Controlling the
Heart’s Current A steady heartbeat is an essential
element of cardiac health, as electrical impulses regulate the constant
pumping of the heart. Electrophysiology — the study of the heart’s electrical
system — is therefore a much-needed specialty for the many patients with
abnormal heart rhythm (cardiac arrhythmia).
In recent years, advancements in electrophysiology have provided
cardiologists with tools to combat a variety of cardiac arrhythmias.
Some patients have arrhythmia problems that originate in the upper chambers
of the heart. These arrhythmias make the heart beat faster than normal and
inefficiently. In many such patients, it is possible to identify the
precise spot in the heart causing the problem and to eliminate the spot by
cauterizing or freezing the spot with a catheter. This is a procedure called
catheter ablation. “Catheter ablation can cure such problems in a high
proportion of patients; there are not a lot of other treatments in cardiology
that are curative,” said Peter L. Friedman, M.D., Director of the Cardiac
Electrophysiology Laboratory at Cape Cod Hospital. The curative nature of the
treatment is especially important, he added, because a number of the patients he
treats are younger.
In many patients, cardiac arrhythmias stem from the lower chambers of the
heart and can be life-threatening. For such patients, implantation of a cardiac
defibrillator, or lCD, protects the patients from sudden cardiac death. These
devices automatically recognize the presence of a life-threatening arrhythmia
and deliver an internal shock restoring the heart rhythm to normal. According to
Dr. Friedman, lCD therapy is one of the major advances in cardiology in the past
50 years and has saved tens of thousands of lives.
Another new treatment that is available now is cardiac resynchronization
therapy. This therapy involves implantation of a pacemaker or lCD that has the
customary two wires on the right side of the heart (one in upper chamber, one in
lower chamber) but in addition, has a third wire that paces the left side of the
heart. By stimulating both sides of the heart, the heartbeat can be synchronized
to ensure better efficiency relieving the symptoms and signs of heart
failure.
“We have more patients with heart failure
in the Cape Cod population than anywhere else in Massachusetts,” said
Charles Haffajee, M.D., who specializes in electrophysiology at Cape Cod
Hospital. “Cardiac resynchronization devices,” he added, “are much more
effective at treating heart failure than many
medications.” Dr. Haffajee believes that, with time and greater awareness, many
more patients with heart failure will benefit from this
approach.
Controlling the
Heart’s Current