Cardiac Arrhythmias

More than 4 million Americans suffer from arrhythmias–abnormal heart rhythms caused by a disruption of the heart’s normal electrical conduction system. Our electrophysiologists (cardiologists trained in the diagnosis and treatment of heart rhythm disorders) evaluate and treat a wide range of arrhythmias, including:

• Atrial fibrillation
• Sinus tachycardia
• Bradycardia
• Atrial flutter
• Ventricular premature contractions
• Ventricular tachycardia
• Ventricular fibrillation
• Supraventricular tachycardia

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Our advanced electrophysiology lab provides the latest in diagnostic and therapeutic services for arrhythmias. Heart rhythm specialists use the following tests to document the presence of an arrhythmia and identify its point of origin:

• 12-lead electrocardiograms (ECG/EKG)
• Holter monitoring
• Transtelephonic monitoring
• Implantable memory loop recorders
• Tilt-table tests
• Electrophysiology (EP) studies

12-lead electrocardiogram (EKG)

This test uses 12 electrodes affixed to the legs, arms and chest to record the heart’s electric signals.

Holter monitoring

 Patients wear a small, portable tape recorder connected to disks on their chest. The device records their heart rhythm as they go about their daily activities over a period of 24 hours.

Transtelephonic monitoring

Also known as an event recorder, this pager-sized device allows patients to record arrhythmias as they occur and send the resulting EKG reading by telephone for analysis.

Implantable memory loop recorders

This device is especially useful for patients with syncope (fainting) due to suspected arrhythmias. It is implanted under the skin for continuous, long-term monitoring.

Tilt-table test

One of many assessments used as part of a syncope (fainting) evaluation, this test involves monitoring the patient’s heart rhythm and blood pressure while lying flat, then sitting up at various angles. The result can indicate whether syncope is a cardiac-related event or caused by other factors.

Electrophysiology (EP) studies

These catheter-based studies allow our electrophysiologists to investigate heart rhythm problems or provoke an arrhythmia so they can determine the best way to treat it. EP studies are also valuable in evaluating the effectiveness of medications a patient may be taking to control a serious arrhythmia.

 Treatment

At UC Irvine Medical Center, treatment options include:

• Drug therapy
• Pacemaker implantation
• Cardiac defibrillator implantation
• Pacemaker-defibrillator devices
• Biventricular pacemakers/cardiac resynchronization ( link – cardiomyopathy)
• Radiofrequency catheter ablation

Drug therapy

Pharmaceutical therapy is often the first approach to treating abnormal heart rhythms. As a university-based medical center, we are able to offer patients access to clinical trials of new and promising drugs not available elsewhere.

Pacemaker implantation

Pacemakers can control bradycardia–a slow heart rhythm. This device senses the heart's rhythm and delivers a stimulus to accelerate the cardiac rate. If the heart beats too fast, an implantable cardiac defibrillator (ICD) may be needed to deliver pacing signals and/or electric shocks to stabilize the arrhythmia. Some patients require both a pacemaker and a defibrillator, which are combined in one device. The pacemaker speeds up the heart rate if it becomes too slow, while the defibrillator interrupts rapid and irregular heartbeats. Biventricular pacemakers are also available. (Link–cardiomyopathy)

Radiofrequency catheter ablation (RFA)

This procedure involves eliminating the abnormal heart tissue causing the arrhythmia. Radiofrequency waves are sent through a special catheter to destroy the faulty pathways or cells causing the abnormal heartbeat. RFA is invaluable in treating atrial and ventricular fibrillation and ventricular tachycardia.

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