Listen to your heart, especially for irregular beats
Dr. Ramesh Hariharan is professor and chief of the Cardiac Electrophysiology section with McGovern Medical School at UTHealth Houston, and medical director of Cardiac Electrophysiology at Memorial Hermann-Texas Medical Center.
September is National Atrial Fibrillation Awareness Month,
and with the Centers for
Disease Control and Prevention estimating that more than 12 million people in the U.S. will have Atrial Fibrillation (AFib) by 2030, it’s important to raise awareness for these heart irregularities that many don’t fully understand. In this article, Dr. Ramesh Hariharan, a cardiac electrophysiologist, unpacks everything you need to know about heart arrythmias, electrophysiology and the cutting-edge treatments available for these conditions.
Q: What are heart arrythmias?
A: Heart rhythm disorders, or heart arrythmias, occur when one has an irregular or abnormal heartbeat. There are many different types of arrythmias depending on where they occur in the heart and the pace of the rhythm. Common arrythmias include atrial tachycardia, supraventricular arrythmia, Wolff-Parkinson-White Syndrome and others. However, AFib is the most common and complex type of arrhythmia.
AFib occurs when the upper and lower chambers of the heart aren’t coordinated and experience too many electrical signals, causing the heart to beat too quickly, too slowly or irregularly. It’s like simultaneously pressing your feet on the gas pedal and brake pedal of your car.
While many people think they’re experiencing palpitations due to stress or a workout, you should see a doctor if you notice your heart racing or fluttering for no apparent reason, especially if it continues to be an issue. Having chest pain or experiencing extreme fatigue during lowintensity activities, such as getting the mail or going to the grocery store, also warrants a visit with your doctor. Risk factors for developing an arrythmia include advancing age, high blood pressure, obesity, diabetes, heart disease, moderate to heavy alcohol use and sleep apnea. If not treated, heart arrythmias can lead to debilitating strokes, heart failure and death.
Q: What is electrophysiology?
A:
Electrophysiology tests for and treats problems involving irregular heart rhythms. The heart has several mechanical components, including its own wiring system. Electrophysiologists treat this wiring, whereas other cardiologists focus on the vascular system. Think of electrophysiologists as expert electricians and other cardiologists as expert plumbers. Electrophysiology is a fastgrowing field of cardiology due to an increase in cuttingedge technology and a deeper understanding of the heart’s synchrony. As an example, when I was in training, patients were given pacemakers that would simply keep them alive.
Today, we have miniature pacemakers the size of a pill with remote monitoring capabilities that will automatically call us when it detects an urgent issue and set up follow-up appointments for the patient. Memorial Hermann offers expansive electrophysiology care at all 11 of its hospitals throughout Greater Houston, meaning there’s access to treatment no matter where you are in the community. At the Electrophysiology Center at Memorial Hermann – Texas Medical Center, we offer research trials and highly specialized care.
Q: How can you treat AFib and heart arrythmias?
A:
Memorial Hermann’s electrophysiology program offers multiple innovative treatments for patients, with UTHealth research being done every step of the way. We offer minimally invasive procedures such as ablations, which allow us to map the inside and outside of the heart so we can see exactly what portion is causing the irregularity. We then cauterize the small area of heart tissue causing the abnormal heartbeats so the heart can return to its regular rhythm.
There are also device therapy options such as implantable technologies that reduce stroke risk in AFib patients by allowing them to come off blood thinners. Hospitals must meet strict criteria set by the Centers for Medicare & Medicare Services (CMS) to offer these devices to patients, which are currently available at multiple Memorial Hermann facilities. We also offer implantable cardioverter defibrillators (ICDs), which are miniature devices connected to your heart that keep track of your heart rate and correct abnormal heart rhythms. ICDs prevent sudden death in patients who have a high risk for certain arrythmias by sending electrical signals and shocks that return the heartbeat to normal. Pacemakers also regulate the heartbeat. Many patients have had their pacemakers implanted for decades, and sometimes infections from the device are inevitable. In order to heal from the infection, the pacemaker must be removed, but they often become so implanted in the body that they require advanced skills to remove them. Our electrophysiology team also is highly specialized in extracting pacemakers, so rest assured if you do ever need to have your pacemaker replaced, you’ll be treated with expertise.
In sum, Memorial Hermann’s heart team brings together electrophysiologists, cardiologists and surgeons, who work collaboratively to treat all types of arrhythmias, allowing patients to receive the highest quality of care with leading technology capabilities, no matter where they are in Houston.