurgitation is a condition in which the aortic valve does not close properly between each heartbeat. This causes some of the blood that was being pumped out of the heart to leak back into the heart.

It typically takes a prolonged period of time for a person to develop symptoms, which may include fatigue and shortness of breath. aphasia Aphasia is the total or partial loss of the ability to use words. It may be caused by brain injury or disease, but most often it’s caused by a stroke that injures the brain's language center. Sometimes recovery is quick and complete after a stroke, but in other cases there may be permanent speech and language problems. ARB Angiotensin II receptor blockers, also known as ARB blockers or angiotensin 2 receptor blockers, are drugs used to treat high blood pressure and heart failure. They do not interfere with the body's production of angiotensin. Instead, they block the effects of angiotensin, preventing the hormone from narrowing the blood vessels. By relaxing the coronary arteries, blood flow to the heart increases, blood pressure goes down and the heart's workload is reduced. Angiotensin II receptor blockers are often used in patients who cannot tolerate a common type of drugs known as ACE inhibitors. arrhythmia An arrhythmia is an abnormal heart rhythm that, when severe or long-lasting, can prevent the heart from pumping enough blood to the body.

Damage to the heart muscle from a heart attack can make someone prone to arrhythmias, as can some congenital heart conditions. A variety of minerals, such as potassium, magnesium and calcium, with high or low concentrations in the blood and tissue can cause arrhythmias. So can alcohol, cigarettes and recreational drugs. arterial switch operation An arterial switch operation is an open-heart procedure. It is used to correct many forms of transposition of the great arteries, a congenital heart defect in which the aorta and the pulmonary artery are reversed. The surgery switches the two arteries back to their normal positions so the aorta is connected to the left ventricle and the pulmonary artery is connected to the right ventricle. The coronary arteries that carry oxygen-rich blood to nourish the heart muscle also must be re-attached to the new aorta. arteriography Arteriography is a test in which a dye visible to X-rays is injected into the bloodstream. X-ray pictures then are studied to see if the arteries are damaged, narrowed or blocked. Arteriography is done during cardiac catheterization. It's also known as angiocardiography, angiogram and angiography.

aspirin and heart disease Aspirin can help prevent blood clots from forming and is often used to prevent recurrent heart attacks and strokes. The American Heart Association recommends that people at high risk of heart attack take a daily low dose of aspirin, as instructed by their healthcare provider. Heart attack survivors often take a regular low dose of aspirin. Taking an aspirin can also help when a heart attack is in progress, greatly improving chances of survival. asymmetric septal hypertrophy Also called hypertrophic cardiomyopathy, asymmetric septal hypertrophy is a condition that occurs when heart muscles cells enlarge, causing the walls of the lower heart chambers (typically the left ventricle) to become thick and stiff. This makes it difficult for the heart to relax and for a sufficient amount of blood to fill the heart chambers. While the heart squeezes normally, the limited filling prevents the heart from pumping enough blood, especially during physical activity. Children with asymmetric septal hypertrophy are not allowed to play competitive sports because of the possibility of a sudden collapse or increased heart failure. atherectomy An atherectomy is a procedure to remove plaque from arteries. An ultra-thin wire is threaded through a special catheter into the blocked artery.

Several devices may then be used: a high-speed rotating "burr" that grinds the plaque into tiny pieces; a small rotating cutter that "shaves off" pieces of the blockage; or a laser catheter that vaporizes the plaque. atherosclerosis Atherosclerosis is a form of arteriosclerosis in which the inner layers of artery walls become thick and irregular because of deposits of fat, cholesterol and other substances. This buildup is called plaque and can cause arteries to narrow, reducing the blood flow through them. Eventually plaque can erode the wall of the artery and diminish its elasticity. Plaque deposits can rupture, causing blood clots to form at the rupture that can block blood flow or break off and travel to another part of the body. This is a common cause of heart attack or ischemic stroke. atrial fibrillation Atrial fibrillation is a disorder of heart rate and rhythm. Also commonly abbreviated as AF or Afib, it occurs when the heart's two small, upper chambers (atria) quiver rapidly and empty blood into the heart's lower chambers (ventricles) in a disorganized manner instead of beating effectively. Blood that isn't pumped completely out of the atria when the heart beats may pool and clot.

If a piece of a clot enters the bloodstream, it may lodge in the brain causing a stroke. Causes of atrial fibrillation include dysfunction of the sinus node (the heart's pacemaking area in the right atrium), coronary artery disease, rheumatic heart disease, hypertension and hyperthyroidism. atrial flutter An atrial flutter is a very rapid beating of the heart's upper chambers, or atria. It typically is not a stable rhythm and may lead to atrial fibrillation. Atrial flutter occurs most often in people with heart diseases such as pericarditis, coronary artery disease and cardiomyopathy. automated external defibrillator An automated external defibrillator is a computerized medical device that can check a person’s heart as well as shock it back to a normal rhythm. It can help save the life of someone who has suffered sudden cardiac arrest, the abrupt loss of heart function. The AED uses voice prompts, lights and text messages to tell the rescuer the steps to take. AEDs are very accurate and easy to use. With a few hours of training, anyone can learn to operate an AED safely.

automated internal defibrillator Also called an implantable cardioverter defibrillator, an automated internal defibrillator is a small battery-powered device that treats life-threatening irregular heartbeats (arrhythmias), including those that cause sudden cardiac arrest. The device is implanted under the skin of the chest with wires that connect to the heart. If the device detects an irregular heart rhythm, it sends electrical impulses to restore a normal rhythm. autonomic failure Autonomic failure is a condition that occurs when the autonomic nervous system fails to function properly. Because the autonomic nervous system controls blood pressure and heart rate, autonomic failure can cause a rapid drop in blood pressure when standing. It can affect people with diabetes, degenerative neurological diseases and other conditions. Pacemakers and Abnormal Heart Rhythms Pacemakers are implanted two ways: Endocardial approach. This is the most common technique used. A local anesthetic (pain-relieving medication) is given to numb the area. An incision is made in the chest where the leads and pacemaker are inserted. The lead(s) is inserted through the incision and into a vein, then guided to the heart with the aid of the x-ray machine.

The lead tip attaches to the heart muscle, while the other end of the lead (attached to the pulse generator) is placed in a pocket created under the skin in the upper chest. Epicardial approach. This technique is more commonly used in children than adults. A surgeon performs this procedure in an operating room. General anesthesia is given to put you to sleep . The surgeon attaches the lead tip to the heart muscle, while the other end of the lead (attached to the pulse generator) is placed in a pocket created under the skin in the abdomen . Although recovery with the epicardial approach is longer than that of the transvenous approach, minimally invasive techniques have enabled shorter hospital stays and quicker recovery times. The doctor will determine, which pacemaker implant method is best for you. Continued What Happens During the Pacemaker Procedure? The endocardial pacemaker implant takes about one to five hours to perform. You will lie on a bed and the nurse will start an intravenous line (IV) into your arm or hand. This is so you may receive medications and fluids during the procedure. You will be given a medication through your IV to relax you and make you drowsy, but it will not put you to sleep .

The nurse will connect you to several monitors. The monitors allow the doctor and nurse to check your heart rhythm, blood pressure , and other measurements during the pacemaker implant. Your left or right side of your chest will be shaved and cleansed with a special soap. Sterile drapes are used to cover you from your neck to your feet. A strap will be placed across your waist and arms to prevent your hands from coming in contact with the sterile field. The doctor will numb your skin by injecting a local numbing medication. You will feel a pinching or burning feeling at first. Then, it will become numb. Once this occurs, an incision will be made to insert the pacemaker and leads. You may feel a pulling as the doctor makes a pocket in the tissue under your skin for the pacemaker. You should not feel pain. If you do, tell your nurse. After the pocket is made, the doctor will insert the leads into a vein and guide them into position using the X-ray machine. After the leads are in place, their function is tested to make sure they can increase your heart rate. This is called "pacing" and involves delivering small amounts of energy through the leads into the heart muscle. This causes the heart to contract.

When your heart rate increases, you may feel your heart is racing or beating faster. It is very important to tell your doctor or nurse any symptoms you feel. Any pain should be reported immediately. After the leads are tested the doctor will connect them to your pacemaker. Your doctor will determine the rate of your pacemaker and other settings. The final pacemaker settings are done after the implant using a special device called a programmer. Continued What Happens After the Pacemaker Procedure? You may be admitted to the hospital overnight. The nurses will monitor your heart rate and rhythm. You will be shown how to care for your wound. Keep your wound clean and dry. Look at your wound every day to make sure it is healing. Call your doctor if you notice: Increased drainage, bleeding, or oozing from the insertion site Increased opening of the incision Redness around the site Increased body temperature (fever or chills) Your pacemaker settings will be checked before you leave the hospital. You will receive a temporary ID card that tells you: The type of pacemaker and leads you have. The date of the pacemaker implant. The name of the doctor who implanted the pacemaker.

Within three months, you will receive a permanent card from the pacemaker company. Carry this card with you at all times in case you need medical attention at another hospital. Will I Be Able to Move Around After the Procedure? Do not lift objects that weigh more than 10 pounds. Do not hold your arm above shoulder level for three weeks. Avoid activities that require pushing or pulling heavy objects, such as shoveling the snow or mowing the lawn. Stop any activity before you become overtired. Avoid golfing, tennis, and swimming for 6 weeks after the procedure. Try to walk as much as possible for exercise . Ask your doctor when you can resume more strenuous activities. Your doctor will tell you when you can go back to work, usually within a week after you go home. If you have the flexibility at your job, ease back to your regular works schedule. Should I Avoid Certain Electrical Devices With a Pacemaker? Electric blankets, heating pads, and microwave ovens can be used and will not interfere with the function of your pacemaker. Cell phones should not be placed directly against the chest or on the same side as your pacemaker.

You will need to avoid strong electric or magnetic fields, such as some industrial equipment; ham radios; high intensity radio waves (found near large electrical generators, power plants, or radiofrequency transmission towers); and arc resistance welders. Do not undergo any tests that require magnetic resonance imaging (MRI). Your doctor or nurse can provide more information about what types of equipment may interfere with your pacemaker. If you have concerns about your job or activities, ask your doctor. Continued How Long Will My Pacemaker Last? Pacemakers may last five to 10 years and sometimes longer, depending on how often they are used. When the battery becomes low, your pacemaker will need to be changed. How Often Will I Need to See My Doctor? A complete pacemaker check should be done six weeks after your pacemaker is implanted. This follow-up appointment is critical, because adjustments will be made that will prolong the life of your pacemaker. Then your pacemaker should be checked every three months on the telephone to evaluate battery function. Your nurse will explain how to check your pacemaker using the telephone transmitter. Once or twice a year you will need a more complete exam.

If you have a biventricular pacemaker, you may need to visit the doctor's office or hospital more frequently to make sure your device is working properly and the settings do not need to be adjusted. WebMD Medical Reference Reviewed by James Beckerman, MD, FACC on January 18, 2015 Sources Abnormal Heart Rhythms (Arrhythmias) Abnormal Heart Rhythms When Your Heart Rhythm Isn't Normal In this Article Heart Surgery for Arrhythmias " Arrhythmia " means your heartbeat is irregular . It doesn't necessarily mean your heart is beating too fast or too slow. It just means it's out of its normal rhythm. It may feel like your heart skipped a beat, added a beat, is "fluttering," or is beating too fast (which doctors call tachycardia ) or too slow (called bradycardia ). Or, you might not notice anything, since some arrhythmias are "silent." Arrhythmias can be an emergency, or they may be harmless. If you feel something unusual happening with your heartbeat, call 911 so doctors can find out why it's happening and what you need to do about it.

Causes and Types of of Arrhythmias You could have an arrhythmia even if your heart is healthy. Or it could happen because you have: The wrong balance of electrolytes (such as sodium or potassium ) in your blood Changes in your heart muscle Injury from a heart attack Healing process after heart surgery The many types of arrhythmias include: Premature atrial contractions. These are early extra beats that start in the heart's upper chambers, called the atria. They are harmless and generally don't need treatment. Premature ventricular contractions (PVCs). These are among the most common arrhythmias. They're the "skipped heartbeat" we all occasionally feel. They can be related to stress or too much caffeine or nicotine. But sometimes, PVCs can be caused by heart disease or electrolyte imbalance. If you have a lot of PVCs, or symptoms linked to them, see a heart doctor (cardiologist). Atrial fibrillation . This common irregular heart rhythm causes the upper chambers of the heart to contract abnormally. Atrial flutter. This is an arrhythmia that's usually more organized and regular than atrial fibrillation .

It happens most often in people with heart disease and in the first week after heart surgery. It often changes to atrial fibrillation . Paroxysmal supraventricular tachycardia (PSVT). A rapid heart rate , usually with a regular rhythm, starting from above the heart's lower chambers, or ventricles. PSVT begins and ends suddenly. Accessory pathway tachycardias. You can get a rapid heart rate because there is an extra pathway between the heart's upper and lower chambers. It's just like if there was an extra road on your way home as well as your usual route, so cars can move around faster. When that happens in your heart, it can cause a fast heart rhythm, which doctors call tachycardia. The impulses that control your heart rhythm travel around the heart very quickly, making it beat unusually fast. Continued AV nodal reentrant tachycardia. This is another type of fast heartbeat. It's caused by there being an extra pathway through a part of the heart called the AV node. It can cause heart palpitations, fainting , or heart failure . In some cases, you can stop it simply by breathing in and bearing down.

Some drugs can also stop this heart rhythm. Ventricular tachycardia (V-tach). A rapid heart rhythm starting from the heart's lower chambers. Because the heart is beating too fast, it can't fill up with enough blood . This can be a serious arrhythmia -- especially in people with heart disease -- and it may be linked to other symptoms. Ventricular fibrillation. This happens when the heart's lower chambers quiver and can't contract or pump blood to the body. This is a medical emergency that must be treated with CPR and defibrillation as soon as possible. Long QT syndrome. This may cause potentially dangerous arrhythmias and sudden death. Doctors can treat it with medications or devices called defibrillators. Bradyarrhythmias. These are slow heart rhythms, which may be due to disease in the heart's electrical system. If you experience this, call your doctor. Sinus node dysfunction. This slow heart rhythm is due to a problem with the heart's sinus node. Some people with this type of arrhythmia need a pacemaker . Heart block. There is a delay or a complete block of the electrical impulse as it travels from the heart's sinus node to its lower chambers.

The heart may beat irregularly and, often, more slowly. In serious cases, you'd get a pacemaker . Symptoms of Arrhythmias An arrhythmia can be silent, meaning you don't notice any symptoms. A doctor can find an irregular heartbeat during a physical exam by taking your pulse or through an electrocardiogram (ECG or EKG). If you do have symptoms, they may include: Palpitations (a feeling of skipped heart beats, fluttering or "flip-flops") Pounding in your chest Weakness or fatigue (feeling very tired) Continued Diagnosis of Arrhythmias To diagnose an arrhythmia or find its cause, doctors use tests including: Electrocardiogram -- Also called an EKG or ECG, this test records the electrical activity of your heart. You wear small electrode patches on your chest, arms, and legs for the quick, painless test, which you take in your doctor's office. Holter monitor -- This is a portable EKG that you'll use for 1 to 2 days. You'll have electrodes taped to your skin . It's painless and you can do everything but shower while wearing the electrodes.

Event monitor -- If your symptoms don't happen often, your doctor may suggest you wear one of these, usually for about a month. This is a device that, when you push a button, will record and store your heart's electrical activity for a few minutes. Each time you notice symptoms, you should try to get a reading on the monitor. Your doctor will interpret the results. Stress test -- There are different kinds of stress tests . The goal is to check how much stress your heart can manage before having a heart rhythm problem or not getting enough blood flow to the heart. For the most common type of stress test, you'll walk on a treadmill or pedal a stationary bike at increasing levels of difficulty while you're getting an EKG and getting your heart rate and blood pressure monitored. Echocardiogram -- This test uses ultrasound to evaluate heart muscle and heart valves. Cardiac catheterization -- Your doctor will insert a long, thin tube, called a catheter, into a blood vessel in your arm or leg. She will guide it to your heart with help from a special X-ray machine. Then she'll inject dye through the catheter to help make X-ray videos of your heart's valves, coronary arteries , and chambers.

Electrophysiology study -- This test records your heart's electrical activities and pathways. It can help find out what's causing heart rhythm problems and find the best treatment for you. During the test, your doctor will safely reproduce your abnormal heart rhythm and then may give you different medications to see which controls it best, or to see what procedure or device you need to treat it. Head-up tilt table test -- Doctors use this test to find out what's causing fainting spells. It measures the difference in heart rate and blood pressure when you're standing up or lying down. You'll get this test in a lab. You'll lie on a stretcher, tilted at different angles while you're getting an EKG and specialists are checking your blood pressure and oxygen level. Continued Treatment of Arrhythmias Treatment depends on the type and seriousness of your arrhythmia. Some people with arrhythmias don't need treatment. Others may need medication, making lifestyle changes, and surgery. Drugs that treat arrhythmias include: Antiarrhythmic drugs. These drugs control heart rhythm and include beta-blockers and calcium channel blockers. Anticoagulant or antiplatelet therapy. These drugs lower the risk of blood clots and stroke .

These include the blood thinner warfarin (Coumadin) or aspirin. Other blood thinners called apixaban (Eliquis), dabigatran ( Pradaxa ), edoxaban (Savaysa), and rivaroxaban (Xarelto) have been approved to prevent stroke in people with atrial fibrillation. Everyone is different. Finding the medicine and dose that works best for you may take some time. If you notice that your arrhythmia happens more often with certain activities, stop doing them. If you smoke, stop. Limit alcohol to no more than one drink a day for women, and two drinks a day for men. Limit or stop using caffeine . Don't use cough and cold medications that have stimulants. Read the label and ask your doctor or pharmacist what medication would be best for you. What Is Electrical Cardioversion? If drugs can't control a persistent irregular heart rhythm (such as atrial fibrillation), you might need cardioversion . For this, doctors, give you a short-acting anesthesia, then deliver an electrical shock to your chest wall to allow the normal rhythm to restart. What Is a Pacemaker?

This device sends small electrical impulses to the heart muscle to keep a safe heart rate. The pacemaker has a pulse generator (which houses the battery and a tiny computer) and wires that send impulses from the pulse generator to the heart muscle. What Is an Implantable Cardioverter Defibrillator (ICD)? Doctors mainly use ICDs to treat ventricular tachycardia and ventricular fibrillation, two life-threatening heart rhythms. The ICD constantly tracks the heart rhythm. When it detects a very fast, abnormal heart rhythm, it delivers an electric shock to the heart muscle to cause the heart to beat in a normal rhythm again. There are several ways the ICD can be used to restore normal heart rhythm. They include: Anti-tachycardia pacing (ATP). When the heart beats too fast, you get a series of small electrical impulses to the heart muscle to restore a normal heart rate and rhythm. Cardioversion. You may get a low-energy shock at the same time as the heart beats to restore normal heart rhythm. Defibrillation. When the heart is beating dangerously fast or irregularly, the heart muscle gets a higher-energy shock to restore a normal rhythm. Anti-bradycardia pacing.

Many ICDs provide back-up pacing to maintain heart rhythm if it slows too much. Continued What Is Catheter Ablation? You can think of this procedure as rewiring to fix an electrical problem within the heart. The doctor will insert a catheter through the leg. The catheter delivers high-frequency electrical energy to a small area inside the heart that causes the abnormal heart rhythm. This energy "disconnects" the pathway of the abnormal rhythm. Doctors use ablation to treat most PSVTs, atrial flutter, atrial fibrillation, and some atrial and ventricular tachycardias. Some people also need other procedures. Heart Surgery for Arrhythmias The Maze procedure is a type of surgery used to correct atrial fibrillation. During this procedure, the surgeon makes a series, or "maze," of cuts in the heart's upper chambers. The goal is to keep the heart's electrical impulses only on certain pathways. Some people may need a pacemaker afterward.

WebMD Medical Reference Reviewed by Jennifer Robinson, MD on April 21, 2015 Sources Devices That Keep the Heart Beating Articulos en Espanol Devices That Keep the Heart Beating Automated external defibrillators (AEDs) are portable devices that help restore normal heart rhythm to patients in cardiac arrest. Reporting Problems Heart devices such as pacemakers and defibrillators have extended and improved the lives of millions of people worldwide. The Food and Drug Administration (FDA) helps provide access to heart devices that use the latest science and technology, through approval and oversight processes that expedite the availability—and assure the safety—of the products. Recent Actions and Approvals Recent FDA actions and approvals related to heart devices include: Approval of a new type of mechanical cardiac assist device that can be used on people of smaller size than previously possible. An engineering modification to homograft cardiac valves that is the first change in more than 40 years that may improve the durability of transplanted heart valves.

(A homograft is a valve that has been removed from a donated human heart, preserved, and frozen under sterile conditions.) Approval of a protective covering for the heart that can reduce risks associated with the multiple reoperations required for infants with congenital heart ailments. Approval of a catheter replacement for previously placed pulmonary prostheses that have become impaired. This replacement will reduce the number of surgeries needed in children with congenital heart disease. Approval of the first compact heart assist device. In April 2008, FDA approved the first device to support the weakened heart of a small-sized adult man or woman who is at risk of dying while awaiting a heart transplant. Previous models of these surgically implanted mechanical pumps were too large to be placed in the upper abdomen of some people. Comprehensive review of drug coated stents to address concerns about their safety. FDA has concluded that these stents are safe and effective when used within their labeled indication. Approval of the first totally implanted permanent artificial heart for humanitarian uses. The device is for patients with advanced heart failure involving both of the organ's pumping chambers, who are not eligible for a heart transplant, and who are unlikely to live more than a month without intervention.

Approval of pacemakers that reduce severe heart failure symptoms by resynchronizing the pumping action of both heart chambers. Approval of new monitoring devices that allow implantable cardioverter defibrillators (ICDs) to transmit basic information about the patient and the device to physicians between office visits. back to top Types of Heart Devices Automated External Defibrillators (AEDs): Portable and automatic, these devices help restore normal heart rhythm to patients in cardiac arrest. They analyze heart rhythm and can help rescuers determine whether a shock is needed to restore a normal heartbeat. Cardiac Ablation Catheters: Long, thin flexible tubes that are threaded into or onto the heart, cardiac ablation catheters treat abnormally rapid heartbeats that cannot be controlled with lifestyle changes or medications. They work by modifying small areas of heart tissue that are causing abnormal heart rhythms. Cardiac Angioplasty Devices: These are long, thin, flexible tubes that are threaded into a heart blood vessel to open narrowed or blocked areas. They improve blood flow to the heart, reduce chest pain, and treat heart attacks. Cardiac Pacemakers: Small and battery-powered, pacemakers are implanted permanently into the body.

Used when the heart beats too slowly or has other abnormal rhythms, they monitor the organ's electrical impulses and, when needed, deliver electrical stimuli to make it contract in a more normal tempo. Implantable Cardioverter Defibrillators (ICDs): These monitor heart rhythms and deliver shocks if dangerous rhythms are detected. Many record the heart's electrical patterns whenever an abnormal heartbeat occurs, allowing doctors to review the patterns. New monitoring devices allow ICDs to transmit basic information to physicians. Prosthetic (Artificial) Heart Valves: Used for replacing diseased or dysfunctional heart valves, these are available in two forms. Mechanical valves are made of man-made materials and can usually last a lifetime. Biological valves are made from tissue taken from animals or human cadavers. Stents: Small, lattice-shaped, metal tubes that are inserted permanently into an artery, stents help improve blood flow. Some contain drugs that reduce the chance that arteries will become blocked again. Ventricular Assist Devices (VADs): Mechanical pumps that help weak hearts pump blood adequately, VADs were originally intended for short-term use until donor hearts became available. Some are now used for long-term therapy in patients with severe heart failure who are not candidates for heart transplants.

back to top Reporting Problems If you're having problems with your heart device, or any other medical device, contact MedWatch , FDA's program for reporting serious reactions, product quality problems and product use errors regarding medical products. Consumers can also call FDA's toll-free information line, 1-888-INFO-FDA (1-888-463-6332) for information about medical products. This article appears on FDA's Consumer Updates page , which features the latest on all FDA-regulated products. Updated: February 24, 2010 Heart Pacemaker: Purpose, Procedure & Risks Read This Next What Is a Pacemaker? A pacemaker is an electrically-charged medical device. Your surgeon implants it under your skin to help manage irregular heartbeats called arrhythmias. Modern pacemakers consist of two parts. One part contains the battery and the electronics that control your heartbeat. The other part is one or more leads, which send electrical signals to your heart. Leads are small wires that run from the pulse generator to your heart muscle.

Pacemakers generally treat two types of arrhythmias: tachycardia, or a heartbeat that’s too fast bradycardia, or a heartbeat that’s too slow There are also special types of pacemakers called biventricular pacemakers, or bivents. A person may need one of these pacemakers if they have severe heart failure. They make the two sides of the heart beat in sync. This is also known as cardiac resynchronization therapy (CRT). Why Do I Need a Pacemaker? You need a pacemaker if your heart is pumping too quickly or slowly. In either case, the body doesn’t get enough blood. This can cause: fatigue damage to vital organs eventual death A pacemaker regulates the electrical system that controls your heart rhythm. With each heartbeat, an electrical impulse travels from the top of the heart to the bottom, signaling the heart’s muscles to contract. A pacemaker can also track and record your heartbeat. This can help your doctor get a better understanding of your arrhythmia. Not all pacemakers are permanent. Temporary pacemakers can control certain types of problems. You may need a temporary pacemaker after a heart attack or heart surgery.

They can also be necessary if a medication overdose temporarily slowed your heart. Your doctor or cardiologist will test you to see if you’re a good candidate for a pacemaker. How Do I Prepare for a Pacemaker? Prior to receiving a pacemaker, you’ll undergo several tests. These tests can ensure that a pacemaker is the right choice for you: An echocardiogram uses sound waves to measure the size and thickness of your heart muscle. An electrocardiogram uses sensors placed on your skin to measure your heart’s electrical signals. Holter monitoring tracks your heart rhythm for 24 hours with a wearable device. A stress test monitors your heart rate while you exercise. If a pacemaker is right for you, you’ll plan for the surgery. Your doctor will give you complete instructions on how to prepare. Don’t drink or eat anything after midnight before your surgery. Stop taking any medications as advised by your doctor. Take any medications your doctor prescribes. Shower and shampoo well, possibly with a special soap. This reduces the risk of a potentially serious heart infection during surgery. How Is Pacemaker Surgery Performed? Implanting a pacemaker typically takes one to two hours.

You’ll receive a sedative to relax you, and a local anesthetic to numb the incision site. You’ll be awake during the procedure. Your surgeon will make a small incision near your shoulder. Through the incision, they’ll guide a small wire into a major vein near your collarbone. The surgeon will lead the wire through the vein to your heart. An X-ray machine will help guide your surgeon through the process. Using the wire, your surgeon will attach an electrode to your heart’s right ventricle. The other end of the wire attaches to a pulse generator. This contains the battery and electrical circuits. The generator is typically implanted under the skin near the collarbone. If you’re getting a biventricular pacemaker, a second lead will attach to your heart’s right atrium. The atrium is the upper chamber of the heart. When your surgeon is satisfied with the procedure, they’ll close your incision with stitches. What Are the Complications Associated with a Pacemaker? Every medical procedure carries some risks. The majority of risks associated with a pacemaker are from the surgical installation.

They include: an allergic reaction to anesthesia bleeding damaged nerves or blood vessels an infection at the site of the incision a collapsed lung, which is rare a punctured heart, which is also rare Most complications are temporary. Life-altering complications are rare. What Happens After Pacemaker Surgery? You can expect to stay in the hospital overnight. The day after the procedure, your doctor will make sure the pacemaker is programmed properly for your heart’s needs. Your doctor can reprogram the device as needed at follow-up appointments. Over the next month, you should avoid rigorous exercise. You may also need to take over-the-counter medications for any discomfort. Ask your doctors what pain relievers are safest for you. Every few months, you’ll hook your pacemaker up to a phone line using special equipment provided by your doctor. It allows your doctor to receive information from your pacemaker without the need for an office visit. Certain devices could cause interference with your pacemaker. For example, you should avoid: keeping a cell phone or MP3 player in the pocket over your pacemaker standing for too long near certain appliances, such as microwaves long exposures to metal detectors high-voltage transformers

Question: What is the name for an electrical device that regulates heartbeats?
Answer: Pacemaker