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Conditions & Procedures

Conditions
Procedures
  • heart icon
    Cardiac Resynchronization Therapy device implantation ( Bi-Ventricular device)
    Cardiac Resynchronization Therapy is used to treat the delay in heart ventricle contractions that occur in some people with advanced heart failure and can help the heart pump blood more efficiently by coordinating the contractions of the heart’s lower chambers. Heart failure means that the pumping power of the heart is weaker than normal and that not only does the blood move throughout the body at a slower pace, but that the pressure in the heart increases. Because there is a delay between the contractions of the right and left ventricles (meaning that they don’t contract at the same time), the Bi-Ventricular device is needed. Cardiac Resynchronization Therapy is accomplished by surgically implanting an electronic, battery-powered, microcomputer device under the skin. The device uses small electrical pulses to both sides of the bottom of the heart, causing the lower chambers to beat together and more efficiently, which can help the heart pump blood throughout the body more efficiently.
    Expanded Link

    Once implanted, the device detects your heart rhythm through thin, insulated wires called leads, which are placed on or inside the heart muscle and attached to the device. When the device detects an abnormal heart rhythm, it sends an electrical shock to your heart muscle. The purpose, and end result, is improved cardiac function.

    Cardiac Resynchronization Therapy improves symptoms of heart failure in about 50 percent of patients who have been treated maximally with medications but still have severe or moderately severe heart failure symptoms. Not only does it improve survival rate, quality of life, heart function and the abilities to exercise, it also helps to decrease hospitalizations in select patients with severe or moderately severe heart failure.

    Related Conditions
    Heart attack
    Heart failure
    Cardiomyopathy (dilated)
    Atrial fibrillation and ventricular fibrillation (AFib and VFib)
    Facility
    • Memorial Regional Hospital
    • Memorial Hospital Miramar
    • Memorial Hospital Pembroke
    • Memorial Hospital South
    • Memorial Hospital West
    • Florida Medical Center
    • Jackson North Medical Center
    • Aventura Hospital & Medical Center
    • Jackson North Medical Center
    • North Shore Medical Center
    • Westside Regional Medical Center
    • HCA Florida University Hospital
    FAQ's

    Why do I need a CRT-D device?

    When medications and lifestyle changes don’t help symptoms of heart failure, your doctor might recommend an implanted device as the best course of action.

    How often do I need to see my doctor once the device is implanted?

    You will still need to visit your cardiologist or physician regularly so he/she can monitor your progress with the device. Visits will be more frequent after the surgery to review how the incision is healing and also to make any necessary tweaks to the device.

    What happens when the battery needs to be replaced?

    Implantable devices have batteries that last a long time, typically three to 10 years depending on the device and how often it sends electrical impulses to the heart. The battery will not suddenly die, but will give you plenty of warning that it needs to be changed. When it indicates that it does have a low battery, your doctor will not change the battery, but simply change the entire device. This surgery will not typically last as long as the implant surgery because your doctor will plug the new device into your already existing heart leads.

    Can I use a cell phone?

    Yes, just make sure to take extra precautions, such as not carrying your cell phone in your breast pocket and using the ear farthest from the device to talk on the phone.

    Will I have any dietary restrictions?

    The restrictions would be the same for any heart-healthy diet, including enjoying foods low in sodium, fat and sugar, and high in fiber and carbohydrates.

    Can I travel?

    Your doctor is the best source of insight for travel capabilities, but, with most patients who have a device, travel is safe with a little extra planning. You should not have any issues passing through airport security, but make sure you have your identification card just in case. If airport security needs to perform a pat-down search with the use of a wand, just inform them to expedite the wand scanning and not to hold it over the device for longer than a second.
    Post Operative Instructions
  • heart icon
    ICD Implantation
    An implantable cardioverter-defibrillator (ICD) is a pager-sized device that is placed in your chest to reduce your risk of dying should the lower chambers of your heart (ventricles) go into a dangerous rhythm and stop beating effectively (cardiac arrest). The device is typically implanted in your chest, just below the collarbone, and contains a battery and a tiny computer that is housed in a small titanium case. Small insulated wires are also implanted to carry signals from your heart to the device and to deliver needed therapy to your heart. Expanded Link

    ICDs continuously monitor your heartbeat and deliver electrical pulses to restore heart rhythm when it detects any abnormal heartbeats. You might need an ICD if you have a dangerously fast heartbeat or a chaotic heartbeat that prevents your heart from supplying enough blood to the rest of your body.

    ICDs uses these electrical pulses or shocks to treat life-threatening arrhythmias that originate in the lower chambers of the heart. When ventricular arrhythmias occur, the heart is unable to pump enough blood to your body and you could potentially pass out within seconds and die within minutes if not treated. To prevent death from these lower heart arrhythmias, the heart must be treated right away. The device can treat these ventricular arrhythmias with lower energy pulses to disrupt the arrhythmia and convert the heart back to a normal rhythm. If these low energy pulses aren’t successful, the device will deliver a shock directly to the heart to reset the heart into a normal rhythm.

    Related Conditions
    Atrial fibrillation (AFib)
    Heart attack
    Low blood pressure
    Sudden cardiac arrest
    Arrhythmia
    Cardiomyopathy
    Abnormal heart rhythms
    Ventricular fibrillation (VFib)
    Facility
    • Memorial Regional Hospital
    • Memorial Hospital Miramar
    • Memorial Hospital Pembroke
    • Memorial Hospital South
    • Memorial Hospital West
    • Florida Medical Center
    • Jackson North Medical Center
    • Aventura Hospital & Medical Center
    • Jackson North Medical Center
    • North Shore Medical Center
    • Westside Regional Medical Center
    • HCA Florida University Hospital
    FAQ's

    What should I expect during implantable cardioverter defibrillator (ICD) surgery?

    Placing the ICD requires minor surgery that is usually performed in a hospital. You will be given medicine that will help you to relax but remain conscious, medicine to numb the area, and also antibiotics to prevent infections. Your doctor will then thread the ICD wires through a vein to the correct place in your heart, and, once in place, will make a small cut into the skin of your chest or abdomen and will place the ICD just under the skin. The ICD contains the battery, pulse generator and computer. Your doctor will then give you medicine to sleep while he/she tests the device (so you don’t feel any electrical pulses) and, after successful testing, will sew up the cut. The entire procedure takes a few hours.

    What happens when I receive a shock?

    Experiencing a shock from an ICD can be a concern for many individuals. An implantable defibrillator shock will most likely take you by surprise. You may feel fine afterward, or you may feel dizzy, sick, or disoriented after the shock occurs. It’s important to talk to your doctor and have a plan in place so that you know exactly what to do when you experience a shock. Your doctor may want you to call in or schedule an appointment after you’ve had a shock

    Will the device affect my appearance?

    Overall, you can expect to see/feel a slight bump underneath your skin where the implant was placed.

    Will I have to change my lifestyle?

    This heart device won’t limit you from taking part in sports and exercise and should allow you to enjoy activities you’ve always enjoyed. It might be a good idea to avoid full-contact sports, such as football, as contact sports might shake loose the wires in your heart. In general, it is always a good idea to consult with your doctor if you are concerned or are thinking of enjoying a new activity.

    Where can I find additional resources?

    Not only are there are a lot of good resources online, but your doctor is a great source of information. You can find out more information on asktheicd.com, which is a website based on all things ICD related.
    Post Operative Instructions
  • heart icon
    Implantable Cardiac Monitor (Loop)
    An implantable cardiac monitor is a tiny device (less than 2”) implanted underneath the skin that can help to diagnose cardiac arrhythmias. It will detect and record any electrical signals of your heart and detect any arrhythmias that may occur. The recorder can record your heart rhythm for up to three years and can answer questions about your heart that other heart-monitoring devices cannot provide. Because it allows for long-term heart monitoring, it can capture information that a standard electrocardiogram (ECG or EKG) or Holter monitor missed because some of the heart rhythm abnormalities occur infrequently. Since the recorder monitors heart signals for a long period of time, it’s more likely to capture what the heart is doing during your next fainting spell and provides your doctor with information so he/she can make a definite diagnosis and develop a treatment plan. Expanded Link
    Related Conditions
    Malignant arrhythmia
    Complications of myocardial infarction
    Hypertensive heart disease
    Pediatric ventricular tachycardia
    Arrhythmogenic right ventricular dysplasia (ARVD)
    Cardiac risk index in noncardiac surgery
    Facility
    • Memorial Regional Hospital
    • Memorial Hospital Miramar
    • Memorial Hospital Pembroke
    • Memorial Hospital South
    • Memorial Hospital West
    • Florida Medical Center
    • Jackson North Medical Center
    • Aventura Hospital & Medical Center
    • Jackson North Medical Center
    • North Shore Medical Center
    • Westside Regional Medical Center
    • HCA Florida University Hospital
    FAQ's

    Why might I need a loop recorder implanted?

    Your doctor might recommend a loop recorder if you have fainting episodes or palpitation, and other tests have not yet given you any answers. Repeated fainting can have a negative effect on your physical and emotional health, and can increase your chance for sudden death. A loop recorder will also be helpful if your doctor wants to look for very fast or slow heartbeats, which can cause palpitations or even lead to strokes.

    What are the risks associated with the loop recorder?

    Most patients have no complications with the procedure. However, sometimes problems occur, which could include: bleeding or bruising, infection, damage to your heart or blood vessels, or mild pain at your implantation site.

    How do I prepare for loop recorder implantation?

    Your provider will be able to best prepare you for surgery. You may need to avoid eating or drinking anything before the midnight prior to your procedure. Do not stop taking any of your regular medications unless your provider tells you to do so.

    What happens during surgery?

    The surgery is considered to be minor. You will be given a medicine to help you relax and a local anesthetic will be put on your skin to numb it. Your doctor will make a small incision in your skin, usually in the left upper chest. He/she will then create a small pocket under your skin and will place the loop recorder in the pocket. The machine is about the size of a flat AA battery. The incision will then be closed with sutures and a bandage will be placed on the area.

    What can I expect after implantation?

    In most cases, you will be able to go home the day of the procedure, but will need someone to drive you home. You are able to return to your normal lifestyle after the procedure, but may want to rest. The recorder comes programmed to record certain fast and slow heart rates, and will also come with a handheld activator that tells the loop recorder to save the signals collected over a certain period of time. You may keep the loop recorder for two to three years and, when you no longer need it, it can be removed in a similar procedure.
    Post Operative Instructions
  • heart icon
    Lead Extractions
    A lead is a special wire that transmits energy from a pacemaker or implantable cardioverter defibrillator (ICD) to the heart muscle. A lead extraction is the removal of one or more leads from inside the heart. Your doctor might determine that your lead or leads need to be removed because of damage to the inside or outside of the lead, large amounts of scar tissue forming at the tip of the lead, an infection at the site of the device and/or lead, or a blockage of the vein by a clot of scar tissue. Expanded Link

    The lead extraction is performed in two ways, either the Subclavian Approach or the Femoral Approach. The Subclavian Approach is the most frequently used approach, and is when the leads are extracted through an incision in the upper chest over the subclavian vein. The Femoral Approach is used when the Subclavian Approach is not possible, and when the leads are removed through a small puncture in the groin over the femoral vein.

    Related Conditions
    Atrial Fibrrilation
    Sudden cardiac arrest
    Facilities
    • Memorial Regional Hospital
    • Memorial Hospital Miramar
    • Memorial Hospital Pembroke
    • Memorial Hospital South
    • Memorial Hospital West
    • Florida Medical Center
    • Jackson North Medical Center
    • Aventura Hospital & Medical Center
    • Jackson North Medical Center
    • North Shore Medical Center
    • Westside Regional Medical Center
    • HCA Florida University Hospital
    FAQ's

    How is the procedure performed?

    The procedure is performed under general anesthesia. For patients who are dependent on the pacing function of their device, a temporary pacing wire is placed through a vein in the groin. The doctor will attempt to remove the leads using gentle traction. If they cannot be removed, the leads are prepared using a laser or cutting sheath. If there is no infection and new leads are needed, they are implanted during the same procedure, which can last several hours in total.

    What are the risks for lead extractions?

    All heart procedures have inherent risk. Life-threatening complications can possibly occur during lead extraction, and can include tearing the veins that the leads travel through perforating the heart muscle. In rare instances, open heart surgery may be required to repair the injury. However, in a large study where patients underwent lead extraction, less than one percent of patients required emergency surgery or other intervention.

    What are the alternatives to lead extraction?

    Most often, patients who have an infection in the blood stream or at the pacemaker or ICD pocket do not have an alternative to extraction because antibiotics can not usually cure an infection while there is a presence of foreign material in the body. On the other hand, patients who need an extraction for reasons unrelated to infection have an option to leave the leads in place. This could happen when a lead malfunctions or there is a need for an upgrade from a pacemaker to an ICD is needed. Your doctor will help to decide if the risk of leaving a lead in place is a more suitable option than the risk of lead extraction.

    What is the recovery after lead extraction?

    For uncomplicated case, the recovery is similar to the recovery time for the initial implant. There can be mild pain and discomfort at the incision site that could last for days to weeks. If a new lead or leads are implanted, precautions are taken for several weeks to prevent the lead from dislodging. Your doctor will more than likely recommend follow-up for one to two weeks after the procedure.
    Post Operative Instructions
  • heart icon
    Ablation
    Cardiac ablation is a procedure to correct heart rhythm problems (arrhythmias). The procedure works by scarring or destroying tissue in the heart that triggers or sustains abnormal heart rhythm. In some cases, cardiac ablation prevents abnormal electrical signals from entering the heart and stopping arrhythmia. Expanded Link

    Cardiac ablation usually uses long, flexible tubes (catheters) inserted through a vein or artery in the groin and threaded to the heart to deliver energy in the form of heat or extreme cold to modify the tissues in the heart that cause arrhythmia. The use of catheters makes the procedure less invasive and shortens recovery times, but, in some cases, it is done through open-heart surgery.

    Related Conditions
    Arrhythmia
    Atrial fibrillation
    Facilities
    • Memorial Regional Hospital
    • Memorial Hospital Miramar
    • Memorial Hospital Pembroke
    • Memorial Hospital South
    • Memorial Hospital West
    • Florida Medical Center
    • Jackson North Medical Center
    • Aventura Hospital & Medical Center
    • Jackson North Medical Center
    • North Shore Medical Center
    • Westside Regional Medical Center
    • HCA Florida University Hospital
    FAQ's

    How do I know if ablation is right for me?

    If you battle with common symptoms of atrial fibrillation, including irregular heartbeat, heart palpitations and/or rapid heart rate, ablation might be a good option for you. Ablation is generally recommended for patients whose AFib symptoms do not respond to at least one antiarrhythmic drug or when the patient cannot tolerate medication. Ablation is also recommended for some AFib patients who have heart failure or a reduced ejection fraction.

    What does the procedure entail?

    You will be given intravenous medication prior to the procedure to help you relax. After the medication has taken effect, your doctor will numb an area on your arm, neck or groin and make a small hole in your skin. Then, he/she will guide a thin guide wire and two to three small catheters through blood vessels to your heart. After the catheters have been placed correctly, electrodes at the end of each catheter are used to stimulate the heart and location of the problem areas that are causing the abnormal heart rhythm. The doctor will then use mild radiofrequency heat energy and cyrotherapy (freezing) to destroy the problem area, which is generally very small. Once the tissue is destroyed, the abnormal electrical signals that created the arrhythmia can no longer be sent to the heart. Most people do not experience any pain during the procedure, but may experience a mild discomfort in your chest. Once the procedure is over, your doctor will remove the guide wire and catheter(s) from your chest.

    How do I know if the ablation was successful?

    You will more than likely meet with your doctor at a three-month follow up appointment, at which time he/she will reassess how well your heart is responding to the treatment. At that point, he/she will make decisions regarding any medications you can discontinue or need to continue taking.

    When can I expect to feel better?

    Most patients experience occasional episodes of atrial fibrillation during the first few months after the procedure because it may take three months for the scars to develop. But, this post-procedure atrial fibrillation will eventually cease.
    Post Operative Instructions
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