Performing the most electrophysiology inpatient procedures annually in Oregon, the arrhythmia services’ specialists of Providence Heart and Vascular Institute are your experts in the treatment of heart rhythm conditions. Arrhythmias are prevalent heart conditions that may diminish a patient’s quality-of-life or result in sudden cardiac death if left untreated. Arrhythmia services are among Providence Heart and Vascular Institute’s comprehensive interventional cardiovascular services and are provided at two of our Portland-area hospitals: Providence Portland Medical Center and Providence St. Vincent Medical Center. In addition, Providence St. Vincent Medical Center is home to the Center for the Advanced Treatment of Atrial Fibrillation, a comprehensive center with a focus on the treatment of the most commonly diagnosed heart rhythm disorder.
State-of-the-art treatments and technology
Ashkan Babaie, M.D., electrophysiologist in private practice with The Oregon Clinic
Providence Heart and Vascular Institute offers state-of-the-art cardiovascular laboratories that are fully-equipped to facilitate invasive electrophysiology studies as well as pacemaker and implantable cardioverter defibrillator (ICD) implants. Our board-certified electrophysiologists perform inpatient arrhythmia procedures, provide inpatient consultation in the telemetry and coronary care units, and provide outpatient diagnostic and consultation services. From diagnosis to treatment to follow-up, the heart rhythm specialists of Providence Heart and Vascular Institute work collaboratively with each patient’s primary care physician, cardiologist, and other specialists to ensure appropriate, effective diagnosis and treatment. (back to top)
Diagnostic electrophysiologic studies
Electrocardiogram (ECG) Sensors, or electrodes, detect the electrical activity of the heart by measuring the timing and duration of each electrical phase in the heartbeat. Holter monitor. A portable ECG device worn for a day or more records the heart's activity during the normal daily routine. Event monitor For sporadic arrhythmias, a portable ECG device is attached to the body and activated only when the patient experiences symptoms of an arrhythmia. An ECG strip of the preceding few minutes and following few minutes is recorded. Echocardiogram A hand-held device (transducer) placed on the chest uses sound waves to produce images of the heart's size, structure and motion. Stress test To determine if the arrhythmia is triggered or worsened by exercise, heart activity is monitored by an ECG during a work-out on a treadmill or stationary bicycle. For patients who find it difficult to exercise, drugs may also be used to stimulate the heart in a way that is similar to exercise. Tilt table test For patients with recurrent fainting spells, the heart rate and blood pressure are monitored as the patient is positioned flat on a table. While the table is tilted as if the patient were standing up, the doctor observes how the heart — and the nervous system that controls the heart — respond to the change in angle. Electrophysiologic testing and mapping Thin, flexible tubes, or catheters, tipped with electrodes are threaded through the blood vessels to a variety of spots within the heart. The electrodes precisely map the spread of electrical impulses through the heart, or may be used to stimulate the heart to beat at rates that may trigger — or halt — an arrhythmia. The ability to start and stop the arrhythmia is used to observe the location of the arrhythmia and the mechanisms that may be causing it or to test various treatment methods for effectiveness. (back to top)
Arrhythmia treatments
Radiofrequency catheter ablation Generally considered the preferred first-treatment method for many types of arrhythmias difficult to treat with medications, catheter ablation causes little discomfort and is performed under mild sedation with local anesthesia. One or more catheters are threaded through the blood vessels to the inner heart, positioned along electrical pathways suspected of causing the arrhythmia. Electrodes at the catheter tips are heated with radiofrequency energy, which destroys (ablates) a small spot of heart tissue and creates an electrical block along the pathway causing your arrhythmia. Radiofrequency catheter ablation is most commonly used to treat —
AV nodal reentry tachycardia
Accessory pathways
Atrial fibrillation and atrial flutter
Ventricular tachycardia
Implantable cardioverter defibrillator (ICD) An electronic device that constantly monitors the heart rate and rhythm, and ICD delivers energy to the heart muscle when it detects a very fast, abnormal heart rhythm, causing the heart to beat in a normal rhythm again. Primary candidates for ICDs include patients with previous episodes of sudden cardiac death or ventricular fibrillation; previous heart attack victims at high risk for sudden cardiac death; patients with hypertrophic cardiomyopathy; or patients with at least one episode of ventricular tachycardia. The ICD is programmed to include one or all of the following functions:
Anti-tachycardia pacing
Cardioversion
Defibrillation
Bradycardia pacing
Pacemaker Using a small, battery-powered generator to deliver timed, electrical impulses to the heart muscle through tiny wire leads, a pacemaker helps a patient’s heart beat in a regular rhythm. Traditional pacemakers may have one lead, pacing only the ventricles or the atria, or two leads, pacing both chambers. A more recent innovation in the treatment of arrhythmias, a biventricular pacemaker uses three leads to treat the delay in heart ventricle contractions. This new therapy improves the symptoms of heart failure (fatigue, shortness of breath and exercise intolerance) and the person's overall quality of life. Primary uses for pacemakers include the treatment of:
