Conventional treatments

Cardioversion

A medical procedure by which an abnormally fast heart rate (tachycardia) or cardiac arrhythmia is converted to a normal rhythm using electricity or drugs.  Synchronized electrical cardioversion uses a therapeutic dose of electric current to the heart (using electrodes placed on the chest) at a specific moment in the cardiac cycle.

Electrophysiology Study, or EP Study

This is also referred to as Cardiac Mapping.  An Electrophysiologist carries out the study.  This is a doctor whose expertise is in the hearts electrical system.  An incision is made in the groin or neck and catheters are guided through the blood vessel to the heart.  The catheters have tiny electrodes that allow them to gather data about the electrical signals flowing through the heart.  In some cases a procedure called an Ablation can be performed.  This can often cure an arrhythmia by inactivating a small region of abnormal tissue inside the heart.  In my daughter’s case, there were five or six areas mis-firing and ablation was not an option.

Cardiac Ablation

A procedure that can correct heart rhythm problems (arrhythmias).  It usually uses long, flexible tubes (catheters) inserted through a vein in your groin and threaded to your heart to correct structural problems in your heart that cause an arrhythmia.

Septal Ablation

In this procedure a small portion of the thickened heart muscle is destroyed by injecting alcohol through a long, thin tube (catheter) into the artery supplying blood to that area.

Radiofrequency Ablation

In this procedure doctors guide a long catheter through your blood vessels to your heart.  Electrodes at the catheter tips transmit energy to damage a small spot of abnormal heart tissue that is causing the abnormal heart rhythm.

Septal Myectomy

A surgical procedure performed to reduce the muscle thickening that occurs in patients with Hypertrophic Cardiomyopathy (HCM).  Septal Myectomy is one treatment option for HCM when symptoms persist despite optimal treatment with medications, or if obstruction severely restricts blood ejection from the heart.

Heart Transplant

Surgery to remove a person’s diseased heart and replace it with a healthy heart from a deceased donor.  Most heart transplants are done on patients who have end-stage heart failure.  Heart failure is a condition in which the heart is damaged or weak.

Left Ventricular Assist Device (LVAD)

A mechanical pump that is implanted inside a person’s chest to help a weakened heart pump blood throughout the body.  It does not replace the heart, it just helps it do its job.  The LVAD can be used on a person whose heart needs a rest after open-heart surgery or for someone waiting for a heart transplant (called “bridge to transplant”).

Genetic Testing

A type of medical test that identifies changes in chromosomes, genes, or proteins.  The results of a genetic test can confirm or rule out a suspected genetic condition or help determine a person’s chance of developing or passing on a genetic disorder.

Biventricular Pacemaker

A small electrical machine put inside the chest or abdomen of a person to make the heart beat evenly.

Automatic Implantable Cardioverter-Defibrillator

An apparatus used to control heart fibrillation by application of an electric current to the chest wall or heart.

LifeVest Wearable Defibrillator

This is the first wearable defibrillator.  Unlike an implantable cardioverter defibrillator, the LifeVest is worn outside the body rather than implanted in the chest.  This device continually monitors the patient’s heart with dry, non-adhesive sensing electrodes to detect life-threatening abnormal heart rhythms.  If a life-threatening rhythm is detected, the device alerts the patient prior to delivering a treatment shock, and thus allows a conscious patient to delay the treatment shock.  If the patient becomes unconscious, the device releases a Blue gel over the therapy electrodes and delivers an electrical shock to restore normal rhythm.

Potassium Chloride

A metal halide salt composed of potassium and chlorine.  It is used to prevent or to treat low blood levels of potassium (hypokalemia).  Potassium levels can be low as a result of a disease or from taking certain medicines, or after a prolonged illness with diarrhea or vomiting.

Diuretics

Used to treat the buildup of excess fluid in the body that occurs with some medical conditions such as congestive heart failure, liver disease, and kidney disease.  Some diuretics are also prescribed to treat high blood pressure.  These drugs act on the kidneys to increase urine output.

Blood Thinners (Anticoagulants)

A drug used to prevent the formation of blood clots by hindering coagulation of the blood.

Blood Pressure Control

Appropriate control of blood pressure is essential to effective therapy for persons with heart failure.  The systolic blood pressure must remain below a certain level and this is usually accomplished with medication.

ACE Inhibitors

Use of ACE inhibitors is the current criterion standard in the treatment of left ventricular dysfunction.  They have been shown to decrease mortality rates in both symptomatic and asymptomatic patients with left ventricular dysfunction and to reduce readmissions caused by heart failure.

Beta-Blockers

Previously believed to be contraindicated in patients with left ventricular dysfunction, this class of medications has moved to the forefront of heart failure treatment.  Several trials have shown that beta-blockers are both safe and effective in the treatment of persons with any class of heart failure and that adding beta-blockers to outpatient management of CHF yields great reductions in mortality rates.

Aldosterone Antagonists

Spironolactone is a potassium sparing drug.  It aids in holding onto the potassium in the body which becomes a real issue when diuretics are on board.  It also helps break the cycle of sodium retention and fluid overload.

Antiarrhythmic Agents

Antiarrhythmic agents are useful in patients with supraventricular and nonsustained ventricular tachycardias.  Not all antiarrhythmic agents are considered safe in patients with structural heart disease.  The Cardiac Arrhythmia Suppression Trial (CAST) 1 and 2 implicated class IC agents as causing increased mortality in this population.

Vasodilators

In 1986, the US Veterans Administration Cooperative study showed a 36% mortality risk reduction in patients treated with preload and afterload reducers in addition to conventional heart failure medications.  Sublingual nitroglycerin spray, nitro paste, and intravenous nitroglycerin have also been advocated in the treatment of pulmonary edema secondary to congestive heart failure.

Human B-Type Natriuretic Peptide (BNP)

This is a new class of drug in the treatment of heart failure.  It is produced through recombinant DNA technology and has the same amino acid sequence as naturally occurring human BNP.  Natriuretic peptides have demonstrated effectiveness in correcting hemodynamic derangements in patients with acutely decompensated heart failure via their vasodilatory and diuretic effects.  Data suggest that combined blockade of ACE and neutral endopeptidase also has hemodynamic and clinical benefits.

Inotropic Agents

Long –term use of the drug milrinone has deleterious effects on survival in patients with heart failure.  Improvement of CHF symptoms occurs as the trade-off for this increase in mortality.  This drug is reserved for patients who need hemodynamic-directed treatment during acute decompensation, for those who are refractory to maximal standard therapy, as palliation for end-stage heart failure, or as a bridge to transplantation.

Investigational Therapy for Heart Failure

Some areas that are being investigated for the treatment of heart failure are gene therapies, myoblast transplantation, and stem cells.

Gastrostomy feeding tube (G-tube)

A special tube that goes directly into the stomach and helps deliver food and medicines until the person is able to chew and swallow.

Jejunostomy tube (J-tube)

A soft, plastic tube placed through the skin of the abdomen into the midsection of the small intestine.  The tube delivers food and medicine until the person is healthy enough to eat by mouth.

Stroke Rehabilitation

The goal of a stroke rehabilitation program is to help you relearn skills you lost when stroke affected part of your brain.