Anurag Gupta, M.D.
Creating an environment devoted to this purpose has enabled us to provide everything needed for the best patient outcomes in one place.
The center enables leading cardiac electrophysiologists and cardiovascular surgeons to collaborate with a team of specially trained professionals, including a clinical nurse specialist, cardiac anesthesiologists, registered nurses, and technicians with special training in electrophysiology procedures.
Using state-of-the-art equipment, these professionals perform many procedures previously available only at leading academic medical centers. These include the most technologically advanced computer assisted diagnostic electrophysiology studies and catheter ablation procedures, as well as, the expert implantation of pacemakers, defibrillators and cardiac resynchronization devices.
Normally, electricity flows throughout the heart in a regular, measured pattern. Problems can develop anywhere along the electrical pathways, disrupting the regular beating of the heart and causing an abnormal heart rhythm, or arrhythmia. Left untreated, arrhythmias can lead to serious consequences such as heart failure or sudden cardiac death, two leading causes of death in the U.S.
A comprehensive medical examination and special tests help cardiac electrophysiologists – cardiologists with advanced training in the diagnosis and treatment of arrhythmias – properly identify the rhythm problem. The treatment that best matches the individual needs of the patient can then be determined.
The most common form of arrhythmia, atrial fibrillation, is an irregular heart rhythm originating in the upper chambers (atria) of the heart in which the heart’s electrical system causes the atria to quiver, or fibrillate. The quivering upsets the normal rhythm between the atria and the lower chambers (ventricles) of the heart, hindering the heart's ability to pump blood and depriving the body of oxygen and nutrients.
Hybrid Atrial Fibrillation (AF) Program
Our hybrid Atrial Fibrillation (AF) program is a newer development which combines minimally-invasive epicardial radiofrequency ablation (ablation on the outside of the heart) with endocardial cryoablation, done directly within the heart’s chambers.
This is used for patients who experience persistent AF following multiple previous ablations, or when the left atrium is severely enlarged. We feel this procedure is the most painless for our patients, with the shortest postoperative length of stay, and we are seeing a high success rate with our process.
The below computerized rendering of the left atrium shows atrial fibrillation originating from the pulmonary veins and extending into the posterior wall of the left atrium. Our new hybrid approach combines a surgical ablation of the posterior wall with endocardial ablation of the pulmonary veins.
Implantable Cardiac Defibrillator
An implantable cardiac defibrillator (ICD) uses electrical pulses or shocks to help control life-threatening arrhythmias, especially those that can cause sudden cardiac arrest. John Muir Health was one of the first Northern California hospitals to implant a completely subcutaneous ICD, with no electrical leads placed within the heart.
Laser Lead Extraction
Lead extraction is performed to remove pacemaker or ICD leads that are infected, malfunctioning, occluded or redundant. This procedure is performed as a heart team with an electrophysiologist and a cardiac surgeon working together in the procedure. An excimer laser is used to vaporize scar tissue that surrounds the problematic leads and allow its extraction.
Pacemakers are implanted for a number of conditions including bradycardia, heart failure and syncope.
The Cardiac Rhythm Center features specialized equipment designed to assist physicians during complex electrophysiology studies. These include: