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Developments in device therapy ensure future health of cardiac patients

By: Hannah Blick, hannah.blick@gazette.com
February 17, 2016 Updated: February 18, 2016 at 4:22 pm
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Look for Heart Health features on gazette.com/heart throughout American Heart Month, sponsored by Penrose-St. Francis Health Services.

After experiencing a heart attack or stroke, a cardiovascular disease patient often needs physical rehabilitation to regain strength and begin monitoring his or her health for the long haul. As well, the heart sometimes requires long-term monitoring and pacing assistance to ensure it works to the best of its ability as long as possible. That’s where cardiac electrophysiology comes in.

Cardiac electrophysiology helps monitor rhythm disorders of heart disease within the electrical system of the heart, like including Atrial fibrillation (a-fib). “A-fib is the most common type of heart arrhythmia in America,” said Dr. Derrick Fansler, MD, FACC, FHRS, electrophysiologist at Penrose-St. Francis Health Services. “The lifetime risk for developing a-fib is 1 in 4: that’s a huge number, it’s incredibly common.” Penrose-St. Francis is part of the Centura Health Heart and Vascular Network, the region’s leading provider of cardiovascular care.

Often, devices – including pacemakers and defibrillators – are inserted in the bodies of heart disease patients to mechanically manage arrhythmia, or irregular heart rhythms. “We use device therapy to put the heart back in sync electrically,” Dr. Fansler said. Pacemakers help slow quickened heart beats, defibrillators restart the heart in the case of sudden cardiac death.

Dr. Fansler also said the Penrose-St. Francis team has started using cardiac resynchronization (CRT) and ablation therapies in recent years. “CRT helps pace the left and right ventricles simultaneously,” he said. “Ablation therapy is aimed more at rapid heartbeats and targeting the short circuits that cause them. Ablation technologies are constantly improving; we now have catheters that can sense how much force they’re placing on the heart.”

In addition, Dr. Fansler cited improvements in remote device monitoring and subcutaneous device capabilities with improving overall device therapy effectiveness for his patients.

“Subcutaneous defibrillators are a type of defibrillator that does not touch the heart, it’s solely under the skin, which helps avoid the risks involved with touching the heart and blood vessels,” he said. “As technology improves and devices become smaller and smarter, we have more opportunities to inject under the skin and avoid opening patients up. Devices also have improved in long-term monitoring capabilities, and are now MRI compatible. The more advanced we get with imaging, it shortens our procedures with higher rates of success, improving and shortening recovery time for patients.”

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