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Process



How we proceed

First, we clinically diagnose exactly what your symptoms are and how to intelligently move forward to eliminate the causes of your problems.
Shortness of breath, chronic fatigue, or anxiety are often manifestations of arrhythmia.

Sometimes, a simple examination, including an electrocardiogram will be enough to suggest what to do next.

Medications
One way to treat arrhythmias is with specific medications called anti arrhythmic drugs.
These may include:
* Amiodarone (Cordarone)
* Flecainide (Tambocor)
* Norpace
* Procainamide (Procanbid)
* Rhythmol
* Sotalol (Betapace)
* Tikosyn
* Multaq

In addition, there are rate slowing medications including:
Beta-blockers such as Metoprolol, Atenolol, Bisoprolol and Nadolol which reduce the heart’s workload and heart rate.
Calcium channel blockers such as Diltiazem and Verapamil, which also can reduce the heart rate.

Because these drugs only control abnormal heart rhythms, not cure them, you may have to take them for life.

Side Effects
Yes, antiarrhythmics do have side effects. Notify us immediately if you experience any of the following side effects:
* Worsening arrhythmias
* Allergic reaction
* Chest pain
* Fainting
* Swelling of the feet or legs
* Blurred vision
* Shortness of breath
* Abnormally fast heartbeat
* Abnormally slow heartbeat
* Dizziness or lightheadedness
* Cough

When first taking antiarrhythmics, avoid operating heavy machinery (for example, driving) until you know how the medication will affect you. Ask your doctor for advice about what to avoid doing and when you can resume.

Cardiac Ablation
This is an alternative to medication. It is a minimally invasive procedure which may cure the problem rather than treat it. There are many different types of ablations for the many different kinds of arrhythmias and this must be discussed with us. We tend to use the newest, safest technology available, to best serve our patients.

Cardioversion
Electrical cardioversion is a procedure in which an electric current is used to reset the heart’s rhythm back to its regular pattern (normal sinus rhythm). The low-voltage electric current enters the body through metal paddles or patches applied to the chest wall.
Before cardioversion for atrial fibrillation, the patient is sedated by an anesthesiologist to ensure there is no pain. Depending on the duration of atrial fibrillation and anticoagulation with blood thinners, the patient may require a TEE , which is an ultrasound probe inserted into the esophagus or food tube to look at the left upper chamber under ultrasound and make sure there is no clot present which may dislodge and cause a stroke.

What To Expect After Cardioversion
After cardioversion, you will be monitored to make sure that you have a stable heart rhythm.
You will take an anticoagulant, for at least a few weeks after your cardioversion. This medicine lowers your risk of a stroke.
Additional medicines to help prevent the return of heart rhythm problems (antiarrhythmics) also may be given before and after the procedure.

Reasons to have Cardioversion
As a non emergency procedure to stop atrial fibrillation that has not stopped on its own. For people who have just started having episodes of atrial fibrillation, treatment typically includes cardioversion.
As an emergency procedure if atrial fibrillation is causing your heart to pump dangerously fast or causing your blood pressure to drop dramatically.
How Well It Works
Cardioversion usually restores normal rhythm in over 95% of cases. How long it will last and how long you will stay in sinus rhythm is unpredictable

Electrophysiology Study
An electrophysiology (EP) study is a minimally invasive procedure which is similar to a heart Cath or Angiogram. We use sedation by anesthesiologist and insert very fine electrical wires, through the veins in the thigh, into various positions within the heart. Electrical impulses are delivered and results are recorded enabling the electrophysiologist to diagnose exactly what the problem is, where it is, and then to destroy it with radio frequency, which is called ablation.

Why You May Need an EP Study?

1) To determine the cause of an abnormal heart rhythm
2) To locate the site of origin of an abnormal heart rhythm
3) To decide the best treatment for an abnormal heart rhythm

There are a number of different causes of arrhythmia; and therefore a number of different treatments.
The most common include atrial fibrillation, supraventricular tachycardia (SVT), atrial flutter, premature ventricular contraction (PVC) and ventricular tachycardia., among others.

Sometimes, we may determine that an EP study will need to be conducted to confirm which implantable cardioverter/defibrillator (ICD) device is best for your particular situation.

Depending on the outcome of your EP Study, we will suggest the correct therapy to resolve and often to cure your electrical situation.

We use the newest, safest technology available in medicine, to best serve our patients.


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Cardiac Arrhythmia Services

We are sometimes referred to as the electricians of the heart. We treat all types of heart rhythm disorders: hearts that beat slowly, quickly or erratically. We evaluate patients with palpitations to help diagnose the etiology of palpitations and then cure the underlying problem. In addition to palpitations, shortness of breath, fatigue, anxiety, dizziness (syncope) are some other manifestations of arrhythmia.

Common arrhythmias that we deal with are atrial fibrillation, supraventricular tachycardia (SVT) and ventricular tachycardia (VT). We usually try medication to treat arrhythmias but when medications are insufficient we may recommend an ablation procedure.

There are different types of ablation but they all aim at eliminating the source of the arrhythmia. Our practice is at the forefront of technology and we use the newest techniques and equipment available to provide the safest and most effective therapy to our patients. We implant and manage all types of pacemakers and defibrillators. We have one of the largest and most efficient remote monitoring programs in the state of Florida. Remote monitoring allows us to watch over and treat our patients in between their office visits. At Cardiac Arrhythmia Services we have 3 cardiac electrophysiologists, 2 physician assistants, 2 remote monitoring technicians, 3 nurses and a staff of 19 people who all work together on daily basis to ensure that our patients get the best care possible.

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