Outcomes 2018 - Baylor Scott & White Heart and Vascular Hospital | Page 38

ELECTROPHYSIOLOGY
Clinical electrophysiology cardiologists on the medical staff at Baylor Scott & White Heart and Vascular Hospital – Dallas have been treating patients with heart arrhythmias for decades . A well-respected and known teaching site for future electrophysiologists through a dedicated fellowship program , the hospital ’ s clinical team , together with electrophysiologists on the medical staff , treat patients from all over the United States . Fiscal year 2018 volumes information indicated a robust year for EP procedures with more than a 12 percent increase in the number of electrophysiology procedures over prior year .
Firsts
Home to innovative research and many “ firsts ” in the history of the diagnosis and treatment for patients suffering from abnormal heart beats , the philosophy of the electrophysiology team is to support involvement from the referring primary care physician and the patients ’ noninterventional cardiologists . In addition , the Heart Rhythm Center on the Dallas campus is a resource for patients needing information , treatment options and ongoing support for heart arrhythmias .
The first balloon ablation procedure was performed in 2006 on the Dallas campus and the procedure became mainstream and for commercial use in 2010 . Also a first for North Texas and part of the history of electrophysiology on the Dallas campus , is the launch several years ago for the third generation cryoablation device . The third generation used today includes a thin new version of the cryoablation catheter introducing critical changes that make the catheter more maneuverable by the electrophysiologist while still delivering the energy needed to successfully treat paroxysmal atrial fibrillation . It also allows for better monitoring by facilitating more appropriate dosing of the ablation .
Leadless Pacers
Electrophysiologists on the medical staff at Baylor Scott & White Heart and Vascular Hospital are able to place the world ’ s smallest pacemaker called the Micra™ Transcatheter Pacing System produced by Medtronic in patients . Receiving FDA approval in fiscal year 2016 , cardiologists on the medical staff helped achieve U . S . approval for the commercial use of the leadless pacemaker , Micra . The size of a nickel or paperclip , the pacemaker represents the first entry in what is a new class of slender , minimally invasive pacemakers that rest entirely inside the heart .
The pacemaker attaches to the inner heart wall directly , avoiding the need for insulated wires called leads to deliver the pacemaker ’ s electric pulses . Leads have been called the “ Achilles ’ heel ” of pacemakers because they can wear out and create infection risk .
This type of leadless pacemaker is placed directly into the right ventricle . A traditional pacemaker is placed in a “ pocket ” of skin near the shoulder , and connects to leads strung through major blood vessels to deliver electric pulses to the heart . In contrast , leadless pacemakers fit in a flexible tube the size of a large drinking straw , which is advanced into the heart from a small incision in the leg . Tiny bits of metal on the end of the pacemaker hook or screw into the heart tissue .
Device Lead Extraction
Micra™ Transcatheter Pacing System Pictured at actual size . Micra is 93 % smaller than conventional pacemakers .
Electrophysiologists on the medical staff at Baylor Scott & White Heart and Vascular Hospital – Dallas are often referred patients with complex conditions needing removal of leads because of electrical malfunctions , blocked blood vessels , or infection . In most cases , the leads can be removed using a catheter-based approach .
Catheter Ablation of Ventricular Tachycardia
In the past fiscal year , catheter ablation has grown as a good treatment option for patients with ventricular tachycardia ( VT ), the abnormal rapid heart rhythm originating from the lower pumping chambers of the heart – the ventricles . Patients with VT have a rapid rate of 120 to 300 beats
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