Treating arrhythmia with His-bundle pacing

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Treating arrhythmia with His-bundle pacing

An innovative heart pacemaker procedure called His-bundle pacing was performed at Life Vincent Pallotti Hospital in Cape Town. This is how the procedure helps treat arrhythmia.

What is arrhythmia?

When your heart functions normally, it delivers oxygen- and nutrient-rich blood to your body’s cells and beats at a consistent rhythm. However, when the rate or rhythm of your heartbeat is irregular, the condition is referred to as an arrhythmia. This could be the result of a fault in the heart’s electric circuitry. 

While an irregular heartbeat is fairly common, many people are unaware of it until they experience symptoms. 

Irregular heartbeat symptoms could include:

  • Heart palpitations
  • Fluttering sensation in the chest or neck
  • Dizziness or lightheadedness caused by an inadequate oxygen supply
  • Fainting or near-fainting spells
  • Fatigue or a feeling of being drained of energy

If you experience any of these symptoms, consult your doctor who can run screening tests required for a diagnosis. ‘The condition can present with dizziness or heart palpitations, loss of consciousness and chest pain,’ explains Dr Vinod Thomas, an electrophysiologist and cardiologist at Life Vincent Pallotti Hospital.

Treating arrhythmia 

Dr Thomas explains that common procedures to treat arrhythmia include cardiac electrophysiology and the installation of cardiac devices.

‘The practice of cardiac electrophysiology diagnosis manages and treats heart rhythm disorders by installing cardiac devices into the heart or using catheters to discern healthy tissue from tissue that needs to be destroyed,’ he explains.

‘An electrophysiology study is conducted to show where the arrhythmia is coming from and can help to plot a course of action; in other words, does the patient need medicine, catheter ablation or installation of a cardiac device?’ 

Dr Thomas says that the high success rate of ablations and installations as opposed to prescription medicine is something to be noted. ‘Prescription drugs for heart health maintenance can be avoided in many instances – and what could be better than undergoing the surgery and/or ablation and feeling 100% better after the procedure,’ he remarks.

What is a pacemaker? 

A pacemaker is a small device, surgically implanted in the chest or abdomen to help control an abnormal heart rhythm. Electric pulses are emitted from the device which keeps the heart pumping at a regular pace. 

While a traditional form of pacing is highly successful and provides a low-risk treatment option for most patients with heart rhythm irregularities, certain patients who present with a dysfunction between the ventricles (dyssynchrony) can benefit greatly from His-bundle pacing.

What is His-bundle pacing?

Dr Thomas explains: ‘His-bundle pacing is a relatively new technology available to cardiologists who treat heart failure. Unlike conventional pacing, His-bundle engages the heart’s intrinsic conduction system, or natural rhythms, to activate the ventricles. The result is synchronised and steadies contractions of both heart ventricles.’ 

Dr Thomas cautions that not all patients are ideal candidates for the procedure. However, His-bundle pacing is proving to be particularly beneficial in patients with heart failure and a slow heart rate, where pacing is anticipated to be greater than 20–30%.

Do you need a pacemaker?

Several tests need to be done before your doctor decides if you are an ideal candidate for pacemaker implantation. The Mayo Clinic states that this could include:

  • Electrocardiogram (ECG). Sensor pads with wires called electrodes are attached to your chest (and limbs) to measure your heart’s electrical impulses.
  • Echocardiogram. Harmless sound waves are used to allow your doctor to see the actions of your heart. A small instrument is placed on your chest to collect the echoes (sound waves) from your heart to a machine. Images are created with the sound waves and can be seen on a monitor.
  • Stress test. This test shows how your heart works during exercise. A stress test usually involves the measuring of your heart rhythm, blood pressure and breathing while walking on a treadmill or riding a stationary bike.

Living with a pacemaker

If you have a pacemaker fitted, your symptoms, such as fatigue and lightheadedness, may improve as your heartbeat becomes steadier. Your doctor will need to check your pacemaker every three to six months to ensure that it is working correctly.

Talk to your doctor if you experience any symptoms after getting a pacemaker implant. Keep in mind that once fitted, it could last between five and 15 years.

The information is shared on condition that readers will make their own determination, including seeking advice from a healthcare professional. E&OE. Life Healthcare Group Ltd does not accept any responsibility for any loss or damage suffered by the reader as a result of the information provided.