The third podcast in the What are Palpitations? series focuses on what tools/techniques your care providers have to diagnose abnormal heart rhythms. A brief outline includes:

  1. Electrocardiogram (ECG or EKG)
  2. Twenty-four-hour Holter monitor
  3. Two- to four-week outpatient telemetry monitor
  4. Hospital telemetry
  5. Smartphone-based applications
  6. Tilt-table test
  7. Implantable loop recorders
  8. Summary

Please check back with the Heart Rhythm Center for future podcasts to include:

  • Work-up and Evaluation of Heart-Rhythm Disorders (Meeting the Heart-Rhythm Physician)
  • What Are the Common Supraventricular (Top-Chamber) Tachycardias?
  • What Is Atrial Fibrillation?
  • What Are the Common Ventricular (Bottom-Chamber) Tachycardias?
  • Treatment Options for Arrhythmias
  • The Electrophysiology Study and Ablation Procedure
  • Possible Complications of Electrophysiology Studies and Ablations
  • Postoperative Care after an EP Study (and possible ablation)
  • Psychosocial Impact of Arrhythmias

This second podcast in the What are Palpitations? series focuses on palpitations and other symptoms that may represent heart-rhythm abnormalities. A brief outline includes:

  1. Introduction
  2. What is a normal heart rhythm?
  3. What are abnormal heart rhythms?
  4. What are palpitations?
  5. Other symptoms that may represent heart-rhythm abnormalities
  6. Know your ejection fraction
  7. What are ventricular fibrillation and ventricular tachycardia?
  8. Is there a difference between atrial fibrillation and ventricular fibrillation?
  9. Congestive heart failure and risk of arrhythmia

Please check back with the Heart Rhythm Center for future podcasts to include:

  • How Are Heart-Rhythm Abnormalities Diagnosed?
  • Work-up and Evaluation of Heart-Rhythm Disorders (Meeting the Heart-Rhythm Physician)
  • What Are the Common Supraventricular (Top-Chamber) Tachycardias?
  • What Is Atrial Fibrillation?
  • What Are the Common Ventricular (Bottom-Chamber) Tachycardias?
  • Treatment Options for Arrhythmias
  • The Electrophysiology Study and Ablation Procedure
  • Possible Complications of Electrophysiology Studies and Ablations
  • Postoperative Care after an EP Study (and possible ablation)
  • Psychosocial Impact of Arrhythmias

 

Thousands of patients every year are admitted to hospitals because of irregular, fast, or strong heartbeats. For the portion that will eventually be diagnosed with a heart condition, there are important choices to make moving forward. But there is rarely time in a short doctor’s visit to go over all the details.

The Heart Rhythm Center’s podcast What are Palpitations? serves as a comprehensive overview fills that information gap by imparting everything there is to know about abnormal heart rhythms through all stages of care. Dr. Jeffrey L. Williams, MD, MS, FACC, FHRS, CPE, has worked to provide patients with complete information. There are various types of arrhythmias, and the benefits and risks of treatments for each will vary for each individual patient. Patients, as well as their families, need a thorough understanding to make a fully informed decision.

Along with types of treatments, Dr. Williams discusses what is happening on a physiological level and explains the full evaluation process that doctors use. His knowledge, gained over years of study and practice, offers the what, why, and how of this medical issue, so anyone can make the best decisions for the health of his or her family.

Please check back with the Heart Rhythm Center for future podcasts to include:

  1. Palpitations and Other Symptoms That May Represent Heart-Rhythm Abnormalities (Arrhythmias)
  2. How Are Heart-Rhythm Abnormalities Diagnosed?
  3. Work-up and Evaluation of Heart-Rhythm Disorders (Meeting the Heart-Rhythm Physician)
  4. What Are the Common Supraventricular (Top-Chamber) Tachycardias?
  5. What Is Atrial Fibrillation?
  6. What Are the Common Ventricular (Bottom-Chamber) Tachycardias?
  7. Treatment Options for Arrhythmias
  8. The Electrophysiology Study and Ablation Procedure
  9. Possible Complications of Electrophysiology Studies and Ablations
  10. Postoperative Care after an EP Study (and possible ablation)
  11. Psychosocial Impact of Arrhythmias

 

 

2018 Speakers Group Pic.jpg
2018 LRH CV Symposium Speakers. From left to right, Dr. Khanna, Dr. Carl Pepine, Dr. Fred Kusumoto, Dr. Daniel Yip, Dr. Andres Medina, Dr. Williams. Not pictured: Dr. Doug Ebersole and Dr. Victor Cotton.

Thanks to all the faculty and attendees of the 2018 Lakeland Regional Health Cardiovascular Symposium! We appreciate the time away from family and hope the education proves to be worthwhile. You will find link to PDF’s of all lectures below; please note that faculty may have altered their presentations from these files.

2018 Pepine Pic
Dr. Carl Pepine from the University of Florida discussing women and heart disease. Forty two percent of adult women have hypertension which is the number one cause of mortality! Dr. Pepine is a true giant of cardiology.

Pepine CVD in Women

 

2018 Yip Photo
Dr. Daniel Yip from Mayo Clinic discussing management of congestive heart failure.

Yip LRH CV Symposium 2018

2018 Kusumoto Pic
Dr. Fred Kusumoto from Mayo Clinic discussing anticoagulation for atrial fibrillation.

Kusumoto LRH CV Symposium 2018

IMG_3749
Dr. Doug Ebersole from The Watson Clinic discussing left atrial appendage occlusion in clinical practice.

Ebersole LRH CV Symposium 2018

Cotton 2018 Pic.jpg
Dr. Victor Cotton explaining medical liability risk mitigation. Always a great speaker and hard to tell if he is more entertaining or informative!

Cotton LRH CV Symposium 2018

IMG_3761.JPG
Dr. Andres Medina of The Watson Clinic and Lakeland Regional Health discussing transcutaneous aortic valve replacement.

 

 

Medina 2018 TAVR

Thompson CV Symposium 2018

Khanna 2018 EKG

Williams LRH CV Symposium 2018

Thanks again for attending and please let us know what you’d like to hear about next year. You can submit suggestions for next year by commenting here.

We hope you will join us for Lakeland Regional Health’s 2017 Cardiovascular Symposium. We believe that you will find this opportunity to learn from leaders in our profession both educational and inspiring. Speakers from University of Pennsylvania, Vanderbilt University, University of Pittsburgh, and University of South Florida as well as local faculty will be presenting state-of-the-art topics in cardiovascular disease.

Lakeland Regional Health is committed to delivering nationally recognized healthcare, strengthening our community and advancing the future of healthcare. The experienced physicians of our Heart Center place patients at the heart of all they do. We are Polk County’s pioneer in expert cardiac care and have been for more than three decades.

Upon completion of our Symposium, participants should be able to:

  • Understand the latest research in managing patients with artificial hearts and/or ventricular assist devices.
  • Describe the long-term impact of cardiovascular care on function in the elderly.
  • Identify outpatients with pulmonary hypertension.
  • Recognize and describe the pros and cons of rate versus rhythm control for atrial brillation.
  • Identify and describe interventional cardiology technologies that are currently available to treat structural heart disease.
  • Describe the latest methods for outpatient management and diagnosis of peripheral vascular disease.
  • Describe the current inpatient and outpatient congestive heart failure care continuum.
  • Understand survival rates and long-term complications of adults with congenital heart disease.

    We look forward to seeing you in February. If you have any questions, please do not hesitate to contact us at 863.687.1190.

The Symposium offers 5.25 AMA Category 1 CME credits) and registration is free at 2017 Lakeland Regional Health Cardiovascular Symposium.

What is a Defibrillator? Cover

A defibrillator implant is a small device surgically implanted in the chest to maintain the heart’s electric rhythm. The surgery is very common: over 130,000 Americans receive a defibrillator implant every year.

If you or a loved one requires a defibrillator implant, you’ll undoubtedly have many questions—questions that can’t always be adequately explained in a forty-five minute doctor’s appointment. I recently published a complete, easy-to-understand guide to defibrillator implantation.

What Is a Defibrillator? begins with an explanation of how defibrillators work and the conditions they treat. I then discuss how doctors determine whether patients are good candidates for defibrillators and provides an overview of the implantation process. Potential complications both before and after defibrillator implantation are discussed, as is surgical recovery and follow-up treatment. For readers having difficulty with medical terminology, there is a helpful glossary at the back of the book.

Patients, caregivers, and family members alike will benefit from these straightforward explanations. If you’re a candidate for defibrillator implantation, this book can help you approach surgery with a full understanding of the procedure and what it means to your quality of life.

What is a Defibrillator? is available in print and electronic versions at Amazon.com (http://www.amazon.com/What-Defibrillator-Cardiologists-Patients-Providers-ebook/dp/B011EXAQL4/ref=sr_1_4?s=digital-text&ie=UTF8&qid=1438283493&sr=1-4).

A recent article from The Advisory Board Company found a group of hospitals that had an advantage when it came to providing an excellent patient experience: specialty hospitals. An Advisory Board analysis of recent Hospital Compare data suggests that specialty hospitals dominate the rankings when it comes to patient satisfaction.

Patient satisfaction may not be the only benefit of a specialty hospital or “center of excellence.”  We examined the demographics, complications, re-admissions, and accessibility of care in a community electrophysiology (EP) program to add to the body of knowledge of ‘real-world’ EP device implant complications. Two hundred and fifty consecutive patients who underwent device implantation by a single electrophysiologist in a new non-academic community hospital EP program starting from its inception in July 2008 were included for analysis. Standard procedures for implantation were used. Pacemakers, defibrillators, and generator changes were included; temporary pacemakers were excluded. Major complications were defined as in-hospital death, cardiac arrest, cardiac perforation, cardiac valve injury, coronary venous dissection, hemothorax, pneumothorax, transient ischemic attack, stroke, myocardial infarction, pericardial tamponade, and arteriovenous fistula. Minor complications were defined as drug reaction, conduction block, hematoma or lead dislodgement requiring re-operation, peripheral embolus, phlebitis, peripheral nerve injury, and device-related infection. This community cohort had similar ejection fractions but was older with worse kidney function than those studied in prior reports. There was one major early complication (0.4%) and seven minor early complications (2.8%). Left ventricular lead placement was successful in 64 of 66 patients (97%). This was the first community-hospital based EP program to examine device implant demographics and outcomes, and revealed an elderly, ill population with lower overall rates of complications than seen in national trials and available reports from single non-community centers. Contrary to current perceptions, these data suggest that community centers may subselect an elderly, ill patient population and can provide high-quality, cost-effective, and more accessible care.

 

“Specialty hospitals are under increasing scrutiny, but there may be a role for ‘niche’ hospitals that, while offering the full spectrum of general hospital care, can provide certain procedures at an exceptional level of quality and cost-effectiveness. Recent literature continues to document the paucity of data available on rates and predictors of ICD implantation in routine clinical practice.(24,25) The Ontario ICD Database (24) revealed major complications related to de novo defibrillator implantations in 4.1% of procedures. Adjusting our data to match their definition of major complications, our center had major complications in 1.0% of de novo defibrillator implantations (a 76% relative reduction in major complications). The cost of major complications among Medicare beneficiaries receiving implantable defibrillators was examined in 30,984 patients.(25) They found that 10.8% of patients experienced one or more complications resulting in an increase in length of stay by 3.4 days and costs by $7,251. Superiorly performing ‘niche’ hospitals that reduce major complication rates from defibrillator implants by 76% in the uS (conservative estimate of 100,000 yearly implants) could realize an estimated $60 million in cost savings while improving patient safety.” (Williams et al, 2010, full link to reference below)

Demographics and complication rates seen in this report versus those reported from non-community centers and national trials.
Demographics and complication rates seen in this report versus those reported from non-community centers and national trials.

Please take this one question poll about specialty hospitals:

For More Details Please See:

This is the fifth in a series of short (less than 5minutes), educational videos designed for patients and their care providers to develop a thorough understanding of pacemakers.  Lecture 5 What to Expect on the Day of Pacemaker Implant Procedure describes the events that take place on the day of pacemaker implantation.  Important topics include hospital registration and check-in, the implant procedure, and post-implant events.

Please see the Patient Education section of Heart Rhythm Center for other lectures in this series.

Lecture 1: Basics of Heart Anatomy and Conduction System

Lecture 2: Reasons for Pacemaker Implantation

Lecture 3: What are Pacemakers and How Do They Work?

Lecture 4: Preoperative Workup and Evaluation (Meeting the Implanting Physician)

This is the fourth in a series of short (less than 5minutes), educational videos designed for patients and their care providers to develop a thorough understanding of pacemakers.  Lecture 4 Preoperative Workup and Evaluation (Meeting the Implanting Physician) describes the preoperative evaluation for patients preparing to undergo pacemaker implantation.  Important topics include the types of physicians that perform pacemaker implantation and questions to ask the doctor to minimize the risk of complications.

Please see the Patient Education section of Heart Rhythm Center for other lectures in this series.

Lecture 1: Basics of Heart Anatomy and Conduction System

Lecture 2: Reasons for Pacemaker Implantation

Lecture 3: What are Pacemakers and How Do They Work?

 

 

This is the third in a series of short (less than 5minutes), educational videos designed for patients and their care providers to develop a thorough understanding of pacemakers.  Lecture 3 What are Pacemakers and How Do They Work? describes the basics of pacemaker implantation and how the pacemakers work.

Your care providers have extensive training assessing the reasons—also called indications—that a patient may need a pacemaker. In particular, it is very important that the benefits of pacemaker implantation outweigh the risks of the pacemaker implant surgery (to be discussed later). The American College of Cardiology (ACC) is one of the major professional societies that develops guidelines to help care providers make educated clinical decisions that are based upon prior clinical studies. This is the basis of “evidence-based” medicine: the process by which clinical ideas are tested, reported, and reevaluated to decide the most appropriate care for a particular condition.

The ACC has developed guidelines that help care providers decide when a patient would be best served by a pacemaker.  The easiest rule to remember is: pacemakers are most appropriate for patients who are having symptoms related to an abnormally slow—or at times, fast—heart rate. These symptoms include: shortness of breath, chest pain, dizziness, fainting (also called syncope), heart failure, arrhythmias (such as ventricular tachycardia/fibrillation), or fatigue.   The decision to implant a pacemaker also requires evaluation of the permanence of the AV block. Electrolyte abnormalities (like potassium) can cause significant AV block, but correction of the abnormality can lead to resolution of the AV block. Some diseases—like Lyme Disease—often follow a natural course where the AV block is temporary and resolves as the disease is treated. Some types of AV block that occur during periods of vagal activation can reverse very quickly (e.g., nausea and dizziness during a blood draw may cause transient AV block or during sleep in patients with sleep apnea). In addition, after aortic valve surgery, inflammation can cause transient AV block that resolves within days of the operation. Finally, there are some diseases that warrant pacemaker implantation, because the AV block may continue to worsen (for example, sarcoidosis, amyloidosis, or neuromuscular diseases).

Basics of Heart Anatomy and Conduction System 

Reasons for Pacemaker Implantation