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Northern NJ cardiac physicians help patients overcome potentially dangerous heartbeat irregularities

  • Category: News
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  • Written By: Susan Bloom/nj.com
Northern NJ cardiac physicians help patients overcome potentially dangerous heartbeat irregularities

Read this article as it originally appeared July 8, 2021 on nj.com.

A heartbeat that’s too slow, too fast or otherwise irregular can be debilitating and even deadly.

Thanks to the Prime Healthcare regional network of hospitals — Saint Clare’s Health in Denville and Dover, St. Mary’s General Hospital in Passaic and Saint Michael’s Medical Center in Newark — patients are overcoming potentially dangerous heartbeat irregularities to live healthy, fulfilling lives.

Prime Healthcare is an award-winning health system that operates 46 hospitals and more than 300 outpatient locations in 14 states, providing over 2.6 million patient visits annually. It is one of the nation's leading health systems, with nearly 50,000 employees and physicians dedicated to providing the highest quality health care.

“It’s incredibly gratifying to see patients cured through removal of diseased heart tissue, or to see their health and quality of life significantly enhanced with a heart monitoring device,” said Atul Prakash, MD, director of electrophysiology at St. Mary’s General Hospital in Passaic and Saint Michael’s Medical Center in Newark and regional director of electrophysiology services for Prime Healthcare.

Joaquim Correia, MD, chief of cardiology at Saint Michael’s Medical Center in Newark, agrees.

“Watching people go from severe cardiac impairment to playing with their grandkids again and pursuing other activities they enjoy — few things could be so satisfying,” Dr. Correia said.

How Atrial Fibrillation Is Treated

Atrial Fibrillation, commonly referred to as A-fib, affects as many as 1 in 16 adults in the United States, according to American Heart Association estimates. The condition causes blood to pool and form blood clots in the heart’s upper chambers. This increases the risk of stroke, ultimately causing long-term damage to the heart, brain or other organs and potentially leading to death or permanent disability. (See “Symptoms of Atrial Fibrillation” below to learn the warning signs.)

Atrial Fibrillation is typically treated by a cardiac electrophysiologist, a doctor who specializes in managing electric heart rhythm disorders, or arrhythmias. “Through electrophysiology services, we evaluate and identify abnormal heart rhythms and can then target the scarred or diseased heart tissue that trigger these abnormalities,” Dr. Correia said.

As a first-line treatment, patients with A-fib may receive medication to prevent blood from clotting, such as prescription clopidogrel or over-the counter aspirin. A blood-thinner may be added for some patients.

If the patient is still at high risk of a stroke despite medication, the electrophysiologist will surgically destroy the diseased heart tissue, usually by burning or freezing it in a procedure called ablation. The electrophysiologist inserts catheters through the blood vessels and to the heart while the patient is under local anesthesia. Using a miniature camera attached to the catheter combined high-resolution monitors and mapping technology, the electrophysiologist can pinpoint and treat the source of the arrhythmia. The procedure usually takes two to four hours.

“We perform several ablations every week at Prime Healthcare hospitals, as well as ablations for tachycardia (an abnormally fast heart rate) and supraventricular tachycardia,” Dr. Prakash said. “Most patients go home the same day.”

Thanks to technological advances in imaging and surgical techniques, ablation is more precise and effective than ever. “Ablation allows us to eradicate many abnormalities, including Wolff-Parkinson-White (WPW) syndrome (a disorder that causes a rapid heartbeat) and other electrical disorders not necessarily connected to heart disease,” Dr. Prakash said.

Treatment Alternatives

If ablation does not resolve a patient’s arrhythmia, the electrophysiologist can try a different treatment approach.

“At Prime Healthcare, we take pride not only in our ability to achieve a ‘cure,’ but also in the process we use to determine which treatment approach would most benefit each patient,” Dr. Prakash said. “We have a very thorough, honest discussion of each option with our patients and ultimately leave the decision to them, because we believe it’s always the patient’s choice.”

Other treatment options include:

Atrial implant: The Watchman left atrial appendage closure implant is designed to keep blood from thickening within the heart, eliminating the need for blood thinners and other medications.

“With A-fib, blood clots form in the heart’s left atrial appendage, but the Watchman device plugs up the appendage to prevent blood from traveling there and keep clots from forming,” said Dr. Prakash, who launched St. Mary’s General Hospital’s highly successful Watchman program. “With Watchman, the risk of stroke is reduced as effectively as with blood thinners, and there are no side effects if the device is placed properly.”

Implantable Defibrillator: Patients whose arrhythmia has not responded to conventional treatments may be candidates for a defibrillator, an implanted device, similar to a pacemaker, that monitors and resets the heart if it starts beating too slowly or quickly. Defibrillators also can benefit patients who are at high risk of sudden death due to congestive heart failure.

“If you have a bad or weak heart and have a defibrillator, your chances of dying decrease by 30%,” said Dr. Correia, who noted that the American Heart Association has deemed defibrillators a priority (or Class 1) treatment that should be considered for high-risk candidates based on the benefits the devices offer.

Defibrillators also can be used for cardiac resynchronization therapy, another heart rhythm correction procedure. Extra wires are added to the device to send electrical impulses that synchronize the heart walls so that they contract together.

Defibrillator implantation usually is performed within 2 hours, depending on the number of wires used, and patients are placed under moderate sedation rather than full anesthesia for the procedure, Dr. Correia said. “After the procedure, we ask patients to restrict their activities for three to four weeks,” he adds, “but after that, patients can do anything they did before, and they often experience an overall improvement in the condition of their heart with this option.”

Defibrillators last from five to 13 years and are then changed for a new battery and chip. “We monitor our patients’ heart rhythm readings remotely and can detect issues early and reach out to patients based on the level of urgency,” Dr. Correia noted.

Pacemakers: For a patient whose heart beats too slowly or stops, a pacemaker can be a life-saving treatment option. The pacemaker comprises two parts:

  • a battery-operated generator, implanted under the skin in the chest, that generates electrical pulses.
  • leads (or electrodes), one to three flexible wires placed in one or chamber of the heart that deliver the pulses to control the heart’s regular electrical rhythm.

Prime Healthcare cardiologists have vast experience in pacemaker therapy and use the latest pacemaker technologies to ensure optimal outcomes.

“Both St. Mary’s General Hospital and Saint Michael’s Medical Center have a long history of expertise in cardiac management, surgery and electrophysiology services and in delivering improved survival and quality of life,” Dr. Correia said. “Our experience and cutting-edge technology enable us to provide state-of-the-art services and safe, excellent outcomes.”

To learn more about Prime Healthcare’s cardiology services or to schedule an appointment, call 973-576-5320 or visit heartnj.primehealthcare.com.

Symptoms of Atrial Fibrillation

Knowing the symptoms of atrial fibrillation (A-fib) can help you recognize the condition and seek treatment sooner. The American Heart Association urges people to watch for these symptoms:

  • General fatigue
  • Rapid and irregular heartbeat
  • Fluttering or “thumping” in the chest
  • Dizziness
  • Shortness of breath and anxiety
  • Weakness
  • Faintness or confusion
  • Fatigue when exercising
  • Sweating