Arrhythmia Management

Also known as: Irregular Heartbeat

Providence provides a broad array of techniques to manage arrhythmia, or irregular heartbeats.

Mapping and ablation

Ablation is a procedure where the heart’s abnormal rhythm is stimulated, and a radio frequency is applied, creating a pea-sized scar that blocks the abnormal rhythm in the future.
Our three-dimensional mapping and ablation equipment, one of two locations available in Washington, creates the ability to tackle the most difficult cases, providing curative treatment for patients.

Electrophysiology study

An electrophysiology study (EP study) is an invasive catheterization procedure that provides detailed information about the nature and behavior of the heart's internal electrical signals. The EP study maps the heart's electrical activity to pinpoint the exact location of the arrhythmia.

An electrophysiologist (a cardiologist who specializes in clinical cardiac electrophysiology) inserts small platinum and plastic catheters into the heart using one or more veins. As many as six electrocatheters, each containing 4-12 platinum wires, are inserted into the heart and connected to physiologic monitoring equipment.

The procedure takes 1-4 hours and is usually followed by a short period of bed rest. EP study patients are often released on the same day or within 24 hours.

Radiofrequency catheter ablation

This highly sophisticated procedure takes place in the EP Lab and is performed by an electrophysiologist and a specially trained staff. It is used to treat an abnormal rhythm caused by one or more extra heart fibers, or a small region of damaged heart muscle, that generates electrical signals of its own.

During the 3-6 hour procedure, electrode catheters are introduced into the heart, (much like in the EP study), to record the heart's electrical activity. The heart is stimulated electrically to initiate the abnormal rhythm. The catheters are moved around within the heart to pinpoint the source of the arrhythmia. Then the ablation catheter is positioned at the site and radio-frequency current is slowly applied. Application of the frequency current creates a pea-size scar in the heart which blocks the abnormal electrical activity and allows the heart to function normally.

A patient is often allowed to go home in 24 hours and return to work and normal activity soon thereafter. Most often it eliminates the need for rhythm-controlling medication.

Implantable Defibrillators

These tiny devices provide life-saving shock to the patient’s heart when rhythm becomes unstable.


A permanent pacemaker is a small electrical device, surgically implanted in the upper chest, which monitors every heartbeat. The procedure is performed in the Cardiac Catheterization Lab, usually under local anesthesia.

There are many variations of arrhythmias, so a cardiologist must select the proper pacemaker and have it electronically programmed for your specific needs.

The pacemaker monitors heart rhythms as programmed by the cardiologist. When necessary, the pacemaker emits tiny electrical signals to stimulate the heart when the heartbeat becomes too slow, fails to beat within a certain period of time, or if the atria or ventricles beat with no relationship to each other.

Information from the pacemaker can be sent from the telephone to the doctor's office. If adjustments need to be made, they will be taken care of in your doctor's office. Follow-up visits with your physician will be scheduled.

Home monitoring

A recently approved pacemaker uses wireless cellular technology to remotely monitor the pacemaker and patient. This device can be programmed to automatically transmit data about the patient's current condition and the pacemaker system to the physician's office anytime, and from anywhere cellular services are available.

The wireless system requires no patient action. This means that as long as the patient carries the cellular communication device, they can maintain a normal daily routine while their pacemaker maintains regular contact with the physician's office.

The pacemaker communicates with a cellular transmission device similar to a cell phone. Communication from the pacemaker to the doctor's office occurs in several steps but typically takes only minutes to complete. First, the data is sent from the pacemaker to the communication device, which then transmits the data to a service center.

The data is compiled and then faxed to the physician's office in the form of a "Cardio Report." To safeguard the data and ensure accurate transmission, the home monitoring system uses multiple security techniques.

ICD (Implantable Arrhythmia Control Device)

An AIACD (Automatic Implantable Arrhythmia Control Device) is an implanted device used to detect and terminate dangerous ventricular arrhythmias. The generator is two thirds the size of a deck of cards, and is implanted under the collarbone. One or two wires connect the heart and the device through a large vein.

These wires transmit heart rhythm information to the generator, which processes the input and decides whether a pacing therapy or shock is necessary to restore normal beats. It's like having a "paramedic in the chest." This procedure is performed in the Electrophysiology Lab.

Since implantation is a surgical procedure, the patient stays in the hospital for a few days to recover and to determine if the AIACD needs to be electronically adjusted. During this time, the patient and family members receive instructions regarding special considerations to be taken after discharge from the hospital.

Sometimes a repeat EP study is required to reprogram the device before going home. After the patient leaves the hospital, the cardiologist can analyze and make adjustments in the office if needed. Additional patient and family education is provided during office visits.

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