Comprehensive Electrophysiological Care
Comprehensive Electrophysiological Care
Team Approach to
Treatment of
Arrhythmias
Drs. James Hummel (l)
and Darren Traub (r)
use a team approach
to care for patients
with arrhythmias.
St. Luke's Hospital & Health Network's electrophysiology team provides specialized care for the treatment of arrhythmias. Offering advanced services, including medical management, device management, ablation and cryoablation, it is considered a regional leader in arrhythmia care.
There are many types of arrhythmias, including atrial fibrillation — the most common form of arrhythmia — atrial flutter, Wolff-Parkinson-White Syndrome, AV nodal reentrant tachycardia, atrial tachycardia, ventricular tachycardia and bradycardia. If not treated appropriately, these arrhythmias can predispose patients to potentially dangerous complications.
Working as a Team
Through St. Luke's Hospital & Health Network, patients have access to two experienced electrophysiologists — James Hummel, MD, and Darren Traub, DO — who are experts in their field. Utilizing a team approach, these physicians are able to provide high-level electrophysiological services to patients locally without requiring referral to larger academic centers.
Drs. Hummel and Traub perform procedures together and discuss patients on a daily basis to help identify the most appropriate treatment plans.
“At St. Luke's Hospital & Health Network, we offer all of the services normally seen only at tertiary care centers,” says Dr. Hummel. “If ablation, device management or medical management is ineffective and patients need surgery for correction of their arrhythmias, we also have a knowledgeable surgical team in place.”
Drs. Hummel and Traub communicate with the cardiac surgical team so that when applicable, procedures can be performed together, such as ablation therapy for atrial fibrillation in conjunction with other cardiac surgical procedures.
An Individualized Approach to Care
A comprehensive approach is taken to electrophysiological care, ensuring all treatment plans are individually customized to best meet each patient's specific needs. Factors — such as age, symptoms, previous medication tolerance and comorbid heart conditions, including cardiomyopathy, previous heart attack or valvular disease — are taken into consideration when developing a treatment plan that may include device implantation, ablation, cryoablation and medical management.
Device Implantation
Device implantation can include placement of a pacemaker or cardioverter defibrillator. The type of arrhythmia and symptoms patients are experiencing help decide which device will be most appropriate.
For patients suffering from bradycardia, pacemakers are indicated. These devices can be programmable to provide support for patients whose bradycardia is intermittent or can be set to meet a patient's specific metabolic demands for those whose heart rhythm regulation is dependent upon pacemaker use. In this instance, if a patient begins running, for example, the pacemaker will sense the metabolic change and adjust accordingly to control his or her heart rate.
A cardioverter defibrillator may be indicated for patients who have been previously resuscitated from sudden cardiac arrest or who are at risk for developing cardiac arrest due to cardiomyopathy. This defibrillator is programmed to send electrical shocks to regulate the heart if a dangerous tachycardia is developed.
“For many patients, utilization of a defibrillator or pacemaker to control arrhythmia can actually make the heart beat stronger and help improve quality of life,” says Dr. Traub.
Ablation and Cryoablation
Depending on a patient's age, symptoms and comorbid heart conditions, ablation may be indicated. A minimally invasive, endocardial procedure that uses radiofrequency energy to ablate the abnormal circuits causing the arrhythmia, ablation often provides appropriate candidates with a curative approach that eliminates the need to take additional medications. For many patients with supraventricular tachycardia, cure rates can be as high as 95% to 97% after ablation with very low complication rates.
“For younger patients with tachycardias, ablation is a desirable choice because it prevents the need for them to take medications,” says Dr. Traub. “It is also appropriate for patients who develop atrial fibrillation or atrial flutter later in life and would like to reduce their symptoms or avoid medication use.”
St. Luke's Hospital & Health Network provides the most advanced technology available for catheter ablation, including a 3-D anatomical mapping system that allows physicians to create virtual images of the patient's heart, which aids physicians in determining both the abnormal circuits that need to be ablated and catheter placement.
Cryoablation is a newer technique that also provides a curative approach for arrhythmia. Through purchase and implementation of a state-of-the-art cryosystem, physicians are able to deliver a safer form of energy that prevents inadvertent damage to important heart structures, which can occur during traditional catheter ablation.
Future Plans
Looking to the future, plans are in place to provide an Atrial Fibrillation Clinic through St. Luke's Hospital & Health Network. Because there are many different types of atrial fibrillation and many treatment modalities available, this will allow easy access for patients who are looking for an option that does not involve medication.
“Certain arrhythmias are treated better using certain approaches,” says Dr. Hummel. “Through our team approach to care, we are able to examine every option and offer patients state-of-the-art solutions.”