When does one see the results after cardiac ablation?

In most cases, patients require several treatments to complete destroy the abnormal electrical pathways in the heart. Unfortunately, even after treatment, many patients still need to take medications for a long time. Cardiac ablation does decrease the frequency of certain abnormal rhythms but in many cases, drug therapy is still required afterwards. To keep your heart healthy, avoid smoking, maintain decent weight, avoid too much caffeine and alcohol, and exercise on a regular basis.

How is cardiac ablation done?

In most cases it is done in a cardiac laboratory which has full monitoring capabilities. You will be hooked on to a monitor and have an IV started,. You may also receive medications to help your relax. A small tube will be inserted in a groin vessel and wire will be passed through it all the way to the heart. The producer is done under x-ray. The doctor will then locate the abnormal pathways in the heart and use heat energy to destroy them. This will stop any abnormal electrical activity going through the scar tissues. The procedure may take 2-6 hours. Most people require an overnight stay in hospital.

Does cardiac ablation have any complications?

Sure, like any procedure on the heart, there are certain risk. The following can occur:

Bleeding at the groin site where the catheter was inserted

Damage to the blood vessel

Puncture of the heart with the wire

Damage to the heart's electrical system

Heart attack or stroke

The dye used during the procedure can damage the kidneys. The risks of dye injury to the kidney are increased in diabetics or those with existing renal disease. In general cardiac ablation tends to be of high risk in elderly people.

Why is cardiac ablation done?

In some people, the abnormal heart rhythms are recurrent and not controlled with medications. In others, the adverse effects of medications cannot be tolerated. Cardiac ablation is done for abnormal heart rhythms that are considered to be of high risk like Wolff Parkinson white syndrome. In such cases, cure is possible with cardiac ablation.

What exactly is cardiac ablation?

Cardiac ablation is a fancy name to describe a procedure that can terminate the abnormal heart rhythms. The treatment involves use of a flexible wire that is inserted through the groin vessel and moved towards the heart. The origin of the abnormal heart rhythms in the heart are located and destroyed by heat energy. This helps prevent abnormal heart rhythms. In some cases, cardiac ablation is done during open heart surgery. Today most cardiologists perform the ablation in the cardiac lab and there is no surgical incision involved. Like any procedure, you need to be fasting for 8-12 hours. You maybe told to stop taking some of your heart medications a few days prior to the procedure.

When are results of holter monitor available?

Once the monitoring is over, the device is handed back to the doctor. The electrodes are removed and the list of your symptoms will be given to the doctor. The doctor will then interpret the symptoms with any changes in heart rhythm. It usually takes about 3-5 days before the results are available. If the holter fails to record any abnormal heart rhythm, your doctor may then order an event recorder. This is a small finger tip like device that is inserted under the chest skin using local anesthesia. It can record heart rhythms for up to a month.

Is the holter monitor safe?

Yes, the holter monitor is a non invasive device. It does no harm nor does it generate any electrical shocks. However, the holter monitor can be damaged by rough handling, water or any other liquids. The holter monitor is not affected by microwave ovens or computers. When going through metal detectors, the holter monitor needs to be removed. The holter monitor is usually placed at the doctor’ office. Electrodes on sticky tape are attached to the skin and the leads are attached to the holter device. The holter is then worn around the neck. In addition, you will also be told to record any abnormal symptoms (chest pain, shortness of breath palpitations,) and the time when these symptoms appear. The holter can be worn anytime, but for most patients, weekends are convenient.

Why is a holter monitor used?

There are some people who gave an irregular heart rate or may complain of palpitations. The ECG in these patients is often unrevealing. In order to detect abnormal heart rhythms, a holter monitor is used. The holter is able to detect abnormal rhythms that may occur for a few seconds or minutes. A holter monitor is often used to record heart rhythms in patients suspected of having paroxysmal atrial fibrillation or hypertrophic cardiomyopathy.

What is a holter monitor?

A holter monitor is a small device that can record the heart rhythm over a few days. In most cases, the holter monitor is worn for 2-3 days. The holter is usually used to assess the heart rhythm in patients. The portable recording device comes with electrodes. The holter monitor must be worn continuously and can be of some inconvenience. You can do most daily living activities but should not participate in sports. At the end of 3 days, the holter is returned back to the doctor who can then determine the heart rhythm over the past few days.

What are the results after a ventricular assist device?

These devices are difficult to look after and a team of surgeons, nurses and other specialists will most likely follow you. You definitely wont be able to work. Most people need to be close by to a heart transplant center in case something happens. You will be closely monitored on a daily basis. While waiting for a transplant, you will be enrolled in an exercise program.

What are risks of a ventricular assist device?

These devices have connections that need to be sutured on to the large blood vessels around the heart. Hence bleeding is a very common complication. Secondly, inserting artificial material in the body also increases risk of blood clots. Therefore, a blood thinner is often prescribed to patients who receive a VAD. Infection of the pump or power source can occur. In such cases, the entire device may have to be removed. Device malfunction is a very common complication and usually require immediate attention.

What exactly is a ventricular assist device?

A ventricular assist device is an implantable pump that is often used in people who have a failing heart. This device can help pump blood to the rest of the body. There are many types of such devices- some which are implanted on the left side and others on the right side of the heart. The majority of people who have a ventricular assist device are waiting for a heart transplant. In some cases, these devices are used to support the body while the heart is recovering. 

VAD are inserted by a cardiac surgeon and have serious complications. When inserted with care, these devices can be life saving.

What changes can I make in my life to lower my cholesterol?

Lifestyle changes are a key to lowering blood cholesterol. This is not a one shot deal but has to be lifelong. The first thing you should do is quit smoking and starting eating a healthy diet. You must incorporate some type of exercise. Walking 30 minutes twice a day is as good as any other exercise. 

If you remain motivated, not only will you lose weight, this will lower your blood pressure and blood sugars. In the end, you save money by reducing the need for medications.

Should I be taking statins?

Statins have been around for 2 decades and newer agents continue to be developed. These drugs act by lowering blood cholesterol and decrease the risk of forming plaques in your blood vessels. Eventually, this prevents angina and heart attacks. The available statins include lipitor, mevacor, zocor, crestor and pravachol. They all act in a similar fashion. There are also generic statins available which are more affordable. 

Statins are generally recommended if you have risk factors for heart disease. However, if you only have high cholesterol, the first step is to change your diet and exercise. In most people, lifestyle changes can help lower cholesterol and avoid the need for statins.

When will I see the benefits of angioplasty?

The results are usually immediate. The procedure will improve blood flow to your heart. Your chest pain will decrease and you may develop more exercise endurance. However, in order to sustain the benefits of angioplasty, you will need to 1) stop smoking, 2) lower your blood cholesterol 3) decrease your weight if you are obese, 4) control your diabetes/hypertension and 5) exercise regularly. If you remain motivated, you may avoid open-heart surgery in future.

How is angioplasty usually done?

Angioplasty is usually done in a cardiac lab. you have to be fasting for the procedure. The procedure takes about an hour. A dye is used to decipher the anatomy of your blood vessels. During the procedure, you will be monitored and also be given some sedation. The procedure is not painful. Prior to the procedure, you will undergo blood tests, ECG and a chest x-ray. After the procedure, you will need to rest for 6-8 hours and will need someone to drive you home.

Does angioplasty have any risks?

Sure, like any procedure, there are risks but they are small. Some of the risks associated with the procedure include the following:

Renarrowing of the blood vessel. This occurs in 30% of people in the first year. To prevent this from happening, stents are used

Formation of blood clots can occur if the patient does not take blood thinning medications, like aspirin or plavix

Bleeding may occur at the groin site where the procedure is done. Today, many cardiologists perform the procedure using the vessel in the hand and hence this complication is very rare.

Other rare complications include a heart attack, damage to the coronary vessel, stroke and abnormal heart rhythms.

What exactly is an angioplasty?

When a blood vessel in your heart becomes narrowed, it can lead to chest pain and even a heart attack. An angioplasty is a procedure that can be used to open up clogged blood vessels. The procedure is usually done in a special lab. Angioplasty is often combined with stenting to keep the blood vessel open. Angioplasty is far more effective than medications at opening blood vessels. Unfortunately, angioplasty may not always work and is not suitable for all types of narrowed blood vessels. In addition, even after angioplasty, if you do not change your lifestyle, the vessel may re-develop narrowing.