Cardiac Arrhythmia

During an episode of arrhythmia, a patient may usually exhibit one or more of the following symptoms:

• Palpitations
• Lightheadedness
• Loss of consciousness
• Chest pain
• Shortness of breath especially in patients with structural heart disease

Arrhythmia can also occur when the patient is already suffering from a Coronary Artery Disease, Hypertension induced heart disease, heart disease consequent to Diabetes, Congenital Heart Disease, Rheumatic Heart Disease, and forms of Valvular Heart Disease and Primary Heart Muscle Diseases called Cardiomyopathies. The incidence of arrhythmia increases in all the above cases as the cardiac muscle starts getting weak. Due to cardiac muscle weakness you can get cardiac arrest and you may have to get cardiac arrest treatment.

There are many electrical disorders in the heart, with complex causes and mechanisms, including genetic abnormalities. Due to such complexities, cardiac arrhythmia has now become a major subspecialty in Cardiology and is managed by cardiologists who are called electrophysiologists. At Max Institute of Heart and Vascular Sciences (MIHVS), we have a team of expert cardiologists who specialize in treating arrhythmia with Antiarrhythmic agents, Automated External Defibrillator, CCBs, Cardioversion, Catheter Ablation and other amenities.

Cardiac arrhythmia needs a coordinated multidisciplinary approach involving several specialities, especially imaging. At Max Institute of Heart and Vascular Sciences, we have the Department of Electrophysiology - a separate, special unit led by internationally acclaimed electrophysiologists. Today, MIHVS is one of the highest volume Electrophysiology centres in the country. Very complex arrhythmias are routinely treated here. The latest Arrhythmia Treatment like Leadless Pacemaker Implant, Alternate Site Right Ventricular Pacing, His Bundle Pacing and Left Bundle Pacing are routinely done here.

Investigations are individualized to a specific arrhythmia and the clinical aspects of the disease. These include:

• ECG, Echocardiography
• Holter Monitoring, ELR (Extended Loop Record) and Implantable Loop Recorder (these are rhythm monitoring devices with a capability to record cardiac rhythm on an outpatient basis while the patient does all his activities)
• Cardiac Catheterization and Coronary Angiography
• Cardiac CT Scan
• Cardiac MRI
• Electrophysiology Study

At Max Institute of Heart and Vascular Sciences (MIHVS), treatment of complex arrhythmia includes using a sophisticated 3-dimensional electroanatomical mapping system to enhance success rates and reduce X-ray exposure to a patient. We offer the following Arrhythmia Treatment options:

Medication

• For heartbeat-related disorders: Antiarrhythmics are used to treat heartbeat related disorders. Antiarrhythmics work in a variety of ways to slow the electrical impulses in the heart so that the heart can regain a regular rhythm.
• For Structural Heart Disease: When structural heart disease progresses to a stage of heart failure, cardiac arrhythmia accounts for almost 50 % of deaths. In patients with structural heart disease, optimal guideline-based medical treatment with drugs is mandatory as it provides for cardiac electric stability, e.g. treatment of Ischemia in coronary artery disease and heart failure management.

Automated External Defibrillator

 It is a kind of portable device that inspects the heart rhythm. If required, it can send an electric shock to the heart to restore a normal rhythm. It is commonly used to treat sudden cardiac arrest.

Calcium Channel Blockers

CCBs are effective medicines that have been shown to lower blood pressure and help prevent and treat the symptoms of Angina (chest pain).

Cardioversion

It is a procedure followed to restore fast or irregular heart rhythm to a normal rhythm.

Catheter Ablation

It is a safe medical procedure to treat some types of arrhythmia and involves the use of radiofrequency (RF) energy. Specific treatment for cardiac arrhythmia is usually interventional and includes Radiofrequency Catheter Ablation, implanting devices like Permanent Pacemakers, ICD (Implantable Cardioverter Defibrillator) and very rarely requires surgery. Radiofrequency Ablation Therapy is applicable for the treatment of many arrhythmias, and many, it is a cure (PSVT, WPW Syndrome Tachycardia, Atrial Flutter, Atrial Fibrillation, some Ventricular Tachycardia in a normal heart. In such patients, the success rates are very high, and the recurrence rate is only 1-2%.

Pacemaker Insertion

Cardiac arrhythmias where the heart beats very slow, are called bradyarrhythmia. In a given person resting heart rates of even 50/min may be normal, especially in physically active persons. Bradyarrhythmias caused by disease of the electrical conduction system is a serious condition which can lead to loss of consciousness. In such cases, it usually needs implantable pacemakers as treatment.

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