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

Most cardiac arrhythmias can occur in paroxysms, starting suddenly often without provocation. They can occur without any evidence of structural heart diseases (some examples being A-V Nodal Reentrant Tachycardia, Pre-Excitation Syndrome, Fascicular Ventricular Tachycardia, Right Ventricular Outflow Tract (RVOT) Tachycardia, Tachycardias related to channelopathies. These occur in absolutely normal hearts and can cause sudden cardiac death.

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.

Max Institute of Heart and Vascular Sciences(MIHVS) is a tertiary care centre equipped with cutting-edge technology that offers cardiac care programs to patients. We also offer an alternative treatment for end-stage heart failure patients with procedures like Pacemaker, ACD, CRT, Heart Hole surgeries (ASD, VSD, PDA), Paediatric Cardiac Surgery, Angioplasty/Angiography and more. The institute is a one-stop destination for several kinds of cardiac treatments like invasive and interventional cardiology, electrophysiology, pacemaker and arrhythmia services, management of abdominal and descending thoracic aneurysm and varicose veins. We are equipped with state-of-the-art Cath Labs, operation theatres, ICU beds and several other heart care technologies.

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 treatments 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 treatment options for arrhythmia:

A) 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.