‘Heart Rhythm Care’

Narayana Superspeciality Hospital, Howrah today launched the first Centre for Heart Rhythm Care in Bengal, with Dr Kapil Kumawat, Senior Consultant Cardiologist & Electrophysiologist, Narayana Health City Bengaluru and Dr Munna Das, Consultant Interventional Cardiologist & Electrophysiologist, Narayana Superspeciality Hospital, Howrah. The services can be availed for inpatients everyday, while outpatient services will be functional on every Thursday from 10:00 am to 5:00 pm, the centre will exclusively focus on the diagnosis and treatment of all types of abnormalities in heart rhythm and irregularities in the electrical circuit of the heart causing heart rhythm disturbance.

Heart rhythm disorder or ‘arrhythmia’ is an abnormality in the timing or pattern of the heartbeat. Arrhythmias may cause the heart to beat too rapidly, too slowly or irregularly. Heart Rhythm Disorders are common and may cause a wide variety of symptoms, such as a racing, skipping or fluttering sensation (called palpitations) in the chest.  This mostly happens due to the electrical disorder in the heart.

The general understanding about disorders of heart pertains to those related to coronary arteries, which supply blood to the heart, which leads to problems like angina and heart. Disorders due to electrical systems of the heart are as much prevalent, though rarely diagnosed or treated appropriately. In fact about half the deaths related to heart disease is due to a condition called ventricular fibrillation which is an electrical (heart rhythm) disorder.

Dr Kapil Kumawat Senior Consultant Cardiologist and Electrophysiologist, Narayana Health City, Bengaluru mentioned, “The heart muscle needs electrical impulse to contract. There is a whole electrical system – complete with generator, wiring and even junction boxes, in the heart to provide this electrical impulse in a coordinated way in the four chambers of heart.” He also added, “The main mode of diagnosis and treatment in Centre for Heart Rhythm Care is Interventional Electrophysiology, which includes Electrophysiology study and Radio-frequency ablation for common arrhythmias.  Radio-frequency ablation is a minimally invasive procedure done in cath-lab. There would be Ablation for complex arrhythmias using 3-D mapping system as well.”

 

Dr. Munna Das, Consultant Interventional Cardiologist & Electrophysiologist, Narayana Superspeciality Hospital, Howrah said, “Many people with Arrhythmia are not even aware of it and get to know about it when the problem becomes extremely serious. Hence it’s very important to create awareness about arrhythmia as patients can be saved if they are alert of the symptoms, solutions and are treated immediately.”

 

 

Types of Heart rhythm disorders (Arrhythmia)

 

·         “Extra” heart beats  (ectopics): mostly harmless.

·         Bradycardia: too slow heart rate. Many of them need artificial pacemaker.

·         Tachycardia : heart rhythm too fast. These need medicines, electrophysiology study and RF ablation and/or ICD (Implantable Cardioverter Defibrillator).

 

Treatment of Heart Rhythm disorders

Most of the times medications are attempted first, but in certain serious disorders medicines alone are not effective.

Patients with very slow heart rates (bradycardia) due to diseased natural pacemaker (Sinus node disease) or heart block (in conduction of electricity, and not block in blood supply), need artificial pacemaker implantation. Artificial pacemaker is small metal box, is implanted under the skin, just below collar bone, using local anesthesia only. It monitors rhythm of heart and if needed delivers electrical impulse if it senses absence of heart’s own rhythm.

Certain types of rapid heart beats, known as tachycardias, are caused by abnormal electrical pathways in the heart that disrupt or short circuit the cardiac electrical signal.  In these cases, if the abnormal pathways can be treated and eliminated, the tachycardia often goes away permanently. This is achieved by a procedure called Catheter Ablation or Radiofrequency ablation (RFA). This is done in same way as Electrophysiology study (see above) and once the precise location is confirmed, the “short-circuit” or ‘abnormal focus’ is either destroyed or blocked. This is done by sending energy through the catheters to destroy a small amount of tissue at the site.

Cardiac ablation is an effective treatment for many types of arrhythmias. It is successful in 90 to 98 percent of cases, eliminating the need for long-term drug therapy.

 

Sudden Cardiac Arrest (SCA)

This accounts for about half of all heart disease deaths. Due to lack of awareness, often ‘Cardiac arrest’ is spoken to of as ‘Heart Attack’ or vice versa. But they are very different (though sometimes related) condition, each requiring a very different approach. In Sudden Cardiac Arrest, the heart stops working because of a malfunction in the electrical system that controls the heartbeat. This is different than a heart attack; which is basically a clogged or narrowed artery blocking the flow of blood to the heart. The reduced blood flow during a heart attack damages the heart muscle, but doesn’t necessarily stop the heart or result in death.

The most common cause of SCA is ventricular fibrillation (VF) a dangerous and abnormal heart rhythm. Immediate Treatment for Cardiac Arrest: With no blood getting to the brain, a person experiencing ventricular fibrillation loses consciousness in seconds. SCA and death can follow within minutes unless the heart is quickly shocked back into its normal rhythm, using a defibrillator (a machine that delivers an electrical shock to the heart).

Arrhythmias may occur at any age but are more common among older people. Many types of arrhythmia are nothing to be worried about while few types are serious problems because they cause the patient to develop heart failure, leading to sudden death due to cardiac arrest. Sudden cardiac death (Cardiac Arrest) is the cause of about half of deaths due to cardiovascular disease or about 15% of all deaths globally. About 80% of sudden cardiac death is the result of ventricular arrhythmias (heart rhythm disorders). About 20 per cent of heart patients suffer from some form of arrhythmia. Heart rhythm disorders can occur even in completely healthy people, with a normal heart. Hence is the need of an exclusive Centre for Heart Rhythm Care.  

The dedicated centre for heart rhythm care with a team of doctors and nurses trained in the diagnosis and treatment of heart rhythm disturbance will be available round the clock apart from special OPD consultation and screening every Thursday. The reason to launch the clinic is to ddiagnose heart rhythm problems using state-of-art technology, treatment, using modern evidence based methodology and follow-up of patients treated.

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