Heart Arrhythmias: Program Provides Comprehensive, Better Care

If you’re one of the millions of Americans who suffer from a potentially life-threatening heart arrhythmia ― or abnormal heartbeat ― you may have experienced difficulty finding a treatment that helps. To speed diagnosis and ensure that patients are getting the most advanced care for their condition, Baptist Health Miami Cardiac & Vascular Institute is expanding its arrhythmia program, developing it into one of a few comprehensive programs of its kind in the country.

The program will treat people with heart rhythm problems including atrial fibrillation, or A Fib, as well as less common arrhythmias such as atrial and ventricular tachycardia, inappropriate sinus tachycardia and any of the many other conditions that can cause the heart to beat too fast, too slow or in an irregular pattern.

Steven Hoff, M.D., cardiothoracic surgeon at Baptist Health Miami Cancer Institute.

Arrhythmias occur when the electrical impulse that precedes a heartbeat is disrupted in some way. It can be the result of many things, including intrinsic disease of the electrical system of the heart, infection, medications, heart failure or heart attack. Some people are born with a heart defect that leads to arrhythmia, others develop it suddenly or as they age.

Factors that place people at high risk for arrhythmia are many of the same things that can lead to heart disease, such as being overweight, smoking, having diabetes and being inactive. There is a known link between atrial fibrillation and obstructive sleep apnea.

It’s common even for otherwise healthy people to occasionally experience the feeling that their heart has skipped a beat, but it’s important to bring the matter to your doctor’s attention so it can be investigated further. An arrhythmia often causes palpitations, dizziness, fatigue and shortness of breath, although some patients have few symptoms. For many, however, the condition diminishes quality of life, requiring long-term treatment with heart rhythm medications and blood thinners. It can also lead to cardiac arrest and death. And while many people think of irregular heartbeats as a problem of the elderly, a recent study showed that AFib deaths in younger adults are also on the rise.

 “People with arrhythmias are often misdiagnosed or don’t receive care right away because of the complexities of their condition or because of a lack of consensus on treatment,” says Steven Hoff, M.D., a cardiothoracic surgeon with the Institute. “That’s why we are developing a dedicated multidisciplinary program. Many healthcare providers understand the first line of therapy based on published national guidelines but may be less familiar with advanced therapies. We’d like to see patients come in with or without a diagnosis and leave with a plan.”

Fortunately, there are a wide range of treatment options, from medications to less-invasive catheter-based interventions to stand-alone surgery and hybrid options. Patients may undergo a cardiac ablation, for example, where a catheter is threaded through a vein or artery to reach the affected area of the heart and heat or cold is used to destroy tissue that is causing the irregular heartbeat. Others may receive a pacemaker or implantable defibrillator, a small device inserted under the skin of the chest that detects problems and delivers a shock to the heart when necessary.

Depending on the type and severity of arrhythmia, it may be a situation that is monitored or a case where immediate treatment is needed. Perhaps the biggest obstacle to care for patients with arrhythmias is that most cardiovascular programs don’t offer a full range of services, leaving patients frustrated as they attempt to navigate their way to better health.

The concept of using a multidisciplinary clinic setting for arrhythmia care is considered daunting by most healthcare organizations, but for Miami Cardiac & Vascular Institute, known for pioneering new and innovative procedures and participating in the development of new technologies, it is a fantastic solution to the problem, says Dr. Hoff, who was previously the surgical director of the Vanderbilt Center for Atrial Fibrillation.

“We’ve learned many lessons from the way oncology care has evolved over the years. Miami Cancer Institute offers multidisciplinary clinics where patients can see many specialists in the same visit and the experts discuss cases and share their ideas,” he says. “We believe converging practices is a cornerstone for cardiovascular care, as well.”

The Miami Cardiac & Vascular Institute program will bring electrophysiologists, who are specialists in the heart’s electrical system, cardiologists, cardiac surgeons and others with very special skill sets together under one roof to see patients and develop care strategies. The program will also participate in national and international clinical trials specific to heart arrhythmias.

Education is key to improving care for arrhythmias, Dr. Hoff says. “Standards of care and state-of-the-art treatment options often change rapidly,” he explains. “We firmly believe that an experienced, specialized team can help healthcare practitioners provide advanced care to their patients with these challenging conditions. Often, the goal is long-term relief of their arrhythmia with medications of blood thinners.”

While many people are aware of the most common heart rhythm problem, A Fib, many have never heard of other arrhythmias such as inappropriate sinus tachycardia, IST. “Even many healthcare providers aren’t familiar with IST. It can be highly symptomatic and enormously disruptive,” Dr. Hoff says. Patients may feel dizzy, have a hard time catching their breath and often pass out.

Despite the complexities in caring for patients with arrhythmias, Dr. Hoff remains optimistic. “These are treatable conditions, and by intertwining our practices and having physicians work together, we will be able to help more people.”

For more information about Miami Cardiac & Vascular Institute’s arrhythmia program, click here.