Is an invasive procedure used to remove or terminate a faulty electrical pathway from sections of the heart of those who are prone to developing cardiac arrhythmias (fast rates). Catheter ablation involves advancing catheters into the heart via blood vessels. Localised heating or freezing is used to ablate (destroy) the abnormal tissue causing the arrhythmia. Cardiac arrhythmia is treatable by ablation include AVNRT (Atrioventricular Node Reentry Tachycardia), AVRT/WPW (Atrioventricular [Accessory Pathway] Reentry Tachycardia/Wolff-Parkinson White), Atrial Tachycardia, Atrial Flutter, Atrial Fibrillation and Ventricular Tachycardia.
Is a procedure where an abnormally fast heart rate (tachycardia) or cardiac arrhythmia is converted to a normal rhythm using direct current electricity. Synchronised electrical cardioversion uses a therapeutic dose of electric current to the heart at a specific moment in the cardiac cycle.
A pacemaker is a medical device that uses electrical impulses, delivered by electrodes contracting the heart muscles, to regulate the beating of the heart. The primary purpose of a pacemaker is to maintain an adequate heart rate, either because the heart’s natural pacemaker is not fast enough, or there is a block in the heart’s electrical conduction system. The pacemaker is typically placed under the skin or muscle in the pectoral region and electrical leads are passed through blood vessels into the heart. Pacemakers can be single chamber (atrium or ventricular), dual chamber (atrium and ventricular) or biventricular (atrial and/or two ventricular leads).
Is a device implantable inside the body, able to perform both pacing and defibrillation of the heart. The device is therefore capable of correcting most life-threatening cardiac arrhythmias. The ICD is used to treat and as prophylactic therapy for patients at risk of sudden cardiac death due to ventricular fibrillation and ventricular tachycardia. The ICD is typically placed under the skin or muscle in the pectoral region and electrical leads are passed through blood vessels into the heart. ICD’s can be single chamber (ventricular), dual chamber (atrium and ventricular) or biventricular (atrial and/or two ventricular leads). The subcutaneous ICD is the latest development, which has one lead that is placed under the skin next to the sternum instead of inside the heart via the blood vessels.
Cardiac Resynchronisation Therapy (CRT)
CRT therapy is used to treat heart failure when not all parts of the lower chambers of the heart (the ventricles) contract simultaneously (ventricular dyssynchrony) which leads to inefficient pumping of the heart muscle. CRT involves the implantation of a CRT pacemaker or defibrillator that has an extra electrical lead overlaying the left ventricle to stimulate both ventricles and coordinate simultaneous contractions.
Implantable Loop Recorder
Is an insertable cardiac monitor that is implanted just under the skin of the chest to record the heart’s electrical activity. It is a used as a diagnostic tool for when patients experience symptoms such as syncope (fainting), seizures, recurrent palpitations, lightheadedness, or dizziness regularly but not often enough to be captured by a 24-hour or 30-day external monitor.
Complex Lead Extraction
Sometimes pacemaker/ICD leads will need to be removed from the heart muscle either due to most commonly infection or degradation. Leads that have been implanted for a decade or two will usually have attachments to the patient’s body at various places in the pathway from device to heart muscle since the human body tends to incorporate foreign devices into tissue. In some cases such as a device that has been inserted for a short amount of time, removal may involve simple traction to pull the lead from the body. Removal in other cases is typically done with a cutting device which threads over the lead and is moved down the lead to remove any organic attachments.