Posts Tagged ‘arrhythmia’

Emory University Hospital Celebrates Pacemaker Clinic 20th Anniversary

Emory University Hospital Atlanta, GAThe Emory University Hospital Pacemaker/ICD Services Program was established in 1991 by Paul Walter, MD, and Nancy Romeiko, RN. Dr. Walter was the medical director and overseeing physician and Ms. Romeiko served as head nurse. In 20 short years, the Pacemaker Program at Emory has grown to employ nine nurses, a technician and full-time administrative staff.

The Pacemaker/ICD Services Program serves over 3,500 patients who are actively receiving device monitoring services, and it has cared for more than 12,000 patients in the last 20 years! Emory’s Pacemaker Program averages approximately 400 to 430 procedures per week, including monitoring services by phone or remote system, and office visits in The Emory Clinic or one of the Program’s five outlying sites (Snellville, Decatur, Conyers, Hiawassee and Toccoa) in addition to Emory University Hospital Clifton Road campus location.

The Pacemaker Program provides device evaluation and monitoring services for all types of pacemakers and implanted defibrillators, including the latest devices used for pacing in congestive heart failure patients.

Many thanks go to the physicians, nurses and staff who have dedicated their careers to providing the highest quality of patient- and family-centered care to our patients in this program.

Related Resources:

 

Lone Atrial Fibrillation (A-Fib) – Takeaways from our Heart to Heart

Lone Atrial FibrillationThank you for those who were able to participate in the Emory Heart & Vascular Center Live Chat on Arrhythmias last week! You all had great questions and highly engaged. If you could not join me, you can view the Arrhythmia chat transcript here. We covered a lot of different topics. Please feel free to use the comments below to let us know if you have other heart and vascular topics you would like to cover in future live chats, and we will see if we can organize!

During the chat, there were questions I did not have time to answer. Specifically, I told attendees that I’d be posting a follow up blog on Lone Atrial Fibrillation, a less discussed type of arrhythmia that I got some good questions around.

What is Lone Atrial Fibrillation (A-Fib)?

Lone Atrial Fibrillation (A-Fib) is atrial fibrillation seen in patients younger than 60 years with no underlying structural heart disease.  It may be caused by a specific trigger or could occur without any trigger.

What are the possible triggers for Lone Atrial Fibrillation?

Lone A-Fib can be triggered by:

  • Emotional or work related stress
  • Physical Overexertion
  • Alcohol use or overuse
  • Caffeine consumption
  • Infection
  • Dehydration
  • Electrolyte imbalances
  • Drugs (cocaine, amphetamines, etc)
  • Hypoglycemia

Unfortunately, in the majority of cases of Lone Atrial Fibrillation occur without any triggers. It is probably difficult to avoid all the potential triggers for Lone A-Fib.  But when a trigger exists, it is  typically specific to each individual.  There is no consistent way to safely and effectively manage Lone A-Fib episodes, so I recommend you consult your cardiologist to ensure you are taking the most appropriate steps for your particular case.

You can visit our website to learn more about Emory’s Arrhythmia Program.

Dr. Mikhael El-ChamiAbout Mikhael El-Chami, MD
Dr. El-Chami completed his residency at Emory in 2003 and he was nominated for a chief residency year at Emory in 2004. His training in cardiology and electrophysiology also was completed at Emory. His areas of clinical interest include: cardiac arrhythmia ablation, cardiac resynchronization therapy and prevention of sudden cardiac death. Dr. El-Chami holds organizational leadership memberships with the American College of Cardiology and the Heart Rhythm Society. He speaks Arabic and French fluently.

Has Your Heart Ever Skipped a Beat?

Arrhythmia Web Chat with Dr. El-ChamiHave you ever experienced a skipped heart beat or a change in the regular beat of your heart? If so, you may have a rhythm disorder called an Arrhythmia. Arrhythmias are common in middle-aged adults. Some arrhythmias are relatively harmless, but others can be fatal if not treated. Nearly 1,000,000 people are hospitalized for an arrhythmia each year, and some arrhythmias, such as Atrial Fibrillation, are extremely common and affect over 2,500,000 million Americans.

Join me on Wednesday, August 24, at 12:30 p.m. for an interactive web chat on the topic of Diagnosing, Managing and Living with Arrhythmias. I will be available to answer questions and discuss various topics about arrhythmias, including symptoms, diagnosis, prevention and treatment, as well as innovative new cardiovascular research on the horizon.

You can register online for the live chat! UPDATE CHAT TRANSCRIPT

Dr. El-Chami

About Mikhael El-Chami, MD

Dr. El-Chami completed his residency at Emory in 2003, and he was nominated for a chief residency year at Emory in 2004. His training in cardiology and electrophysiology also was completed at Emory. His areas of clinical interest include: cardiac arrhythmia ablation, cardiac resynchronization therapy and prevention of sudden cardiac death. Dr. El-Chami holds organizational leadership memberships with the American College of Cardiology and the Heart Rhythm Society. He speaks Arabic and French fluently.

Learn About Atrial Fibrillation (A–Fib) in new Physician “Ask the Expert” Video Series

Atrial Fibrillation Ask the ExpertsAs we have discussed in previous blogs on the topic of arrhythmias, atrial fibrillation, also referred to as A – Fib, is the most common irregular heart rhythm in the United States.  It is so prevalent that over 2 million Americans suffer from it. Even though it is not directly life threatening, it can lead to other heart problems such as congestive heart failure and stroke, as well as shortness of breath, dizziness, chest discomfort and palpitations.

The physicians in Emory’s Arrhythmia Program talk about various arrhythmia topics and how to best manage your condition in our new “Ask the Expert” video series.

You can also view past blogs about arrhythmia including:

If you have further questions or think you may have A- Fib after viewing our atrial fibrillation videos, please call Emory HealthConnection℠ 404-778-7777 to speak with a nurse.

Do you have questions about this procedure or about A-Fib in general? If so, please let me know in the comments section.

About Angel Leon, MD:

Dr. Leon is a Professor of Medicine and the Chief of Cardiology at Emory University Midtown. His specialties include electrophysiology, cardiology, and internal medicine, and his areas of clinical interest include arrhythmia ablation, electrophysiology lab, and pacemaker. Dr. Leon holds organizational leadership memberships with the American College of Cardiology and the American Heart Association. He has been practicing with Emory since 1991.

Case Study: A Catheter Ablation Approach to Atrial Fibrillation

In recent posts, we’ve presented various case studies and examples of patients suffering from atrial fibrillation (A-fib). We’ve seen how debilitating this condition can be, and how severely it can affect a patient’s quality of life.

In this post, we’ll take a glimpse into the life of a Georgia 55-year-old school administrator who developed A-fib over a two-year period, causing him to suffer from fatigue, shortness of breath, and a decreased ability to exercise.

His local physicians made every effort to restore the rhythm of his heart through the use of anti-arrhythmic drugs—unfortunately; the medication generated side effects that necessitated the placement of a pacemaker implant.

When the patients’ A-fib continued to reoccur, the physicians realized that the drug therapy was failing and decided to pursue a course of rate control and anticoagulation therapy. This attempt failed to alleviate the symptoms as well, which prompted his local cardiologist to refer him to Emory University Hospital Midtown to be evaluated for catheter ablation.

Catheter ablation is a minimally invasive procedure that doesn’t involve open-heart surgery, making it a viable option for patients suffering from A-fib. In our patient’s case, it was the ideal solution for his condition—which is why in February of 2010 he underwent the procedure for treatment of his arrhythmia.

Catheter ablation involves threading catheters through the blood vessels towards the heart, which destroys (or ablates) the abnormal heart tissue that causes the condition. We performed the ablation on our patient using conscious sedation, and achieved femoral vein access with catheterization into the patient’s left atrium. Electro-anatomic mapping guided the irrigated-catheter ablation system.

The procedure was completed in less than three hours, and our patient was discharged the following morning. He was able to return to normal activity two days later. After the ablation, we continued to keep him on anti-arrhythmic medication for a month.

At his 3-month and 6-month follow-up visits, he showed no signs of A-fib, and we were able to discontinue the use of the anti-arrhythmic drugs. Today, our patient says that he feels “great”, and he continues to be completely free of atrial arrhythmia and its symptoms.

When anti-arrhythmic drugs fail to alleviate the symptoms of A-fib, catheter ablation is an advantageous alternative. While the procedure works best for patients with recurring A-fib, it can also make sense for A-fib cases without the presence of significant heart disease. Further, recent pilot studies have revealed that catheter ablation is superior to medication as the primary form of therapy for A-fib.

Do you have questions about this procedure, or about A-fib in general? If so, please let me know in the comments section.

About Angel Leon, MD:

Dr. Leon is a Professor of Medicine and the Chief of Cardiology at Emory University Midtown. His specialties include electrophysiology, cardiology, and internal medicine, and his areas of clinical interest include arrhythmia ablation, electrophysiology lab, and pacemaker. Dr. Leon holds organizational leadership memberships with the American College of Cardiology and the American Heart Association, and he’s been practicing with Emory since 1991.

Medication Treatments for Arrhythmia

In previous blog entries, we’ve covered medical procedures for heart arrhythmias. In this post, we’ll explore multiple drug treatment regimens we use to treat various cardiac arrhythmias.

There are several medications used in the treatment of cardiac arrhythmias. The choice of medicine depends on the type of arrhythmia and the presence of different comorbidities, such as heart, kidney or liver diseases.

Let’s explore the main categories of these medications:

Beta Blockers: Beta blockers block the effect of adrenaline on the heart and blood vessels. They are commonly used in the treatment of different arrhythmias. They are mainly used as blood pressure medication and also used in the treatment of coronary artery disease, congestive heart failure and angina. They are usually safe and well tolerated by patients.

Calcium Channel Blockers: Calcium channel blockers disrupt the process of calcium entering the heart and blood vessel tissues.  As with beta blockers, this blockage results in lower blood pressure, which is why this medication is also used to treat high blood pressure and angina. Calcium channel blockers are available in short and long acting forms.  This class of medication is also usually safe and well tolerated.

Antiarrhythmic Drugs: Antiarrhythmic drugs are often used in treating different arrhythmias, especially atrial fibrillation (A-fib). Different antiarrhytmic drugs are available, such as flecainide, propafenone, sotalol, and amiodarone. Each of these drugs has different side effects. A common side effect to all antiarrhythmic drugs is pro-arrhythmia, i.e. the occurrence of dangerous arrhythmias, which is why these medications should only be prescribed by a specialist. Patients taking these drugs should have an ECG done every 6 months to check for any evidence of medication toxicity.

Do you have any questions about any of these treatments or about cardiac arrhythmias in general? If so, I encourage you to leave a note in the comment section below.

About Mikhael El-Chami, MD: Dr. El-Chami completed his residency at Emory in 2003, he also was nominated for a chief residency year at Emory in 2004. His training in cardiology and electrophysiology was completed at Emory as well. His areas of clinical interest include: Cardiac arrhythmia ablation, cardiac resynchronization therapy and prevention of sudden cardiac death. Dr. El-Chami holds organizational leadership memberships with the American College of Cardiology and the Heart Rhythm society, and speaks Arabic and French fluently.

Defining Atrial Fibrillation

Atrial fibrillation, or A-fib, is the most common irregular heart rhythm, or cardiac arrhythmia in the United States. In fact, according to the American Heart Association, approximately two million Americans suffer from A-fib, which results when multiple circuits of disorganized electrical activity in the two upper chambers of the heart (the atria) take over the organized electrical activity normally generated by the heart’s sinus node. This produces a fibrillating, or quivering of the atria, as opposed to a regular heartbeat.

Although A-fib isn’t directly life threatening, it’s often debilitating, as it produces a fast, irregular pulse that can cause fatigue and contribute to additional heart problems over time, such as congestive heart failure. Other symptoms include palpitations, chest discomfort, shortness of breath, or dizziness. In many cases, A-fib greatly increases the risk of stroke; consequently, patients are often placed on blood thinners.

Just a few years ago, patients suffering from this condition were informed that they’d have to learn to live with it. However, increasing numbers of people suffering from A-fib can now be treated or even cured, thanks to innovative therapies and procedures available through The Emory Heart & Vascular Center.

Now that we’re able to successfully treat atrial fibrillation, we’re greatly improving the quality of life for our patients, reducing the number of medications they have to take, and limiting the amount of hospital trips they have to make.

Our next Heart & Vascular post will touch on the diagnosis of A-fib and arrhythmias in general.

Do you have any questions or thoughts about atrial fibrillation? If so, be sure to let me know in the comments.

About Jonathan Langberg, MD:

Dr. Langberg is the Director of Cardiac Electrophysiology at Emory University Hospital, as well as a professor of Internal Medicine. He is board certified in Internal Medicine, Cardiology, and Cardiac Electrophysiology. Dr. Langberg is a pioneer in the field of catheter ablation of arrhythmias and has published over 150 articles related to his field.