2016 Sentara Heart Annual Report

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Electrophysiology Program

Sentara Heart Hospital has one of the country’s leading electrophysiology (EP) programs, featuring four EP labs with advanced 3D mapping systems and a separate Hybrid Cardiac Operating Suite. Our board-certified electrophysiologists treat heart rhythm disturbances using the latest devices and advanced procedures that take place inside the heart without the need for open surgery.

In 2016, Sentara Heart electrophysiologists performed more than 900 catheter ablations to treat cardiac arrhythmias, including atrial fibrillation, ventricular tachycardia and supraventricular tachycardia. This minimally invasive procedure targets areas of the heart causing the arrhythmia. We also have a number of clinical research opportunities that give patients access to the latest cardiac care technologies.

Leadless Device Therapy

As one of the busiest electrophysiology programs in Virginia, the sophisticated device therapy program at Sentara Heart performs more than 1,600 device procedures each year.

In 2016, Sentara Heart Hospital became one of the first hospitals in Virginia to offer the world’s smallest leadless (wire-free) pacemaker, the Micra® Transcatheter Pacing System. This device regulates heart rhythm for patients with bradycardia, a slow or irregular heartbeat of fewer than 60 beats per minute.

Traditional pacemakers rely on leads, or wires, to provide an electrical connection between the device and heart. If these leads malfunction or an infection develops in surrounding tissue, patients must undergo another surgery to replace the device and leads.

Micra is about the size of a large vitamin and weighs the same as a penny. Sentara electrophysiologists use a transcatheter procedure to implant the wire-free device directly into the heart’s right ventricle chamber where it delivers electrical stimulation to the heart.

  • Automatic pacing: Micra automatically adjusts the heart’s pacing based on a patient’s activity level.
  • MRI compatibility: Traditional pacemakers contain metals that can’t undergo magnetic resonance imaging (MRI). Micra doesn’t contain these metals, which means patients can get advanced imaging diagnostic procedures.
  • Permanent placement: Should a patient need more than one heart device, doctors can turn off Micra and implant a new device – while Micra stays in the heart – without risk of electrical interaction.

Permanent His Bundle Pacing

Sentara electrophysiologists also are among a select few in the region with the expertise to perform a pacemaker technique known as permanent His bundle pacing (PHBP).The bundle of His is a group of heart muscle cells that transmits electrical impulses from the atrioventricular node to the left and right ventricles.

Patients with congestive heart failure and bundle branch disease traditionally require cardiac resynchronization therapy (CRT) to treat heart rhythm problems. CRT involves placing leads, or wires, into the right and left ventricles to generate simultaneous pacing of the two ventricles.

With PHBP, our electrophysiologists position the pacemaker leads to directly engage the bundle of His. This alternative therapy enables patients to maintain a regular heart rhythm with less risk of heart muscle damage than traditional right ventricular pacing.

The World's Smallest Pacemaker

In July 2016, Sentara Heart Hospital became one of the first hospitals in the area to implant the world’s smallest pacemaker in patients with bradycardia.The Micra® Transcatheter Pacing System (TPS) is a new device that provides patients with the most advanced pacing technology at one-tenth the size of a traditional pacemaker. Micra is the only leadless pacemaker approved for use in the U.S. The device is small enough to be delivered through a catheter and implanted directly into the heart with small tines, providing a safe alternative to conventional pacemakers without the complications associated with leads – all while being cosmetically invisible.

The MicraTPS is also designed to automatically adjust pacing therapy based on a patient’s activity levels.The MicraTPS is the first and only transcatheter pacing system to be approved for both 1.5 and 3Tesla (T) full-body magnetic resonance imaging (MRI) scans, providing patients with access to the most advanced imaging diagnostic procedures available, if and when they need one.