Follow-up Electrophysiology Study
To make sure the medication is working properly after two or more days in the hospital, you may be brought back to the laboratory for a follow-up study. Our goal is to find the drug that works best for you.
Implantable Device (Pacemaker)
All implantable devices or pacemakers work on "demand" and are used to treat slow heart rhythms. They are small devices that are implanted beneath the skin below the collarbone and connected to a pace wire(s) positioned inside the heart via a vein; this delivers a small electrical impulse to stimulate the heart to beat when it is going too slow.
A technique pioneered at UCSF, 射频导管消融术破坏或干扰部分电通路，导致心律失常, providing relief for patients who may not have responded well to medications, or who would rather not or can't take medications.
导管消融包括将一根微小的金属导管穿过腿部的静脉或动脉，进入心脏. Fluoroscopy, which allows cardiologists to view on a monitor the catheter moving through the vessel, provides a road map. Other catheters, usually inserted through the neck, contain electrical sensors to help find the area causing the short-circuits. 然后，金属尖端的导管被移动到每个有问题的部位，射频波——与无线电和电视传输所用的能量相同——轻柔地烧掉每一缕多余的组织. When catheter ablation was first tried, direct current shocks were used, but researchers later developed the use of radiofrequency waves — a more precise form of energy. With radiofrequency catheter ablation, patients usually leave the hospital in one day, compared to open heart surgery, which requires a week stay and months of recovery.
For conditions like Wolff-Parkinson-White syndrome, 在这个过程中，一根头发一样细的组织在心脏上下腔之间创造了一条额外的电通路, radiofrequency ablation offers a cure. 对于那些对药物治疗反应不佳或有心率过快倾向的患者来说，它已经成为一种首选的治疗方法.
Even in arrythmias that can be controlled with drugs, 该程序已被证明是经济有效的，因为它消除了需要住院治疗的药物失败. 对于容易受到药物治疗副作用影响的老年患者，以及因胎儿可能面临健康风险而不能服用药物的育龄妇女来说，这也是一个有吸引力的选择.
While studies have shown that catheter ablation is more cost effective than drug therapy or surgery, patients who undergo the procedure also experience remarkable improvement in quality of life. 最近的一项研究对近400名心率过快的危险消融患者进行了研究，其中近三分之一的患者被认为是进行心脏直视手术的候选者。研究发现，手术后一个月，98%的患者不需要药物治疗，95%的患者报告称，他们的整体健康状况明显改善. The UCSF study also found improvement in the patients' ability to work, exercise and take on physical activities.
内复律将房颤和心房扑动转化为正常窦性心律是在1991年由UCSF医学中心开发的. 内部心律转复是低能电击(1到10焦耳)，通过插入腹股沟静脉的两根导管和放置在胸部的一个小电极垫在心脏内部传递. This procedure is performed in the electrophysiology lab by our electrophysiologist.
During the internal cardioversion, short-acting sedatives are given to make the patient sleepy. Currently, atrial flutter is successfully "cured" by radiofrequency catheter ablation; but treatment to restore atrial fibrillation to sinus rhythm has been the traditional use of medications and external cardioversion. 体外心律转复是通过连接在胸部的两个除颤器垫传递50到300焦耳的高能电击. In some cases, 体外复律失败是因为电流必须先通过胸部肌肉和骨骼结构才能到达心脏. 当药物和体外复律都不能使病人的心律恢复到正常的窦性心律时，可以进行内复律.
加州大学旧金山分校将房颤患者通过内复律转换为正常窦性心律的成功率为95%. The less time a patient is in atrial fibrillation, the easier it is to cardiovert back to a normal rhythm, 但即使是长期患有慢性心房颤动的患者，也可以通过内复律成功地转换为正常心律. With internal cardioversion, 我们的电生理团队成功地改造了一位患有8年慢性心房颤动的病人.
Implantable Cardioverter Defibrillator
植入式心律转复除颤器是一种为那些容易出现危及生命的心律过快的人准备的设备. It is slightly larger than a pacemaker and usually is implanted beneath the skin below the collarbone. It is connected to a defibrillation/pace wire(s) positioned inside the heart via a vein. 当它确定心率过快时，它有能力向心脏发出电击. It also is capable of pacing or stimulating the heart when it is going too slow.
Biventricular Pace Maker
The U.S. 美国食品和药物管理局(FDA)最近批准了一种新型起搏器，它可以调节两个心室以协调它们的收缩，并提高它们的泵血能力. According to the test results presented to the FDA, cardiac resynchronization therapy (CRT):
- Increases the amount of daily activities patient can perform without the symptoms of heart failure
- Improves the overall quality of life as judged by standard measurements
- Promotes changes in heart anatomy to improve cardiac function
- Reduces the number of days patients spend in the hospital and the total number of hospitalizations
CRT devices work by pacing both the left and right ventricles simultaneously, which results in resynchronizing the muscle contractions and improving the efficiency of the weakened heart. In the normal heart, 电传导系统将电脉冲以一种高度组织化的收缩模式传送到左心室，从而非常有效地将血液泵出心室. In systolic heart failure caused by an enlarged heart (dilated cardiomyopathy), this electrical coordination is lost. Uncoordinated heart muscle function leads to inefficient ejection of blood from the ventricles.
UCSF Health medical specialists have reviewed this information. 这只是为了教育的目的，并不是为了取代你的gpk电子游戏官网或其他卫生保健提供者的建议. We encourage you to discuss any questions or concerns you may have with your provider.
Treatments we specialize in
Implantable Cardioverter Defibrillator
A small implanted device helps regulate the heart rate in patients who experience very fast heart rhythms.Learn more
Millions of people now rely on these tiny electronic devices to keep their hearts beating steadily.Learn more
Seeking care at UCSF Health