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• Patient stays typically two nights post procedure
• Patient will return to an EP lab a few weeks later for a follow-up procedure of cryo-energy ( freezing ) coupled with radiofrequency energy to ablate any areas still emitting abnormal signals
• The electrophysiologist meticulously connects his / her work with the post-exterior ablation that was performed by the cardiothoracic surgeon
• Patient is typically discharged same day following the endocardial portion of the procedure
17 Convergent
procedures ( FY22 )
CATHETER ABLATION OF VENTRICULAR TACHYCARDIA
In the past fiscal year , catheter ablation volumes have grown as a treatment option for patients with ventricular tachycardia ( VT ), the abnormal rapid heart rhythm originating from the lower pumping chambers of the heart — the ventricles . Most commonly seen in patients with a weakened heart muscle from cardiomyopathy or from scar tissue as a result of a prior heart attack , VT left untreated can evolve into potentially fatal ventricular fibrillation ( VF ).
To perform the procedure , the skilled electrophysiologists on the medical staff place a long , thin wire into the heart chambers femorally ( through veins in the leg ). Once the areas of the arrhythmia are identified , a localized burst of radiofrequency energy is applied , cauterizing the abnormal electric circuit of the VT .
The EP labs at Baylor Scott & White Heart and Vascular Hospital – Dallas are equipped with sophisticated 3D mapping technology , decreasing the need for fluoroscopy and improving procedural time efficiency . The arrhythmia-locating technology combines magnetic and current-based technologies for real time display of catheter locations , as well as intra-cardiac echocardiography images of the heart ’ s chambers . These maps contain anatomical , electrical voltage , electrical activation times and ablation data .
LEFT ATRIAL APPENDAGE OCCLUSION
Another early adoption for the department was the use of left atrial appendage occluder ( LAAO ) devices to treat patients at risk of developing blood clots , specifically patients with atrial fibrillation due to the compromised heart pumping ability increasing the potential for clots to form . The LAAO device is designed to prevent blood clots that frequently form in the left atrial appendage from traveling in the blood stream to the brain , lungs and other parts of the body .
Electrophysiologists on the medical staff were successful with bringing left atrial appendage occluder devices through clinical trials and post-FDA approval . Approved by the FDA in 2016 , the device is now a more commonly offered viable option for many patients who have difficulty with blood thinners or not able to tolerate blood thinners .
After receiving this device , patients are generally released from the hospital after 24 hours . Medical
follow-up continues over the course of time as patients decrease their blood thinner medication under the supervision of a cardiologist . Generally , with the device in place , patients no longer have a need for blood thinners .
LAAO device is suitable for patients with nonvalvular atrial fibrillation who :
• are at increased risk for stroke and systemic embolism based on CHADS2 or CHADS2-VASc scores and are recommended for anticoagulation therapy , and
• have an appropriate rationale to seek a non-pharmacologic alternative to oral anticoagulation , taking into account the safety and effectiveness of the device compared to warfarin .
LAAOs performed ( FY22 )
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Baylor Scott & White Heart and Vascular Hospital - Dallas | Electrophysiology