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Keeping Time with Your Heart

With all the talk of trans fats and cholesterol in our diets, our minds turn quickly to clogged arteries. But there’s another side to heart disease that affects the “electrical” operations of the heart, as opposed to the “plumbing” parts. The medical practice surrounding that condition is called electrophysiology (EP), and it’s now available to people in La Porte and surrounding communities, close to home. The service is the newest heart care program to fall under the Heart & Vascular Institute of La Porte Regional Health System - a comprehensive umbrella of medical interventional, and surgical services.

Professionals with the EP laboratory at La Porte Hospital take care of individuals who need or already have pacemakers, defibrillators or other medical treatments to keep their hearts beating normally. The heart’s rhythm is what determines how effectively it can contract to pump blood throughout our bodies.

“Patients come to us from all walks of life,” says medical director Mark Dixon, DO. “Some are young individuals with conditions they inherited or developed at birth. Others may be seniors who suffer from congestive heart failure. But all of them have one thing in common: they want a better quality of life and that is why we are here,” Dixon said.

Recognizing the Rhythm

Many different conditions are treated in the EP laboratory. The heart’s rhythms can be too slow (bradycardias), too fast (tachychardias and atrial fibrillation), or there can be extra beats (premature atrial complexes or premature ventricular complexes). Sometimes there are problems with the heart’s bundle branch blocks - the avenues along which electrical impulses travel. Any of these conditions - particularly tachychardias - can be life threatening and need to be evaluated.

Symptoms for these disorders include dizziness, heart palpitations (when you can actually feel your heart beating quickly for no apparent reason), passing out, difficulty breathing, and even an actual heart attack.

Heart rhythm problems can happen for a variety of reasons, including complications that arise from existing heart disease, congestive heart failure or congenital (birth) defects. Sometimes doctors don’t know what causes an abnormal rhythm.

Most patients will be evaluated by their doctors or cardiologists, who will conduct an electrocardiogram to take a “picture” of the heart’s rhythm patterns. If the symptoms come and go, the patient may wear a holtor monitor at home for a period of time, in order to capture the rhythm symptom when it is actually happening.

If a rhythm problem is defined, the patient may be referred to the EP lab for further evaluation and a treatment plan.

Keeping Time

Some abnormal rhythm symptoms are serious enough to warrant an electrophysiology study. This procedure occurs in the EP lab at La Porte Hospital, which looks similar to a cardiac catheterization lab where angioplasty is done. During an EP study, the physician will make a small incision in the patient’s thigh or groin area, and thread catheters with electrical leads through the vein up to the heart. The patient is kept comfortable with anesthesia called “conscious sedation.” The leads then can “pace” the heart’s rhythms. In some cases, the physician can even induce an abnormal rhythm, and then restore correct rhythm, to see how the heart reacts.

“EP studies are often reserved for individuals who are at high risk for life-threatening arrhythmias or heart attacks. There are other situations where arrhythmias are symptomatic but not life threatening, and can be diagnosed and treated with an EP study. We use the information gained in an EP study to determine what kind of rhythm problem exists and what our next course of treatment will be,” Dixon said.

Some individuals’ heart rhythm problems can be managed with medication. Others need pacemakers or defibrillators, which are small devices that are implanted in the chest at the EP lab. The devices can help control irregular heart rhythms. Still, others may need a procedure called “ablation,” where the physician inserts a catheter through a vein to the heart once again and destroys a tiny portion of the heart that is causing the abnormal rhythm.

Following any EP referral, Dixon will work with the patient’s existing physicians to determine the best course of follow-up, which could include office visits where device data can be downloaded and analyzed, and medications can be monitored.

Race Against Time

If you think you have a heart rhythm problem, contact your doctor today. If you need a physician, visit www.laportehealth.org and click on Physicians, or www.lrpn.org to find a doctor near you, or call the Physician Connection service at (219) 326-2426.

Our Magnet designation exemplifies the dedication of physicians, nurses, and ancillary staff to provide the highest quality cardiovascular services in the region. For more information on the Cardiovascular Services at La Porte Regional Health System, call (219) 326-2511.