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Electrophysiology

Arrhythmias

The cadence of the heart is powered by the body’s electrical system. When the heart’s rhythm is off beat, patients can experience arrhythmias such as atrial fibrillation and atrial flutter, and risk of untreated or poorly controlled arrhythmias can lead to stroke or heart failure. Depending on the type of arrhythmia, treatment can include lifestyle changes such as diet and exercise, medication management, device implantation, or ablation to correct the faulty rhythm.

Patient with arrhythmias are often referred to cardiologists who specialize in electrophysiology, the cardiac specialty that treats arrhythmias. Covenant Health has four cardiologists who are board certified and/or fellowship trained in electrophysiology, as well as many cardiologists experienced in implanting and managing pacemakers and implantable cardioverter defibrillators (ICDs). To find a Covenant Health physician who specializes in electrophysiology and pacemakers/ICDs, click here.


Catheter Ablation

One of the newest approaches to treating arrhythmias such as supraventricular tachycardia and atrial fibrillation include catheter ablation. In this procedure, the electrophysiologist inserts a tube in the area of the heart suspected of generating the faulty rhythm. Then, mild radiofrequency heat energy is used to destroy or ablate the problem area, thereby eliminating the ability of that section of the heart to create the abnormal electrical charges that generate arrhythmias. The radiofrequency used is much like microwave heat, and the total area targeted is generally less than 1/5 of an inch.

“Ablation is a non-invasive procedure with a good success rate and relatively low risk,” says Thomas Wannenburg, MD, board certified and fellowship trained electrophysiologist who practices at Cardiology Associates of East Tennessee. “There is no surgical incision and recovery time is typically overnight.”


Ablation Success Rate

Wannenburg says the success rate of ablation is relatively high depending on the type and duration of arrhythmia. “The success rate of using ablation to treat supraventricular tachycardia is 98%, and between 60% and 80% when treating atrial fibrillation. In patients experiencing arrhythmia for more than one year, the success rate is generally lower; however, with ablation we are able to reduce medications at least 50% of the time.

In some cases, patients with atrial fibrillation who have undergone ablation still require a pacemaker. “With atrial fibrillation, it’s hard to say one is ever cured,” says Wannenburg, “but with ablation, you significantly improve the situation and the patient’s quality of life.”