Maryland Heart Center

Arrhythmias

Arrhythmia Treatments

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Dr. Shorofsky’s Bio | Q&A Archive

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At the Maryland Heart Center we offer a wide range of treatment options for arrhythmias. The treatments we provide depend on the type of arrhythmia, the symptoms that the patient experiences, and the risk of the arrhythmia to the patient’s prognosis. These treatments may include alterations in life-style, medications, a catheter-based procedure to alter the electric properties of the heart (an ablation), a surgical treatment, or implantation of a pacemaker or defibrillator.

Some mild arrhythmias require no treatment. Other arrhythmias can be treated with medicines, or potentially cured with an ablation. If another health problem is causing the arrhythmia, treatment is aimed at taking care of that problem. In more serious cases, other treatments are available.

We are also conducting research on new and experimental treatment methods that may prove to be more effective than current options.

Non-Surgical/Interventional Treatments

Medications: We use a wide variety of medicines, including those that control heart rate and rhythm disturbances (anti-arrhythmia drugs). We specialize in these drugs, and have expertise and experience with all anti-arrhythmia drugs currently available in the U.S.
Ablation: This procedure uses energy to eliminate the tissue in the heart that is causing the arrhythmia. The abnormal electrical tissue is identified during an electrophysiology study -- a procedure that uses a catheter and a device for mapping the electrical pathways of the heart. In special cases, the heart can be reconstructed in 3 dimensions to allow for precise positioning of the catheters. Many arrhytmias can be eliminated using this treatment (see list below).

After you are given medicine to relax you, a catheter is inserted into a vein and guided to your heart. Using high-frequency radio waves, or severe cold, doctors can destroy (ablate) the tissue causing the arrhythmia.

Arrhythmias Amenable to Catheter Ablation:

Ventricular tachycardia
AV nodal reentry
Wolff-Parkinson-White Syndrome
Atrial flutter
Atrial fibrillation
Paroxysmal supraventricular tachycardia
Atrial tachycardia
Inappropriate sinus tachycardia
Sinus node reentry

Implantation of Permanent Pacemaker or Internal Cardioverter Defibrillator: A permanent pacemaker is inserted to provide a reliable heartbeat when the heart's own rhythm is too slow. An internal cardioverter/defibrillator is inserted in patients who are at risk for life-threatening ventricular arrhythmias.

Advanced Pacing Devices for Heart Failure: We are now treating patients who have significant heart failure with special pacemakers and defibrillators. We implant defibrillators and pacemakers that have the ability to pace the heart in special ways to help alleviate the heart failure symptoms (Bi-ventricular pacing).
Cardioversion for Atrial Fibrillation and Atrial Flutter: Cardioversion is the procedure of applying electrical shock to the chest to change an abnormal heartbeat into a normal one.

Surgical Treatment Options (the CryoMaze Procedure)

Currently, treatment of atrial fibrillation is aimed at preventing strokes and improving symptoms. The fast heart rates can be controlled with either medication or placement of a pacemaker after modification of the conduction system in the heart. In many patients, atrial fibrillation can be cured by electrically modifying specific areas of the heart with a catheter.

In rare cases where these therapies don't work and there are debilitating symptoms, the heart can be modified by a surgical procedure during which certain areas are frozen. This surgery, called the cryoMaze procedure, can restore a regular coordinated heartbeat, and can restore coordinated pumping from the upper chambers of the heart. Click here for more information about the cryoMaze procedure.

Please call if you would like to make an appointment or talk to someone about our services. Patients dial 1-866-408-6885, physicians dial 410-328-6622 or 1-800-318-1019.