In Cardioversion a timed electrical shock is used to convert the heart from an arrythmia (abnormal heart rhythm) to a normal rhythm. Cardioversion may be performed in an emergency situation if the heart is beating abnormally and not pumping blood to the body.
Other times, cardioversion is scheduled ahead of time to treat an arrhythmia (most often atrial fibrillation) that is not making the patients acutely ill but has not responded well to medication. For a scheduled cardioversion, you are sedated and your breathing is assisted. The doctor then delivers an electrical shock from a defibrillator to the heart through pads placed on your chest and back. The electrical shock will convert your heart back to a normal rhythm (that's why it's called cardioversion).
Expect to be in the hospital for 3 to 4 hours if you are scheduled for a cardioversion.
Sometimes arrhythmias cannot be controlled with lifestyle changes and medication. Catheter ablations are used to treat or eradicate arrhythmias that arise in the atria (upper chambers) or ventricles (lower chambers) of the heart and are associated with rapid heart beats.
Catheter ablation is a non-surgical procedure, but it is invasive and requires inserting a catheter into your heart from a vein in your groin or neck area. You will receive local anesthesia and mild sedation for the procedure. Catheter ablations can take several hours to complete. You can expect to stay overnight in the hospital after your catheter ablation.
Sometimes a heart arrhythmia results in a slow and inadequate heart rate (bradycardia). Your doctor may recommend a pacemaker if you have persistent symptomatic bradycardia. There are different types of pacemakers; your doctor will discuss the best option for you.
A pacemaker implantation is a surgical procedure which takes about 2 hours. You are sedated and your upper chest where the pacemaker will be inserted is treated with a local anesthetic. During the procedure a catheter is inserted under your collar bone into a vein through which thin wires or leads are threaded into one or more chambers of your heart. These leads are connected to a pacemaker generator which consists of a miniature computer and a battery to deliver electrical signals to your heart. The generator weighs about an ounce and is implanted just under your skin below your collar bone. Once the generator is programmed, the pacemaker will regulate the impulses that signal your heart to contract or beat.
Plan to be in the hospital overnight after your pacemaker implant.
Cardioverter-Defibrillator Implant (ICD)
Some rapid heart arrhythmias such as ventricular tachycardia or ventricular fibrillation are associated with sudden cardiac death. If you have had or are at risk for one of these arrhythmias your doctor may recommend that you get an implanted cardioverter-defibrillator (ICD).
The type of ICD you get will depend on your arrhythmia and heart health history. Most ICDs also have the ability to function as a pacemaker to regulate your heart beat if necessary.
The implant is a surgical procedure similar to a pacemaker operation which takes about 2 hours. During the procedure a catheter is placed under the clavicle and the ICD leads are inserted into one or more chambers of your heart. These leads are connected to the ICD generator. The ICD generator is also a computer and battery but is somewhat larger than a pacemaker and has a larger battery since the device must be capable of delivering enough electrical energy to accomplish a cardioversion if this is necessary. Once programmed, your ICD can stop potentially life-threatening rapid heart beats by overriding or resetting your heart rate or by delivering an electrical shock.
Plan to be in the hospital overnight after your device implant.
Cardiac Resynchronization Therapy (Bi-Ventricular Device Implant)
Cardiac Resynchronization involves implantation of a particular kind of pacemaker that can stimulate both the left and the right ventricles (pumping chambers) to better co-ordinate the beating of the heart. Just as in a standard pacemaker implant, in cardiac resynchronization therapy wire leads are placed in the heart and attached to a generator. This treatment may be effective in people with chronic heart failure (CHF). The leads electrically stimulate the heart muscle so that contractions of the heart's two lower chambers, the ventricles, are synchronized. Synchronized contractions result in more effective pumping of the heart. People with heart failure often find they feel better and have more energy after a bi-ventricular pacemaker implant.
Placement of a bi-ventricular pacemaker is similar to that of a regular pacemaker. The procedure may take 3 to 4 hours. Plan to be in the hospital overnight after your implant.
Loop Recorder Implant
A Loop Recorder is a small device that is implanted under your skin, near your breastbone. The purpose of the device is to detect abnormal heart rhythms (arrhythmias) that may be difficult to detect by other means.
Implanting a Loop Recorder takes about 15 to 20 minutes and can be done under a local anesthesia. The doctor makes a small incision (3/4 of an inch) on your chest, creating a pocket the same size and shape as the Loop Recorder device. The device is inserted in the pocket and is programmed to record your heart rate and rhythm (electrocardiogram or ECG) when you feel symptoms or during a fainting episode.
The Loop Recorder can remain in place for a period of time. Once it records an episode of arrhythmia or when your doctor can make a determination about your symptoms or fainting episodes, the device can be removed.