Cardiac Device/Electrophysiology Clinic in New Jersey
As our hearts and bodies age, sometimes we need help to deal with everyday activity. Pacemakers, a type of cardiac device, help control heart rhythms and heart rates. At Hunterdon Cardiovascular Associates, Dr. Rudnick and the rest of our doctors and staff, are equipped to help control your heart and give you the peace of mind you deserve.
Pacemakers At Hunterdon Cardiovascular Associates
A pacemaker is a small device that is implanted to help control abnormal heart rhythms or heart rates. This device uses low-energy electrical pulses in order to help the heartbeat at a normal rate.
Once a pacemaker has been implanted, it needs to be analyzed in the office once or twice a year. In addition, the patient needs to have the pacemaker checked over the telephone every month or every other month depending on the age of the pacemaker.
The telephone checks are to evaluate two basic parameters:
- The status of the battery
- The competence of the connections from the pacemaker to the heart
If a problem is found, the patient will be advised to have further evaluation.
Medtronic Micra® Transcatheter Pacing System (TPS): The World’s Smallest, Minimally Invasive Cardiac Pacemaker
Unlike traditional pacemakers, the Micra® Transcatheter Pacing System (TPS) is a miniaturized, fully self-contained pacemaker that delivers the most advanced pacing technology available to patients via a minimally invasive approach.
World’s Smallest Pacemaker
- Less than one-tenth the size of traditional pacemakers (~1cc)
- Cosmetically invisible to the patient after implantation
- Comparable in size to a large vitamin
- Weighs the same as a penny (2 g)
Advanced Pacing Technology
- Is attached to the heart via small tines and delivers electrical impulses that pace the heart through an electrode at the end of the device
- Does not require the use of wires, known as “leads,” to deliver pacing therapy
- Has an estimated average 12-year battery life
- Is approved for full-body MRI scans
- Responds to patients’ activity levels by automatically adjusting therapy
What Is The Minimally Invasive Procedure For Pacemakers?
- Delivered directly into the heart through a catheter inserted in the femoral vein
- Does not require a surgical incision or creation of a “pocket” under the skin, which eliminates any visible sign of the device and a potential source of complications
- The Micra design incorporates a retrieval feature to enable retrieval when possible; however, the device is designed to be left in the body
“Dr. Andrew Rudnick has been such a salvation in my daughter’s life in this past year . Unfortunately she suffers from P.O.T.S. and he has been working with her to try to treat her symptoms and give her some relief. She was diagnosed five years ago and he’s done more for her than two other cardiologists have been able to do from large teaching hospitals in such a short period of time. We highly recommend him , he’s kind and caring and listens to the needs of his patients which really make all of the difference!”
An ICD is a small device that is implanted to detect abnormal heart rhythms. If a dangerous and potentially lethal abnormal heart rhythm is detected the device will deliver an electric shock to restore a normal heartbeat. ICDs have been very useful in preventing sudden death in patients with known, sustained ventricular tachycardia or fibrillation. Studies have shown that they may have a role in preventing cardiac arrest in high-risk patients who haven’t had but are at risk for, life-threatening ventricular arrhythmias.
Once an ICD has been implanted, it needs to be in the office twice a year. In addition, the patient needs to have the ICD checked over the telephone every one to three months.
Implantable Loop Recorder (ILR)
An implantable loop recorder is an insertable cardiac monitor which is a small device that is implanted under the skin in order to continuously monitor heart rhythms. It continuously stores information so that various arrhythmias can be detected which may be occurring very infrequently. This recorder is generally left in place for up to three years. Periodically, information is downloaded from the device to assess for any potentially unrecognized arrhythmias.
What Is A Cardiac Ablation?
Cardiac ablation is a procedure that can help to correct abnormal heart rhythms such as atrial fibrillation, atrial flutter, supraventricular tachycardia, and ventricular tachycardia. The ablation works by scarring or destroying certain tissue in your heart that is responsible for triggering or sustaining an abnormal heart rhythm. The procedure is performed usually using long, flexible tubes called catheters which are inserted through a vein or artery in the groin and directed to the heart in order to deliver various energy forms to modify the tissues in the heart that are responsible for causing an arrhythmia.
What is electrophysiology?
Electrophysiology is the study and treatment of the electrical activity and electrical pathways of your heart. The goal of an electrophysiology study is to record the electrical activity of a patient’s heart. These tests can find the cause of an irregular heartbeat, and it can help dictate the best course of treatment to address it.
What do electrophysiologists do that is different from other cardiologists?
Electrophysiology is a highly specialized field of study within cardiology. It deals specifically with heart rhythm disorders and the electric system of the heart. Electrophysiologists are cardiologists who have gone through an extra year or two of training after completing their cardiologist fellowship. Only about five percent of cardiologists specialize as electrophysiologists.
Electrophysiologists are qualified to perform special tests of your heart’s electrical system, such as an electrophysiology study or an ablation. Typical cardiologists cannot perform these tests.
What is the difference between a pacemaker and a defibrillator?
When people hear the term defibrillator, they think of the paddles used to shock a person who has had a heart attack, with the goal of the electric current restarting the heart muscle. But defibrillators are also implantable. People don’t understand how these devices differ from a pacemaker.
Pacemakers are implanted when a person’s heart rhythm is very slow and won’t respond to medications. The pacemaker keeps the heart beating at the proper rate, keeping it from dropping to too slow a pace. Pacemakers only activate when they are needed. They send out electrical pulses to keep the heart at a steady rhythm and rate.
An implanted defibrillator is a bigger device. It is implanted to prevent the patient from going into cardiac arrest. The device shocks the heart if it needs that because a life-threatening rhythm disturbance is occurring in the lower chambers. It can correct this rhythm through these shocks. Some of these defibrillators also have a pacemaker built into them, so they can both prevent the heart from beating too slowly or too fast.
How reliable are pacemakers and defibrillators?
These devices are very reliable. The original implantable cardiac defibrillators were simply protection against the patient going into cardiac arrest. Newer technology enables these amazing devices to now stop the cardiac arrest and to provide the elevation in heart rhythm provided by pacemakers.
These devices are both powered by high-quality lithium batteries that can last 5-15 years.
Are patients under sedation during the implant procedure with these devices?
- Pacemaker implantation: Pacemakers can be implanted under only local anesthesia, but most patients prefer to have sedation. We use conscious sedation because the patient can respond when we need him to.
- Defibrillator implantation: Implanting defibrillators is more complicated due to the function of the device. We have to test it once in place, so we provide more conscious sedation. Once we have placed the defibrillator, we put the patient into cardiac arrest and use the device to shock the patient back to a normal rhythm. Despite what you may think, this is very safe, as we are prepared for all consequences that could occur during these tests.
Do pacemakers and defibrillators replace heart medications?
Our Hunterdon patients often ask if getting a pacemaker or implanted defibrillator will allow them to get rid of their heart medications. Unfortunately, the answer is no. We use these devices in conjunction with medications, as the combination tends to provide better overall outcomes.
The trend is to use implantable defibrillators more than anti-arrhythmic drugs. These drugs have some serious side effects and toxicity.
For elevating the heart rate, medications are generally not the best way to do it long term. Pacemakers are a better solution.
Schedule A Consultation
If you’re interested in learning more about our Electrophysiology Clinic services and schedule a consultation. Our practices are located in Flemington, Clinton, and Bridgewater, New Jersey. please contact us at (908)-788-1710!