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Patients with Ventricular Tachycardia (VT) know—this heart rhythm disorder is serious business. One of the most life-threatening arrhythmias, VT causes the bottom chambers of the heart—the ones primarily responsible for pumping blood to the vital organs and the brain—to beat too quickly. This can cause a wide array of debilitating symptoms, including palpitations, fainting, shortness of breath, and low blood pressure. In some cases, VT can lead to a weakening of the heart muscle and even in increase risk for sudden death.
Luckily for sufferers of this arrhythmia, the arsenal of treatment options for VT is continually growing. One such option is radiofrequency ablation (“ablation” for short), which can be done in a minimally invasive fashion from either inside or outside the heart muscle, depending on where the dysrhythmia is coming from. Here at St. David’s Medical Center, we are fortunate to have some of the most experienced electrophysiolgists and the most sophisticated equipment for performing this complex procedure. Because our staff is so experienced in handling this highly specialized cardiac ablation, we have developed a protocol for the procedure that focuses on the safety of the patient and the success of the procedure.
VT Ablation patients start out in our Cardiology Services Department, a pre-operative area. There, they sign all the paperwork that is needed, such as consents for the procedure. Intravenous (IV) access is started and labs are drawn and sent off. Due to the complexity of these cases, it is imperative that we are prepared for any emergency situation that may arise, so special blood coagulation lab work is drawn, and the patient’s blood type is determined. An EKG performed, the patient’s weight is taken, and the patient is seen by an anesthesiologist or nurse anesthetist before coming up into the Electrophysiology Lab.
Before the patient reaches the lab, nurses and technologists behind the scenes make sure that all the equipment needed for the case is setup in the rooms and working properly. Once this is determined and the patient is ready, they are brought into the room where a series of steps take place to prepare them for the procedure. After they get onto the narrow procedural table, the staff work together to ensure that all patches are placed correctly on the patient for accurate mapping and monitoring purposes. The anesthesiologist works on getting the patient comfortable and ensures that continuous blood pressure monitoring is in place. All complex VT ablation patients receive a urinary catheter. The patient is given a Propofol infusion during the insertion of the catheter for comfort purposes.
Both groins and the subxyphoid area (the area at the end of the breastbone) are prepped with a sterile solution. The physician places an arterial line in the right femoral artery for close monitoring of the patient’s blood pressure throughout the procedure. Medications that are administered during the procedure may include Isuprel, Phenylephrine, Epinephrine and IV caffeine. These are just some stimulants that can help to bring out any dysrhythmia during the procedure. Monitoring of the urine output is important as the patient receives continuous fluid administration during ablation. If the physician decides to perform epicardial ablation, there is further monitoring of any fluid that may be pulled off from the pericardial space. The ablation procedure can take anywhere from 3-8 hours, depending on the complexity of the case.
Once the procedure is completed, the patient is transferred to the Post Anesthesia Care Unit (PACU). The patient will remain in this area until they are cleared by the anesthesiologist to go to the nursing unit. The sheaths that were placed during the case are pulled in the PACU. If a pericardial drain is required to remain as a result of epicardial ablation, the patient is transferred to the ICU where closer monitoring is performed until it can be removed.
Post-VT ablation patients generally spend the night in the hospital and go home the next day if their procedure did not include any complications. The physician may decide to keep the patient longer if there are any other factors that may warrant continued monitoring and hospitalization. Discharge planning for these patients include: repeat ECHO the next day to rule out pericardial effusion, removal of epicardial drain if left in for excessive bleeding, and Ibuprofen for chest discomfort from epicardial access. Patients are instructed to avoid strenuous activity and lift no more than 10 pounds for 5 days, wear a 24 hour cardiac Holter monitor in 6 weeks along with a physician follow up, and to call the physician’s office if they experience any palpitations, light headedness, low blood pressure or shortness of breath.
Complex VT ablations present multiple challenges for everyone involved. I feel that at St David’s we have a tremendous representation of teamwork and communication from all the disciplines that come in contact with the patient. I attribute these valuable relationships to the continued successful outcomes that we provide these patients as they come through our lab.
--Tami Metz, RN
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On July 29, 2011, the U.S. Senate approved Senate Resolution 243, the Atrial Fibrillation Resolution, by unanimous consent. “Promoting increased awareness, diagnosis, and treatment of atrial fibrillation to address the high morbidity and mortality rates and to prevent avoidable hospitalizations associated with the disease,” the resolution was introduced by Sen. Mike Crapo (R-ID) in response to the growing number of Americans affected by Atrial Fibrillation (AF).
Senators Robert P. Casey (D-PA), Daniel Akaka (D-HI), Marco Rubio (R-FL), Patrick Toomey (R-PA), and Daniel Inouye (D-HI) co-sponsored the resolution, which is a companion bill to the House Resolution 295. This resolution was introduced in the U.S. House of Representatives in June 2011 by Representatives Kay Granger (R-TX), Dutch Ruppersberger (D-MD), and Charles Gonzalez (D-TX).
The AF Resolution recommends that the Secretary of the U.S. Department of Health and Human Services and medical community leaders should work together to develop better research, screening, prevention, and surveillance efforts surrounding AF, which currently effects more than 2.5 million Americans. The Resolution goes on to outline key components of these efforts, including developing outcome measures, adopting evidence-based guidelines, advancing research and education, and improving access to medical care for folks with AF.
Passage of the resolution was facilitated by a host of health organizations, including the Heart Rhythm Society, American Academy of Neurology, American College of Cardiology, American Heart Association, and many more.
~ Jamie LaRue, RN
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Ever wonder how medical breakthroughs come about? How did doctors discover that they could put transplant a pig’s heart valve into a human heart and significantly improve the human patient’s quality of life? Or that they could put a little battery in someone’s chest that could pace the heart when it goes too slow? The answer is simple: hours and hours of research.
The desire to cure arrhythmias—or at least significantly improve the lives of patients who suffer from them—is why the doctors at Texas Cardiac Arrhythmia Institute (TCAI) are so gung-ho about research. Several of the techniques and protocols that are standard in arrhythmia management were developed by physicians right here at St. David’s, after doing extensive research to determine what gives the best outcomes for patients.
Earlier this year, for instance, TCAI became the first facility in Central Texas to use a surgical bipolar approach to treat persistent atrial fibrillation (AFib) using radiofrequency ablation. TCAI doctors performed the procedure as part of a study aimed at evaluating the effectiveness and safety of targeting the outer (epicardial) and inner (endocardial) surface of the heart with radiofrequency ablation. The procedure represents a groundbreaking collaboration between electrophysiology and cardiothoracic surgery—the electrophysiologist targets the inside of the heart and the surgeon works on the outside.
While the equipment used in the study procedure was all FDA-approved when used separately, its use together, to treat AFib, is purely investigational. TCAI electrophysiolgist Javier E. Sanchez, M.D., is a principal investigator for the study, and James Edgerton, M.D., is the co-investigator.
It remains to be seen whether the hybrid procedure will prove to be a breakthrough in AFib treatment. But the fact that TCAI doctors are eager to cross into unknown territory to cure AFib certainly proves exciting.
~ Jamie LaRue, RN
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If you’ve been diagnosed with Atrial Fibrillation (AF), the heart rhythm disturbance that affects 3-5% of people over the age of 65, you know exactly what it feels like. Many AF patients describe a feeling like “a fish flopping” or “drums pounding” in the chest. But unless you’ve been in AF, it’s difficult to describe the symptoms. The problem is, Atrial Fibrillation significantly increases the risk for stroke. And if a person doesn’t know what AF feels like, they can’t tell when they’re in danger. Untreated AF can also decrease quality of life and physical stamina, and, in some cases, it can even weaken the heart muscle itself.
That’s why the Heart Rhythm Society (HRS) has launched a television and radio campaign to educate the public about AF, its symptoms and its warning signs. The Public Service Announcement, dubbed “A-Fib Feels Like…” began airing on television stations in the U.S. in May. According to HRS, the campaign is “designed to help the public understand what AF feels like, help them recognize symptoms and to encourage them to seek the support of a doctor to discuss possible treatment options.” The Society has also designated September as AF Month. Check back right here for more info on that in the coming months.
The good news is, there are a variety of treatment options available for AF patients, including mediation, catheter ablation, surgery, and pacemaker therapy. To request an appointment with one of the Texas Cardiac Arrhythmia Institute’s AF expert physicians, or to simply get more information on AFib from on of our nurses, fill out our on-line Request an Appointment form or visit the “Atrial Fibrillation” section of the Heart Rhythm Society’s website.
Happy viewing!
~ Jamie LaRue, RN
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If you’ve ever been to a professional conference, you know what an energizing experience they can be. You come back to the office with a new vigor for the work you do, and often you are inspired to change your work based on what you’ve learned. This was certainly true for the TCAI nurses and technologists who had the opportunity to attend the premier electrophysiology annual meeting—Heart Rhythm Society conference 2011 (HRS 2011).
This year’s theme centered around Science, Discovery, Innovation, and a focus on Technology. The four-day conference featured electrophysiology’s international heavy-hitters, who presented ground-breaking research into the latest advances in the field. There was a special exhibit this year called the “Networked EP Lab,” in which practitioners could actually try out new technologies that improve patient safety and procedural outcomes. Another attraction was the Atrial Fibrillation Summit, where physicians and allied professionals learned about the current status of and future of AFib treatment strategies.
Though they had the opportunity to attend any of the physician-led sessions, nurses and technologists also had their very own track at HRS 2011—The Allied Professionals Forum. Maegen Lane, RN, BSN, one of TCAI’s Atrial Fibrillation Nurse Educators who attended the conference, remarked that “the Allied Health Professionals Forum was very beneficial to me. It gave me an in-depth look into the anatomy of the electrical conduction system of the heart, pacemaker management tools and a closer look at VT ablation.” This is critical information that Maegen put to use as soon as she returned from the conference, during her patient education sessions.
Most importantly, the allied professionals who attended HRS 2011 were able to network with other nurses and technologists, sharing ideas for how they can better care for arrhythmia patients. Maegen Lane and Greg Gilbert, a supervisor in the TCAI Electrophysiology Lab, met with the course directors for HRS and discussed the potential to use St. David’s Medical Center and TCAI as a site for a future Allied Health Professional regional conference.
A lot was learned in the four days of HRS 2011. The benefits of attending such a conference are likely to last TCAI’s nurses, technologists, and patients until HRS 2012.
~ Jamie LaRue, RN
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Ever wonder what all those letters after your doctor’s name stand for? Usually, they mean that a society of practitioners in his specialty has awarded him special distinction, or that he has special certification in a specific branch of medicine. For example, “MD, FACC” after your doctor’s name means that she’s a Medical Doctor and a Fellow of the American College of Cardiology.
As of this month, three staff members at the Texas Cardiac Arrhythmia Institute can tack a few more letters onto their own signatures. Barbara Thomas, RN (Director of Electrophysiology Services), Bai Rong, MD and Luigi Di Biase, MD, PhD (TCAI Research Fellows) were all inducted as Fellows of the Heart Rhythm Society (FHRS) at the 2011 Heart Rhythm Society conference in San Francisco.
Fellowship in the Heart Rhythm Society (HRS) is bestowed the most esteemed members of the society for “significant achievements, service, and prominence in the field of cardiac arrhythmia.” Fellows are elected by vote and must receive letters of support from two current fellows. Candidates must be active in HRS committees, hold certification in their specialty, and have contributed to or written at least five publications, two of which must be in peer-reviewed journals.
“This distinction is a great honor,” said Barbara Thomas, RN, after her induction. “Dr. Bai, Dr. Di Biase, and I join the ranks of the world’s most respected electrophysiologists by becoming Fellows.”
Sure, it will take a little more time for these three electrophysiology super stars to write their signatures, but something tells me the honor is worth it.
~ Jamie LaRue, RN
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May 6, 2011-- Today was a particularly proud day at TCAI! Cindy Williams, one of our Atrial Fibrillation Nurses, was chosen as recipient of the 2011 St. David’s Medical Center Nursing Excellence Award. Each year, St. David’s Medical Center honors two nurses with this award during National Nurse’s Week. Nurses are nominated for exceptional nursing care by their peers and the doctors and nurse practitioners they work with. This year, the nominees were so exemplary that three Nursing Excellence Awards were given!
Cindy has been an AFib nurse at TCAI since 2009. Since then, she has been a shining example of the kind of caring and compassion that St. David’s nurses are known for. A perfect illustration of Cindy’s dedication to her patients occurred in February of this year, when Austin experienced a once-in –a-blue-moon snow storm. Cindy drove in on treacherous roads and realized that her car would not make it up the last hill on the way to the hospital, so she got out of her car and walked the rest of the way to work. Since most of the other employees could not get here, Cindy happily picked up the slack and visited everyone’s patients for them.
Although Cindy is an expert in the field of heart rhythm interpretation and a seasoned nurse, she knows that a nurse’s education is never finished. When the breakthrough new anticoagulation drug, Pradaxa, came on the market in March, Cindy took time outside of work to attend lectures about the drug to be sure that she could properly educate her patients and peers about it.
A mentor to her peers and an exemplary patient educator, Cindy truly does embody the spirit of the Nurse Excellence Award. “ I love working at St. David’s,” Cindy said during her acceptance speech. “I love the job I get to do.”
-- Jamie LaRue, RN
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There are a lot of things that make TCAI unique—being housed in one of Thompson Reuters’ Top 100 Hospitals, having access to the most sophisticated technology available to treat arrhythmias, and our world-respected physicians, to name a few. But one of the most impressive features about TCAI is a group of folks you’ll probably never even see—our Research Fellows. Every day, these guys and gals work tirelessly to investigate new and better ways to care for patients with rhythm disorders.
They study things like what makes heart rhythm disorders happen in the first place, the relationship between other disorders and arrhythmias, and the safest ways to do the procedures that correct rhythm disorders. These behind-the-scenes detectives hail from around the globe, and are responsible for publishing research studies that have advanced the standard of care available to patients everywhere.
Luigi di Biase, MD, PhD, FHRS hails from Italy, and is the author of more than 80 published articles and eight book chapters. Luigi is an assistant professor at the Department of Biomedical Engineering at the University of Austin, Texas, and at the University of Foggia, Italy. His most recent publication investigated the safety and efficacy of cryoablation for treatment of ventricular tachycardia. [Link]
Rong Bai is a Doctor and Professor of Medicine originally from China. He has also studied in Italy, Germany, and in the U.S. at the Cleveland Clinic. Rong recently published an article about using a novel form of echocardiogram to guide placement of defibrillator leads. [Link]
Mitra Mohanty was a family physician for 14 years in India. In addition to her extensive research background, Mitra is a Biology professor at Austin Community College. She is currently working on a study investigating the relationship between migraine headaches and AFib.
Prassant Mohanty is an Epidemiologist who began his career as a Primary Care Physician in Orissa, India. His work has included planning and reviewing cancer-related research studies developing public health monitoring programs. Prassant recently published a study on using a blood test to compare outcomes for men vs. women for atrial fibrillation (AFib) ablation. [Link]
Agnes Pump is a recent addition to the TCAI Research Fellows team from Budapest, Hungary. She was a doctor of cardiology and internal medicine in her home country, and translated a book about AFib from English to Hungarian.
Pasquale Santangeli is a medical doctor from Rome, Italy with extensive experience in researching and treating heart rhythm disorders in his home country. He recently published a broad review of the research that has shaped our treatment of atrial fibrillation with catheter ablation, with recommendations on direction for the future. [Link]
--Jamie LaRue, RN
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TCAI physician J. David Burkhardt, MD, FACC, loves a good challenge.
Which is how he has come to be known as the Western Hemisphere’s “go-to” electro-physiologist for Ventricular Tachycardia ablation (say that three times fast!).
Ventricular Tachycardia [VT] is an abnormally fast heartbeat originating in the lower chambers, or ventricles, of the heart. VT is a potentially life-threatening arrhythmia because it can lead to ventricular fibrillation, which – as our previous blog post explained – can cause sudden cardiac arrest and death.
So for VT patients, treatment is necessary, and might consist of antiarrhythmic medications or an implantable cardioverter-defibrillator [ICD] – an internal “shocking” device. And, as technology advances, VT ablation is becoming a less risky, more effective treatment option.
Cardiac ablation is a non-surgical procedure in which the doctor eliminates electrical “misfirings” in the heart by creating scar tissue to break the heart’s “short circuit” and restore a regular rhythm.
TCAI hosts a state-of-the-art system for remote magnetic navigation – considered the best method for performing VT ablation. This technology manipulates a magnetic field around the patient in order to guide catheters with magnetic tips to the heart’s “problem spots.” The physician maneuvers the catheters remotely via touchscreens and a joystick. This system’s delicate precision lets the doctor deftly map the troubled area without inducing abnormal ventricular rhythms – enhancing safety and positive outcomes for patients.
Dr. Burkhardt is TCAI’s resident VT ablation specialist. He has been performing the procedure for about a decade, treating more than 150 complex VT cases last year alone. He is a master at magnetic navigation, demonstrating the technology and training other doctors worldwide how to use it successfully. Additionally, TCAI is one of very few centers with the technology and expertise to do both endocardial [the interior of the heart] and epicardial [the heart’s exterior] ablation – an intricate and life-saving procedure for some VT patients.
“I often see patients who have been told they have no other option, no other hope,” says Dr. Burkhardt. “Nothing is more rewarding than when I’m able to make them feel better.”
~ Jamie LaRue, RN
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Chances are, if you’re reading this blog, then you probably already know the difference between an interventional cardiologist and an electrophysiologist.
But do you know the difference between a heart attack and cardiac arrest? Did you know there was a difference?
Actually, the difference between these two potentially life-threatening events reflects the difference between the two types of heart doctors.
While interventional cardiologists deal with the “plumbing system” of the heart – its blood-pumping pathways (the arteries), electrophysiologists specialize in the heart’s “electrical system” – the impulses that compel the heart to beat, pumping the blood through.
Likewise, a heart attack is the product of a problem with the plumbing system of the heart, while sudden cardiac arrest means trouble with the heart’s electrical system.
A heart attack [aka myocardial infarction] happens when the arteries to the heart are clogged, so the heart can’t get enough blood. The reduced blood flow can damage the heart muscle, but doesn’t necessarily stop the heart or cause death.
Sudden cardiac arrest [SCA] occurs when the heart’s electrical impulses malfunction, causing the heart to beat chaotically and not deliver blood to the body. Without blood flow to the brain, loss of consciousness is almost instantaneous, and death will follow within minutes without immediate emergency treatment – either CPR or an electrical shock.
Other SCA specifics:
- Sudden cardiac arrest can happen during a heart attack.
- SCA is the leading cause of natural death in the U.S., accounting for about half of all heart disease deaths each year.
- The most common cause of sudden cardiac arrest is an arrhythmia called ventricular fibrillation [VF], an erratic firing of electrical impulses within the lower chambers of the heart.
- The best prevention for SCA is living a heart-healthy lifestyle – eating right, exercising regularly, avoiding obesity, not smoking, and treating heart-related issues like diabetes, high blood pressure and high cholesterol.
- For some patients, preventing sudden cardiac arrest means treating their arrhythmia [which can trigger VF] – via medication, an implantable cardioverter defibrillator or cardiac ablation.
For a helpful heart attack/sudden cardiac arrest comparison chart from the Heart Rhythm Society, click here.
~ Jamie LaRue, RN
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At TCAI, our top priority is, of course, our own patients – their successful diagnosis, treatment and recovery.
But “behind the scenes,” TCAI’s world-class research team is continuously working to help improve the outcomes of all heart-arrhythmia patients everywhere. Our researchers lead and are involved in many clinical cardiac and electrophysiology studies, and their works are frequently published in medical journals.
This month’s issue of Journal of Cardiovascular Electrophysiology, for example, features an article co-authored by several TCAI doctors and their colleagues about the connection between atrial fibrillation [a-fib] and brain natriuretic peptide [BNP].
Brain natriur-huh?
BNP is a chain of amino acids secreted by the heart that tends to increase in people with heart trouble like a-fib. Women with a-fib naturally have a higher level of BNP in their plasma than men with a-fib do. So our researchers wanted to see how the connection between BNP and a-fib might be different for male vs. female patients who undergo cardiac ablation.
They found that men with a higher BNP before ablation were more likely to have their a-fib return after the procedure. But in women, baseline BNP made no discernible difference in whether a-fib recurred following an ablation procedure.
This information will help doctors, nurses and a-fib patients alike have better expectations and be better prepared before, during and after ablation treatment and recovery. And being prepared and knowing what to expect? Yes, please.
Another similar research project is just coming to a close at TCAI – researchers are studying whether a patient’s biomarkers [bloodstream signs] for inflammation before ablation can help forecast whether their a-fib recurs following the procedure.
And finally, if you’re an a-fib patient who suffers from migraine headaches, then it might ease your pain a little to know our researchers are currently studying how catheter ablation might affect migraines in people with a-fib.
With TCAI’s research team on the case, you just never know what new connection, revelation or revolutionary breakthrough may be coming next.
Learn even more about research at TCAI by clicking here.
~ Jamie LaRue, RN
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Almost all TCAI procedures – from cardiac ablations to transesophageal echocardiograms – are performed at St. David’s Medical Center [SDMC]. At nearly 90 years young, not only is SDMC the flagship hospital of St. David’s HealthCare – one of Texas’ largest healthcare systems – but it’s also consistently ranked within the top 100 hospitals nationwide by Thomson Reuters.
Which is grand. But here are some of the little things that seem to make a big difference for St. David’s patients and their families.
Arrive in SDMC style
You know all about bedside manner, but how about a little curbside service? SDMC offers valet parking, available M-F, 7a.m.-6p.m. and conveniently located out in front of the hospital lobby. Of course, SDMC also provides plenty of covered self-parking in our Central Garage, which is complimentary for individuals age 55 and over.
Dine in SDMC style
The traditionally dreaded term “hospital food” is being deliciously redefined at SDMC. Patients can order from a room-service menu – featuring a wide variety of entrees, seasonal fresh fruits and vegetables, salads and desserts – anytime between 6:30 a.m. and 7:30 p.m., and their hot, made-to-order meal is delivered within 45 minutes. Guests can also order an in-room meal for an extra fee.
Location, location, location
If you’ll be spending some time in Austin before/after your procedure, then SDMC is where you want to be. SDMC is located in the heart of the city, just minutes from downtown, the Capitol and UT Austin. Beautiful parks, extraordinary eateries and of course, lots of live music are all within easy reach of St. David’s.
Click here for more reasons SDMC is so great!
~ Jamie LaRue, RN
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If you’re located around College Station, and want to learn more about your atrial fibrillation and possible treatments for it, then your chance is coming!
Please join TCAI for an a-fib seminar:
Tuesday, March 29th
6 – 9 p.m.
Hilton Hotel & Conference Center
801 University Avenue
College Station, Texas
The seminar will be led by TCAI’s Dr. Rodney Horton, a nationally renowned a-fib expert. Dr. Horton will give an informal presentation all about a-fib and treatment options, followed by Q&A sessions with the audience. All seminars are free and open to the public.
Whoop!
For further information, please call TCAI at
512.544.2342
~ Jamie LaRue, RN
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A-fib patients who need anticoagulants now have a choice: less money, or less hassle?
Sometimes known as “blood thinners,” anticoagulants are medicines to help keep your blood from clotting and help keep it flowing easily. For years, Coumadin [warfarin] has been the anticoagulant for a-fib and other patients who may be at higher risk for stroke.
But last fall, the U.S. Food and Drug Administration approved Pradaxa [dabigatran] for stroke prevention in a-fib patients. In clinical trial, not only did Pradaxa patients experience fewer strokes than patients on warfarin, but they also don’t have to continually monitor their clotting speed via blood tests, like they do with warfarin.
But such convenience doesn’t come cheap.
“Several of our patients have chosen to take warfarin rather than dabigatran simply due to the current cost of the new medication,” notes TCAI Nurse Educator Wendy Brandhorst. “But the patients who have chosen Pradaxa have been pleased not to need frequent blood testing or modifications to their diet.”
~ Jamie LaRue, RN
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Six TCAI doctors, researchers and staff returned to Austin this week – well-informed about their field, well-acknowledged by their peers, and just a little jet-lagged.
They came from Hong Kong, where they had participated in CardioRhythm 2011.
This biennial global conference – organized by Hong Kong College of Cardiology and Chinese Society of Pacing and Electrophysiology – featured presentations by world leaders on the latest heart-health advances, from ablation and other a-fib treatments, to implantable-device technologies, to new meds.
Not only did TCAIers share their expertise with colleagues from around the world, but they also were honored for their work:
TCAI senior researcher Dr. Luigi Di Biase earned the conference’s Best Abstract award and TCAI researcher Dr. Rong Bai earned the Best Poster award for their work in endocardial/epicardial ablation of ventricular tachycardia patients with arrhythmogenic right ventricular dysplasia [say that three times fast!] – an emerging technique to help patients with a dangerous arrhythmia due to heart muscle replaced by fat or fibrous tissue.
Gong xi [congratulations], TCAI!
~ Jamie LaRue, RN
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TCAI docs have been busy hosts this month . . .
No, not parties. But big events with groups of people – and for our electrophysiologists and the other attendees, the fare was still fairly thrilling.
– February 9-10th, TCAI and St. David’s Medical Center, along with Stereotaxis – a cardiac technologies company – sponsored the first-ever International Symposium on Remote Navigation for the Treatment of Complex Heart Arrhythmias.
Okay, yawn-inducing name. But cool conference.
Why? Because “remote navigation” means magnets, controlled via computer by your doctor, guiding catheters and other devices to and around the heart – with incredible precision and outstanding safety – to fix complex arrhythmias. And this system works with information and networking systems so that doctors anywhere with Internet access can collaborate and consult on procedures in real-time.
The symposium was led by TCAI electrophysiologists Dr. David Burkhardt and Dr. Rodney Horton, along with guest physician Dr. Tamas Szili-Torok, Clinical Head of Electrophsiology at Erasmus Medical Center in the Netherlands. About 30 medical professionals attended, observing live procedures and discussing a variety of technology “hot topics,” like how to achieve effective lesions and the next frontier for remote navigation.
– February 19-20th, TCAI and St. David’s Medical Center, along with Medtronic – a medical technology company – held a Basic Concepts of Device Management for Cardiology Fellows training, teaching future cardiologists how to use devices like pacemakers and implantable cardioverter-defibrillators [ICDs] to solve heart-rhythm problems.
Led by TCAI director Dr. Andrea Natale, TCAI electrophysiologists Dr. Robert Canby and Dr. Jason Zagrodzky, and Dr. Manish Assar, an electrophysiologist from Baylor Heart & Vascular at Baylor University Medical Center, about 30 cardiologists-to-be from across the country – from California to New York – participated. The students attended classroom, auditorium and virtual cath lab sessions, learning critical heart-device information and actually performing a simulated pacemaker implant procedure.
~ Jamie LaRue, RN
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On Valentine’s Day – the heart-centric holiday, appropriately enough – the Texas Cardiac Arrhythmia Institute at St. David’s Medical Center became the first Texas facility and second facility nationwide to implant the new Medtronic Revo MRI™ SureScan® pacing system since the device’s approval by the Food and Drug Administration (FDA) just last week.
So, what’s so great about the new pacemaker? It’s MRI-compatible.
Until now, Magnetic Resonance Imaging (MRI) scans were considered unsafe for patients with heart-pacing implants, because the MRI magnets could interfere their device.
“The strong magnetic fields produced by MRI machines can disrupt the electronic pulses created by the pacemaker … which can result in a potentially life-threatening heart arrhythmia,” explains TCAI electrophysiologist Robert Canby, MD. “The magnets can also send energy through the leads [wires] … which can result in a shock or burning of the heart tissue.”
About 200,000 American pacemaker patients a year have had to skip MRI scans that could help with the early diagnosis and treatment of serious health threats like stroke, cancer, or neurologic or orthopedic conditions.
The new pacing system is the first and only pacemaker in the U.S. designed especially for use with MRI scanning – a great leap forward for the 50-75% of pacemaker patients who will need an MRI scan during their device’s lifetime.
Learn more about TCAI’s successful implant of the new device here.
~ Jamie LaRue, RN
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Wouldn’t it be fantastic if you could learn more about your atrial fibrillation and possible treatments for it from one of America’s best doctors – in person, close to home and without even an appointment?
You can – and it’s FREE!
TCAI will hold a series of A-fib seminars around Central Texas this spring, each featuring one of our electrophysiologists with specialization in A-fib. The doctors will give an informal presentation all about A-fib and treatment options, followed by Q&A sessions with the audience. All seminars are free and open to the public.
Here’s the schedule – for details about times and locations, please call TCAI at 512.544.2342.
- Wednesday, March 2nd – San Marcos/Kyle area
- Tuesday, March 29th – College Station
- Wednesday, April 6th – St. David’s Medical Center, Austin
- Monday, April 25th – Round Rock/Cedar Park area
~ Jamie LaRue, RN
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It’s always good to have a guide when you’re navigating new territory.
Whether it’s the GPS in your car giving directions, or the translator on your trip to Japan offering cultural interpretation, we all feel better with someone helping us through a new situation.
Which is why the Texas Cardiac Arrhythmia Institute Center for Arrhythmias & Atrial Fibrillation initiated its extraordinary Nurse Navigator program.
The Nurse Navigator program connects our a-fib patients one-on-one with a TCAI nurse who serves as their personal guide through their journey back to heart health.
From diagnosis through recovery, your Nurse Navigator is your point-person for all the information and attention you might need.
Over the course of your treatment process, your Nurse Navigator will likely provide:
- her direct telephone number, so she can be your go-to guide for answers and assurance;
- clarification and complete understanding of your diagnosis, treatment and recovery;
- realistic expectations for every part of the process;
- important instructions both before and after a procedure;
- key logistical information, like driving directions, local lodging, etc.; and
- a full year of followup post-procedure, to help you manage medications, monitoring or other continuing care.
TCAI Nurse Navigators – tour guides for your return to heart health.
Learn more about TCAI’s Nurse Navigator program and
meet our staff of Nurse Navigators here.
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Welcome to the blog at the Texas Cardiac Arrhythmia Institute!
Through regular posts – full of all you need to know about TCAI and heart-rhythm health – this blog aims to be your source for all things arrhythmia.
Here, you’ll find fascinating facts and insightful info, with upcoming topics like:
- Heart attack vs. cardiac arrest: Know the difference
- Are a-fib & sleep apnea bunkmates?
- “Greening” the lab
- Cardiac ablation 101
- Can ablation affect migraines?
- Redefining “hospital food”
We hope you’ll bookmark this blog, visit us often, and let your family or friends know where they can find us.
Come back soon for news you can use, as we cover the cardiac arrhythmia beat!
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The November 2009 American Heart Association meeting in Orlando, Florida, – the largest cardiology meeting in the nation – drew outstanding representation from the Texas Cardiac Arrhythmia Institute and St. David's Medical Center. Our group presented eight abstracts, which is an exceptional accomplishment for a meeting of this caliber.
Among the research topics presented were our findings from the first study on the convergent approach to the treatment of atrial fibrillation. As explained by my colleague, Dr. Rodney Horton, “The study represents the first combined surgical and electrophysiological approach to treating the most challenging atrial fibrillation patients without any chest incisions or ports.”
Our findings were significant. All patients left the procedure room in normal sinus rhythm (normal heartbeat and normal heart rate). What’s more exciting is that 80 percent of patients remained in normal sinus rhythm and off anti-arrhythmic drugs six months later.
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It was my pleasure to serve as Co-President of the 2009 of the Venice Arrhythmias meeting held in October 2009 in Venice Italy. It was an honor to serve with Dr. Raviele, who is President. The event was attended by electrophysiologists from around the world, who, along with enjoying a spectacular series of cultural and musical events, had the opportunity to share their experiences and ideas in the multifaceted field of EP.
I was joined in this exciting four-day meeting by a number of my colleagues, and I am pleased to report that our presentations may now be viewed online. Visit http://www.venicearrhythmias.org/va2009_session.htm to view a schedule of presentations. Physicians from Texas Cardiac Arrhythmia Institute who presented (in addition to myself) include Drs. David Burkhardt, Joseph Gallinghouse, Rodney Horton, Javier Sanchez, and Luigi DiBiase, who has spent time training with our group.
I think you will enjoy viewing our video presentations, as they cover a range of topics pertinent to the treatment of electrophysiological disorders. The topics we presented include:
• Ablation as the first line of therapy in young patients with lone AF (Natale)
• Ablation and pace therapy in drug refractory AF (Natale)
• Polymorphic VT and idiopathic VF (Natale)
• Long-term results of ablation are as good as short-term results (Burckhardt)
• LVOT tachycardia (Burckhardt)
• Pulmonary Vein Antrum Isolation (Gallinghouse)
Experience with robotic navigation systems in ablation (Gallinghouse)
• Vagal AF (Horton)
• Treatment of recurrences – When is a redo necessary? (Horton)
• Elderly make good candidates for ablation (Sanchez)
• Periprocedural complications (DiBiase)
Many of our patients have come to know our nursing staff, who navigate patient care before and after procedures, and are involved in other activities such as research and data collection. Barbara Thomas, RN, director of Electrophysiology Services for Texas Cardiac Arrhythmia Institute, was the co-organizer of a program for the Allied Health Professional seminar (from the USA side). The program presented information that empowers nursing professionals to provide improved management of patients undergoing electrophysiology procedures. I was pleased that many of our nurses were able to attend the program and presented interesting topics that captured the audience's attention.
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People who have had a Maze procedure in the past often ask me if they will be able to have a cardiac ablation. For those reading who may be unfamiliar with the Maze procedure, let me explain. Maze is an open heart procedure that is performed to create a lesion that blocks an arrhythmia. In certain cases, the Maze is performed on patients who have an arrhythmia but also have other cardiac issues that require open heart surgery, such as blocked arteries.
In most cases, patients who have had a Maze procedure in the past may have a cardiac ablation if their arrhythmia returns or if they develop new arrhythmias.
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This is a common question, and I am sometimes asked if I will personally perform my patient's ablation. The answer is always, "Yes." At Texas Cardiac Arrhythmia Institute, the electrophysiologist whom a patient sees for a consult is the same one that performs that patient's ablation. The Texas Cardiac Arrhythmia Institute here at St. David's Medical Center is an International Training Center; however, electrophysiologists from around the world may visit and learn from observation but they do not take part in the ablations that we perform. Patients are assured that only their personal electrophysiologist will perform their procedures.
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Electrophysiology is a specialized form of cardiology that treats arrhythmias; therefore, our office sees only patients who have been formally diagnosed with an arrhythmia. The information that should be gathered prior to the first consult - and this will be explained to those who call for an appointment - includes medical records from a general cardiologist, EKGs and/or Holter monitor results, and echocardiogram test results.
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Patients sometimes ask if ablation will be more effective than medications. There is a critical difference between the two; medications offer relief from symptoms while ablation can offer a cure. The goal of ablation is for the patient to live free of Coumadin and anti-arrhythmic medications. (Please note that patients who take Coumadin for non-arrhythmia reasons need to continue this drug following ablation).
While medications are often the first form of treatment, in general they are not effective over a long period of time. There also may be issues related to side effects. Many of the patients that I ablate have come to me because their medications are no longer effective.
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Many patients ask me to provide a success rate for ablations performed through the Texas Cardiac Arrhythmia Institute. I am pleased and proud with the outcomes of our patients. Our goal is for ablation to provide a cure and for patients to live free of arrhythmia medications and symptoms. That said, I must note that success rates depend on a number of factors such as the size of a patient's left atrium, the type of atrial fibrillation diagnosed (paroxsysmal versus persistent versus chronic) as well as the experience of the electrophysiologist. Also, it is important to know if a facility's success rate refers to success after one ablation or after multiple ablations.
Because many factors determine success rate, I advise patients to discuss this in person with the electrophysiologist. During their discussion, the patient can obtain an accurate well-informed prediction of his or her chances of realizing a cure.
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Prospective patients often ask about the recovery period following ablation. Here are some general guidelines; however, physicians have specific recommendations individual cases. Patients must not do strenuous activity for one week; generally we ask them to miss a week of work. The ablation creates the start of a lesion that blocks the abnormal impulse that triggers an arrhythmia. This lesion needs about four to six weeks to fully form; therefore, patients usually continue to experience arrhythmias during this timeframe.
Patients are sent home with a small monitor that transmits heart rhythms to us via telephone line. This allows the nurses and physicians to continue to monitor patients as they recover.
We ask our international patients to remain in Austin for one week following their ablation. For patients who live in the U.S., we request that they stay in Austin three to five days, depending on the length of their flight. This time period allows the catheter insertion sites in the groin to heal prior to taking a journey via car or airplane.
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Late last month, TCAI became the first in Texas to implant a new pacemaker that allows a physician to constantly monitor a patient's heart rhythm. This fascinating piece of technology (called the Accent™ RF pacemaker, developed by St. Jude Medical) is equipped with wireless capabilities that notify us of changes in a patient's device or condition-without the patient having to physically visit our office.
Here is how it works:
On scheduled dates, data from the pacemaker is sent to us wirelessly-with no patient interaction required. This data transmission typically happens while the patient is sleeping. And if there are significant changes with the device or with the patient's heart rhythm in between scheduled device checks, the pacemaker automatically pages us. We will be alerted as long as we have access to a phone or computer, which is essentially all the time.
With this new wireless capability, patients can be monitored continuously without having to make the drive into the office. And if there is a problem, we'll know about it instantly.
This device not only significantly increases the level of care we can provide for our patients, it also gives them peace of mind.
Cardiac Electrophysiologist, Texas Cardiac Arrhythmia Institute at St. David's Medical Center (TCAI)
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On May 1, 2009, the Texas Cardiac Arrhythmia Institute (TCAI) celebrated its one year anniversary. This has been a tremendous year on many fronts. Patients have benefited from the new technology available in the EP Labs at St. David's Medical Center; a number of these technologies are only available at a handful of sites in the world. Our team of electrophysiologists now has access to four world class EP Labs, another plus that is not available at too many places. Each lab features a specific benefit allowing us to match the patient's placement in a lab with the specific technology needed to treat his or her case. For example, one patient may benefit from Hansen robotics while another may require stereotaxis equipment.
As the milestone of one year has passed, I offer my sincerest gratitude to my patients, my colleagues and to the nursing staff and leadership of St. David's Medical Center. Many patients live a symptom-free life because of the efforts of our team. Thank you!
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Recently I was asked if atrial fibrillation is more common now than it was a decade ago. Rather than provide a simple "yes or no" answer, I can report that electrophysiologists are seeing more cases of AFib than ever before. Why is this occurring?
There are actually two answers to this question. A decade ago, we did not have the treatment options or technology that we have today. Cardiologists did not refer patients to electrophysiologists because of the lack of treatment options. Today, these patients are referred for specialized care because we now have a variety of treatment options (such as effective ablations) that can offer a cure. Many patients are cured and live medication-free, following ablation.
Another factor is the aging population. AFib typically occurs later in life, although I have treated patients as young as nine years of age. (I have also treated a 91-year-old man.) Since the chance of developing AFib increases with age, we are seeing more cases simply because the longer lifespan we now enjoy.
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Last month I told you
about a new procedure performed at St. David's Medical Center,
combining the skills of the surgeon with those of the
electrophysiologist. For the first time in Austin and only the second
time in the nation, these two cardiac specialists performed such a
procedure in an EP Lab at St. David's. The surgeon accessed the heart
via small incisions, followed by an ablation performed by the
electrophysiologist. This is an example of how a minimally invasive
procedure can be used to cure arrhythmias that were previously
difficult to treat.
The news media was on hand to conduct
interviews following the procedure, which was performed by
cardiovascular surgeon Andrew Hume, electrophysiologist Rodney Horton,
MD, and me. Dr. Horton shared his excitement regarding the procedure.
"This will allow a certain population of people who suffer from atrial
fibrillation to be cured; not just treated, but cured,” he said.
Since
March, we have performed this procedure on six additional patients. The
procedure is most effective for cases of AFib involving extremely
dilated (enlarged) atria (upper chambers of the heart).
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When I first became involved with electrophysiology, the standard treatment for arrhythmias involved open heart surgery. After a cardiothoracic surgeon opened the patient's chest and exposed the heart, the electrophysiologist worked to correct the arrhythmia. As you can imagine, this procedure was quite invasive and complex.
By the early 1990s, catheter ablation had come to fruition, allowing electrophysiologists to perform ablation without the need for open heart surgery. The earliest cases involved very simple arrhythmias. Today, our team is able to use technology to approach even the most complicated cases -- patients who not only have arrhythmias but also suffer from other forms of heart disease. Advances in technology have resulted in new techniques that again bring together cardiothoracic surgeons and electrophysiologists. I look forward to sharing with you the news of the exciting innovation that brings together these medical specialists for the benefit of arrhythmia treatment in very complex cases.
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Last month, the FDA approved a new type of catheter used in the ablations. I am proud to announce that, upon its approval, we incorporated the device into our work at St. David's Medical Center.
This new technology is called the NaviStar ThermoCool Catheter, which is manufactured by Biosense Webster. The device is the only bi-directional irrigated catheter currently available. Features that are important to those of us who practice electrophysiology are the device's precision steering, which allows us to penetrate into more sections of the heart without having to use multiple catheters.
In clinical trials for this device, patients were significantly more likely to be free of recurring episodes of A Fib. We are pleased with the device in our clinical practice. I want to note that our team is consistently among the first to adopt new technology into our practice. In fact, our team is currently involved with approximately 30 clinical trials.
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In recent blogs, I have talked about some of the new technology available in the EP Lab. Cardiac imaging and other technological advances have been key factors in evolving and advancing ablation procedures. The end result of such innovation is increased success rates for patients undergoing ablation, as well as decreased risk for these individuals.
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I am pleased to share news about an upcoming international conference, Venice Arrhythmias 2009, which will take place in Venice, Italy, October 4-7, 2009. Texas Cardiac Arrhythmia Institute at St. David's Medical Center is a co-host of the conference. As co-president of Venice Arrhythmias, this program is near and dear to my own heart. While cardiac electrophysiologists at St. David's Medical Center have been able to perform new procedures using the latest technology, the conference brings us the opportunity to share what we have learned and to discuss the many technological advances in our field.
The conference features the latest scientific news and clinical applications in electrophysiology. Through poster sessions, presentations, information on clinical trials, satellite symposia, and other forums, experts from around the world will share their knowledge and bring back to our hospitals the best practices available.
Whether you are a patient reading this blog, or a physician or allied health professional, I encourage you to share my excitement and visit the website for Venice Arrhythmias:
www.venicearrhythmias.org.
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This week represents a
major breakthrough as a new procedure will take place at St. David’s
Medical Center, making it one of only two centers in the nation that
currently offers this option. My colleague, electrophysiologist Rodney
Horton, MD, and other members of our team performed the first cases in
Europe using this technology earlier this year.
I am
particularly enthusiastic about this development as it is truly
leading-edge, combining the skills of an electrophysiologist and
cardiovascular surgeon. Together, we will offer A Fib patients,
particularly those with complicated circumstances, a new treatment
option. During this procedure, the cardiovascular surgeon makes small
incisions to access the heart, and creates surgical lesions that will
block the triggers and pathways of the A Fib. When the surgical portion
of the procedure is complete, the electrophysiologist takes over,
creating a map of the heart using a cardiac mapping system to identify
gaps in the lesions created by the surgeon. After the gaps are located,
the electrophysiologist completes the ablation using a specialized
irrigation catheter. This portion of the treatment is similar to a
standard A Fib ablation, but requires less time.
You may wonder
who is eligible for this type of ablation? The targeted patient
population consists of those with chronic A Fib and extremely dilated
left atria. These patients typically are very difficult to treat with a
single – or even a second – EP catheter ablation. In fact, very few
electrophysiologists will even attempt ablations on these individuals.
This procedure opens the door for more electrophysiologists to pair
with a surgeon and treat such cases.
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Ventricular remodeling is
a surgical procedure that changes the size and shape of the heart with
the goal of improving its function in patients who experience heart
failure. Some of these patients, following a ventricular remodeling
procedure, experience ventricular arrhythmias, which may be life
threatening.
In the past few years, I have been involved with research using cardiac
resynchronization therapy (CRT) to reverse ventricular remodeling,
thereby reducing ventricular arrhythmias. In the study, my colleagues
and I were interested in determining whether CRT would lower the
occurrence of ventricular arrhythmias and appropriate shock therapies.
We found that this therapy improves survival and may reduce sudden
cardiac death, as well as the burden of ventricular arrhythmias. The
study was featured in the October 28, 2008, edition of the Journal of
the American College of Cardiology.
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Last month I talked about
the "firsts" that my colleagues and I bring to our patients. Another
first is unfolding as we begin using the new Siemens Artis Zeego, a
type of robotic fluoroscopy system that allows us to perform real-time
live CT imaging within the EP Lab. This technology provides updated
information on certain anatomical structures of the heart, such as the
left atrium, and helps us guide the catheter during ablation.
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I recently received a
note from Professor Massimo Santini, MD, chairman of the Scientific and
Organizing Committee for the 13th International Symposium on Progress
in Clinical Pacing. Dr. Santini wrote to thank me for my participation
as a keynote speaker during the event.
On a personal level, I was
energized by this conference, which took place in December. Over 2,200
electrophysiologists from more than 40 nations attended. Meeting rooms
pulsated as the diverse group debated topics related to our field. (The
explosion in technology is leading to rapid change – very exciting!) I
am passionate about my work and welcome the opportunity to share
knowledge from my clinical experiences and research. And when the plane
touches down in Austin, it is always energizing to get back to the
heart of what I do – treating patients.
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Over the last few
weeks, as I reflected on the past year and welcomed the new one, I
talked about the excellent care and upbeat environment at St. David’s
Medical Center. These factors are key to successful patient outcomes.
Technology also plays a major role.
In the field of
electrophysiology (like many other medical specialties), it is
important to stay on the leading edge, and to continually research new
and improved techniques. I particularly enjoy the latter, and when my
schedule permits I travel around the world, teaching physicians about
new procedures. In the end, patients benefit when they have access to
the latest technology.
One of the reasons I was attracted to St.
David’s was the willingness of its leadership to invest in technology.
A key example occurred during 2008 when St. David’s became the first in
the nation to implement the CoHesion™ 3D Visualization Module—an
enhancement to the state-of-the-art Hansen Robotic system used to treat
cardiac arrhythmias. With the visualization module, patients are
exposed to about 30 percent less radiation and doctors have greater
ability to move a catheter throughout the heart, as well as increased
control over placement of the catheter. I look forward to bringing to
my patients more "firsts.
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When the clock struck
midnight on December 31, the phrase “Happy New Year” was shouted in
many languages around the world. What does it mean to have a "happy"
new year? Obviously, there are as many answers as there are
individuals, for we each have our own priorities and goals.
One factor that brings joy to me every day is working in an environment
that is positive – or “happy” – throughout the year. Since arriving at
St. David’s, I have noticed that the hospital exudes a positive, upbeat
feeling. The spirit is evident in the EP Labs as well as in the patient
care settings. I feel strongly that my patients are cared for in a
setting that conveys optimism. After all, what I provide to patients is
hope – the chance to live a normal life after struggling with the
challenging symptoms of an irregular heartbeat. So to all, I wish a
happy, healthy, and hopeful new year.
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As 2008 comes to a close,
I reflect on events of the past year. On May 1, we introduced the Texas
Cardiovascular Arrhythmia Institute at St. David’s Medical Center.
Since that date, our group of electrophysiologists has been able to
forge new ground. We continue to bring to Austin patients from around
the world, many who had lived with very complicated cardiac arrhythmias
and had been given no hope. I am proud to say that our team has given
such patients a second chance at living a normal life. But not only are
our physicians leading edge – our staff is superb as well.
As a physician, I must have faith and confidence in the nurses and
electrophysiology staff who care for my patients. I am grateful for the
excellent care provided at St. David’s Medical Center. Out of all HCA
facilities around the nation, the hospital ranks sixth in patient
satisfaction. When I count my blessings for the year, giving my
patients the opportunity for top-rated patient care is definitely among
them.
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Last week, I discussed
research findings published in the New England Journal of Medicine. The
study showed superior results when pulmonary vein ablation was utilized
in heart failure patients with drug refractory AFib.
Research has shown that almost all atrial fibrillation signals come
from the four pulmonary veins. In PVAI, also called pulmonary vein
ablation, a doctor inserts catheters into the blood vessels of the
atrium (an upper chamber of the heart). A special machine delivers
energy through the catheters to the opening of the pulmonary vein. The
energy produces a lesion that blocks impulses firing from within the
pulmonary veins, thereby “disconnecting” the pathway of the abnormal
rhythm and preventing atrial fibrillation.
Success rates for PVAI are defined as a restored normal heart rhythm
without the need for medications. Pulmonary vein antrum isolation has
about an 80 to 85 percent success rate with the first ablation. For
those who have returned for further ablation, the success rate has been
about 95 percent.
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I was pleased with a
study published in the October 23, 2008 issue of the New England
Journal of Medicine. I served as the lead investigator in this
research, which also involved 28 other physicians. The study centered
on a comparison of two forms of ablation – pulmonary vein isolation and
atrioventricular-node ablation with beventricular packing – in patients
who had heart failure and drug refractory AFib. Our findings revealed
pulmonary vein isolation yielded better outcomes. Such findings serve
as helpful guidelines for physicians planning their approach to
treatment. I realize that pulmonary vein isolation may be an unfamiliar
term for individuals reading these posts; next week I will discuss how
the procedure works.
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I truly believe in the
importance of experience. I highly recommend that people seeking
treatment for Atrial Fibrillation locate an electrophysiologist who has
performed many ablations.
Our team has performed thousands of
ablations, most of the time involving complex cases. Often our patients
come to the Texas Cardiovascular Arrhythmia Institute with AFib
compounded by structural defects of the heart. These cases bring
challenges, and also provide great rewards. All of the physicians at
the Texas Cardiovascular Arrhythmia Institute feel gratified when they
are able to cure a patient who was previously told there was no hope.
That is what experience is all about.
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Since I began working
in this field nearly 20 years ago, I have seen firsthand the phenomenal
growth of technology. In the early 1990s, my work was performed during
open heart surgeries. A cardiothoracic surgeon opened the chest and I
performed procedures to correct atrial fibrillation. Today we are
fortunate that technology has given us the tools to treat AFib without
open heart surgery. In place of having open access to the heart, we
perform ablation with the use of specialized catheters.
Technology
has made the ablation procedure safer for the patient, and our team has
access to some of the most leading-edge technology available in the
world. The technology is so accessible that each of our physicians can
select the specific tool most appropriate for the case. Advanced
imaging technology gives us real time information, and mapping
equipment provides precision and accuracy. As part of our commitment to
technology, our physicians are involved in a number of clinical trials.
In one study, the Texas Cardiovascular Arrhythmia Institute is the only
site in the world testing a revolutionary radiofrequency ablation
catheter, which provides electrophysiologists with data that can result
in a more effective ablation. In future postings, I will share more
information on this and other studies.
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I am pleased to
welcome J. David Burkhardt, MD, to the Texas Cardiac Arrhythmia
Institute. Dr. Burkhardt and I have practiced together in the past,
and it is wonderful to once again work with him.
A bit of information on Dr. Burkhardt…
He is board certified in three areas: Internal Medicine, Cardiovascular
Disease and Cardiac Electrophysiology. Dr. Burkhardt’s research in the
field of AFib has been widely published. He enjoys putting his
research findings to work in the clinical setting, especially when
working with patients who have been told that there is no hope. (This
is something we hear frequently.) Dr. Burkhardt, like the other
physicians on our team, is very rewarded when we offer cures for these
very challenging cases.
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I am pleased to
announce that I have been named executive medical director of the Texas
Cardiac Arrhythmia Institute at St. David’s Medical Center in Austin,
Texas, where I have recently begun treating patients.
St. David’s
and Texas Cardiovascular Consultants share the vision of excellence and
progressive patient care necessary to establish the Texas Cardiac
Arrhythmia Institute as the world’s premiere center for training,
research and treatment of heart rhythm disorders. This is just one of
the many reasons why I made the decision to move here.
With the
Texas Cardiac Arrhythmia Institute, St. David’s has technology in place
that is essential to providing the highest level of patient care
available today. In my opinion, there is no other place in the country
that has this kind of structure, expertise and quality of care.
Joining
this innovative team was a deliberate decision to practice with a group
that shares my commitment to providing the highest quality of patient
care, while setting the bar for the treatment of heart rhythm
disorders. I am excited and honored to be a part of such an innovative
and dedicated team of health care providers and look forward to helping
establish the Texas Cardiac Arrhythmia Institute as the world’s leading
center for the treatment of A Fib.
Andrea Natale
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