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Heart & Cardiology Procedures
Stress testing and noninvasive cardiac risk stratificationA stress test may be necessary to diagnose heart disease or to estimate the patient’s risk of a future cardiac event, and in many cases some kind of imaging is necessary to fully evaluate the patient. As an office-based procedure, we perform stress testing both with nuclear imaging, in which a mildly radioactive tracer is injected in order to measure blood flow, and with stress echocardiography, in which the heart is watched with ultrasound during exertion.
EchocardiographyOur physicians have decades of experience with this common procedure, in which the heart is examined using ultrasound to measure heart function, diagnose disease of the heart valves, and clarify the cause of possibly cardiac symptoms. It is most commonly performed via an ultrasound probe on the chest (transthoracic echocardiography) but in some cases must be performed via a probe inside the throat to look at the heart from behind (transesophageal echocardiography).
Pacemakers and defibrillatorsOur physicians are expert in the placement of these implantable devices. A pacemaker is placed under the skin (usually at the shoulder) with wires extending through the veins into the heart. Electrical signals from the pacemaker can be used to increase heart rate when the electrical system of the heart fails or is diseased. In addition to being able to act as a pacemaker, an implantable defibrillator senses dangerous, life threatening heart rhythms (ventricular tachycardia and ventricular fibrillation) and shocks the heart back into normal rhythm, which can be life-saving. This may be recommended either after a life-threatening event which the patient has been lucky enough to survive, or more commonly as a preventative measure in patients who are at high risk for future events of ‘sudden cardiac death.’
Cardiac resynchronizationA significant number of patients with symptoms of heart failure such as shortness of breath, fatigue, and fluid retention also have poor heart function and disease of the electrical system of the heart. The electrical component can be significantly improved, in most cases resulting in improved symptoms and improved heart function, by placing a pacing wire through the veins over to the left side of the heart through the coronary veins. The heart is then paced from both sides, with greater efficiency.
Laser lead extractionUnfortunately, just like any other manmade device, pacemaker and defibrillator wires can break or get infected, and wire that have been implanted for several years can be difficult to remove because of scar tissue that forms around them. Our physicians are extremely experienced in handling this difficult problem of extracting leads using a variety of tools, most frequently laser-powered or mechanical sheaths to break up the scar tissue and remove the leads.
Electrophysiologic study and radiofrequency ablationElectrical or rhythm disorders of the heart can range from the annoying but benign to the life-threatening, and over the last ten to fifteen years, exciting advances have been made in the medical and interventional treatment of these arrhythmias. Small catheters can be placed inside the heart via sheaths in the groin, and the abnormal circuits that cause the arrhythmia mapped out prior to delivering either heat energy (radiofrequency) or freezing energy (cryoablation) to create small scars that break the abnormal circuits. Our physicians have been in the forefront of research and development of these procedures, and we routinely treat all of the arrhythmias that can be ablated, including supraventricular tachcyardias (SVT), ventricular tachycardia (VT), and atrial fibrillation.
The Stereotaxis Niobe Magnietic Navigation System is one such device. This system enables our physician to perform complex procedures. Stereotaxis is a maganetic system that maps and guides catheters safer more efficient, through out the cardiovascular system. Ablation involves using a catheter to create a line of scar tissue within the heart that will act as a road block to short-circuit an arrhythmia. Traditional ablation methods utilize a harder catheter that is three feet long. The only available access to manipulate the catheter is through the groin. Stereotaxis uses magnets to steer the catheter to the precise area in order to terminate the arrhythmia. Follow this link to see an animation of the procedure.
Texas Heart Institute is among the few hospitals worldwide and Dr. Massumi, Rasekh and Razavi are some of the first physicians in Texas to offer the groundbreaking new LARIAT procedure to reduce stroke risk in patients with atrial fibrillation (”a fib” or “AF”) who are unable to take blood thinning medications. Since stroke is the third largest cause of death in atrial fibrillation patients, the new therapy is a potential life saver. Atrial Fibrillation affects an estimated three million people. and patients with this condition are five times more likely to have a stroke. Follow this link for more information.