If your heart begins to flutter, don’t mistake it as a sign of excitement, exertion, or a lovestruck swoon.
It could be an arrhythmia, which disrupts the heart’s natural rhythm, making the beats too fast or too slow or causing an irregular—rather than a steady—rhythm. Depending on the type of arrhythmia, an errant heart rate can lead to fainting, fatigue, dizziness, edema (swelling), cardiac arrest, or stroke caused by a blood clot.
At the Jupiter Medical Center Robson Heart & Vascular Institute, specialists evaluate and identify the cause of a patient’s irregular heartbeat and individualize a treatment plan that may include medication, surgical, or minimally invasive interventions.
“Many types of rhythm problems can be cured,” says Dr. David Weisman, medical director of clinical cardiac electrophysiology at the JMC Robson Heart & Vascular Institute. A fellowship-trained, board-certified cardiac electrophysiologist, Weisman understands the electrical signals that control the heartbeat and specializes in treating heart rhythm disorders.
One of the most common procedures he performs is ablation, which destroys or removes damaging tissue. “The bulk of what I do—about 80 percent—is ablation for fast heart rhythm disorders, when the heart feels like it’s beating out of the chest when it’s not supposed to be,” Weisman says.
Fast or erratic heart rates, often caused by atrial fibrillation (AFib) or supraventricular tachycardia (SVT), originate in the heart’s upper chambers—the atria—causing a “fluttery” feeling (palpitations) because the heart can't fill with blood properly.
Both AFib and SVT can cause chest pain and other symptoms, though some people may not notice that their heart is beating more than the optimal 60 to 100 beats per minute. Weisman notes that AFib patients typically have other health issues, such as diabetes, sleep apnea, high blood pressure, or coronary heart disease. AFib is so common, the Robson Heart & Vascular Institute is home to the AFib Center of Excellence, where an array of innovative, personalized solutions for arrythmias reduce patients’ stroke risk and allow them to return to a fuller life with peace of mind.
“The nice thing is that it simplifies their life,” says Weisman. “They can potentially get off medication, in addition to feeling better.”
Ablation is ideal for most patients who don’t want to be reliant on medicine for the rest of their life. It’s also an effective treatment when medication is not effective or due to intolerance to medication or blood thinners.
During ablation, a catheter is inserted into the groin and threaded internally to the heart. Tissue inside the heart is frozen (cryoablation) or burned (radio frequency ablation) to halt the production of abnormal electrical signals. Weisman has developed his own protocols for performing cardiac ablation without fluoroscopy (X-ray images) to limit radiation exposure during cardiac procedures.
The WATCHMAN procedure is a one-time implant for people with AFib that is not caused by a heart valve problem. The implant reduces the risk of stroke by sealing off a section of the left atrial appendage where 90 percent of clots tend to form. With a catheter, the small device is placed over the atrial appendage’s entrance. Heart tissue grows around the implant and creates a barrier that prevents blood from flooding into it. It is done under light sedation and patients who undergo the procedure typically are discharged the same day.
Weisman is the first physician in the region to offer a concomitant AFib procedure, which combines ablation and a WATCHMAN implanted in one session as opposed to two separate procedures.
Implanted pacemakers have been the go-to for decades for regulating the heartbeat. But in the past, they required an incision that required a long recovery.
The JMC Robson Heart & Vascular Institute offers leadless pacemaker implants that don’t require a large incision in a 30-minute procedure. A catheter is threaded into the right ventricle, where a small, capsule-like leadless pacemaker is positioned and secured.
The minimally invasive Convergent Procedure for treating difficult-to-control AFib involves a hybrid team approach by an electrophysiologist such as Weisman and a cardiac surgeon in a staged procedure.
The menu of minimally invasive procedures offered by the JMC Robson Heart & Vascular Institute “don’t require open incisions, like for open heart. We’re doing it with tubes, cameras, ultrasound, and small punctures,” explains Weisman. “There is not a big recovery from these procedures—a week for most.”
The general population is likely to discover they have an arrhythmia on their own, thanks to the evolution of wearable, health-tracking technology such as the Apple Watch, Oura Ring, and fitness apps, Weisman notes. “People can monitor their health at home, and have it validated by a doctor,” he says, adding patients have come straight to the institute with data in hand without a referral.
“The worst case is if they have AFib and the first time they are seeing the doctor is because they had a stroke,” Weisman says. “It’s better to detect it earlier and prevent that from ever happening.”