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3650 W. Wheatland Rd. Suite C, Dallas, TX 75237
Phone: 214-774-9771
Fax: 214-774-9762
Russell M. Canham
, MD, MCS
Services and Procedures
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ABLATION
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Catheter ablation is a procedure that uses radiofrequency energy or cryotherapy to destroy a small area of heart tissue that is causing rapid and irregular heartbeats. Destroying this tissue helps restore your heart’s regular rhythm. The procedure is also called radiofrequency ablation which can burn the abnormal pathway or cryoablation which can freeze it.
Catheter ablation is used to treat abnormal heart rhythms (arrhythmias) when medicines are not tolerated or effective. This procedure takes place in a special hospital room called an electrophysiology (EP) lab or a cardiac catheterization (cath) lab. Catheters are inserted into the heart and help create a 3D map to identify areas to target.
The procedure is used most often to treat a condition called supraventricular tachycardia, or SVT, which occurs because of abnormal conduction fibers in the heart. Catheter ablation is also used to help control other heart rhythm problems such as atrial flutter and atrial fibrillation and some abnormal ventricular rhythms.
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CARDIAC RESYNCHRONIZATION
THERAPY or CRT
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Cardiac resynchronization therapy or CRT is a procedure to implant a device in your chest to make your heart's chambers squeeze (contract) in a more organized and efficient way.
CRT uses a biventricular pacemaker or ICD (defibrillator) that sends electrical signals to both lower chambers of your heart (ventricles) with proper timing to optimize how is pumps. The signals trigger your ventricles to contract in a more coordinated way, which improves the circulation of blood out of your heart.
Cardiac resynchronization therapy is a treatment for heart failure in people whose ventricles don't contract in a coordinated fashion. If you have heart failure, your heart muscle is weakened and may not be able to pump out enough blood to support your body. This can be worsened if your heart's chambers aren't in sync with each other.
Cardiac resynchronization therapy may significantly reduce your symptoms of heart failure and lower your risk of heart failure complications, including death.
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CARDIOVERSION
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If your heart has an irregular (uneven) beat or is beating too fast, cardioversion is a way to restore a regular rhythm. Abnormal heart rhythms are called arrhythmias.
There are two main kinds of cardioversions. Your doctor may give you one or more medicines to bring back your regular heartbeat. This is called pharmacologic (chemical) cardioversion. Doctors also restore regular rhythms by sending an electrical shock to the heart. This is called electrical cardioversion.
Arrhythmias may prevent blood from circulating properly to your heart and brain. Most often, doctors use cardioversion to treat a fast, irregular heart rhythm called atrial fibrillation or atrial flutter. Cardioversion also treats other kinds of abnormal heartbeats, including other atrial and even more dangerous ventricular arrhythmias in more emergent situations.
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CONSULTATION
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A cardiac consultation, is an opportunity for patients to discuss their cardiac problems and concerns and how to improve and modify risk factors. It also helps in better understanding the treatment methods, options, and cardiac procedures, in addition to appropriate medications and testing.
During the cardiac consultation, your doctor will evaluate past medical history, and perform a physical examination and use tests to assess the risk of developing heart diseases. Early diagnosis may have a better prognosis and minimize the complications.
​To prepare for it, please bring all necessary medical records for the discussion. It helps in better understanding your heart condition and avoids repetition of diagnostic tests. Make sure you discuss your past medical history, surgical history, family history, and know all medications that you are taking which you should bring with you as well.
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DEFIBRILLATORS or ICDs
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Defibrillators or ICDs are very useful in preventing sudden death in patients at risk for dangerous arrhythmias like ventricular tachycardia or fibrillation. Studies have shown ICDs to have a role in preventing cardiac arrest in high-risk patients who haven't had, but are at risk for, life-threatening ventricular arrhythmias in addition to those who have had them.
ICDs may have a dual function which includes the ability to serve as a pacemaker. The pacemaker feature would stimulate the heart to beat if the heart rate is detected to be too slow or needs cardiac resynchronization therapy (CRT) to improve timing and the function of the heart muscle.
If an abnormal heart rhythm is detected the device will deliver fast brief pacing called “overdrive” pacing to electrically convert a sustained ventricular tachycardia or an electric shock to restore a normal heartbeat if your heart is beating abnormally and much too fast. They help by continuously monitoring the heart's electrical system and providing automatic correction when an arrhythmia starts to occur.
You may be at risk of a life-threatening ventricular arrhythmia because of having heart failure, have had a ventricular arrhythmia, heart attack, survived a sudden cardiac arrest or have rare genetic or congenital abnormalities.
The device or generator is implanted just under the skin with wires or leads run from the pulse generator to positions on the surface of or inside the heart and can be installed through blood vessels (transvenous), eliminating the need for open-chest surgery. Other options for some patients are device (SICD or subcutaneous ICD) implanted under the skin on the side with a lead installed under the skin above the heart.
New devices are MRI compatible and offer many other functions to help monitor fluid buildup and signs of heart failure before things worsen to the point of being hospitalized.
Be sure to ask if you hospital allows the doctor to place the most current and up to date model to benefit you the most.
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ELECTROPHYSIOLOGY (EP) STUDY
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An electrophysiology (EP) study is a test performed to assess your heart's electrical system or activity and is used to diagnose abnormal heartbeats or arrhythmia.
The test is performed by inserting several catheters through blood vessels that enter the heart to measure and map electrical activity.
The EP study is performed in the electrophysiology laboratory of the hospital. During the EP study the heart's electrical signals will be recorded to assess the electrical function. Pacing the heart to bring on certain abnormal rhythms for observation under controlled conditions will be done, along with medications that are sometimes used to stimulate your arrhythmia. Once the abnormal pathways or focus of arrhythmias are found, an ablation may take place using radiofrequency or sometimes cryoablation to destroy the problem areas and prevent future arrhythmias.
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IMPLANTABLE LOOP RECORDER
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An implantable loop recorder is a very helpful type of heart-monitoring device that records your heart rhythm continuously for up to two to three years. It records the electrical signals of your heart and allows remote monitoring by way of a very small device inserted just beneath the skin of the chest with an easy and quick procedure, sometimes done in the office.
An implantable loop recorder allows for much long-term heart rhythm monitoring that a holter or telemetry monitor cannot provide. It captures and records information that a standard electrocardiogram (ECG or EKG) or Holter monitor misses because some heart rhythm abnormalities occur infrequently.
It can help figure out why you're having fainting spells, palpitations, and even stokes of unknown origin. It will record any related heart rhythm abnormalities that are too fast, too slow, pauses or abnormal and irregular arrhythmias and can uncover rhythms that can cause strokes. Because an implantable loop recorder monitors your heart signals for a much longer time, it's more likely to capture what your heart is doing during your next set of symptoms.
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LEFT HEART CATHETERIZATION
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A cardiac catheterization, sometimes called a cardiac cath or heart cath, is a procedure to help find out if you have disease of the heart muscle, valves or coronary (heart) arteries. A thin catheter is inserted through an artery in the wrist or leg into a large blood vessel that leads to your heart.
During the procedure, the pressure and blood flow in your heart can be measured. Coronary angiography is done during cardiac catheterization by using small amounts of contrast dye visible in X-rays that flows through the heart arteries. This shows where arteries are blocked.
During this study, a percutaneous coronary intervention (PCI) such as coronary angioplasty with stenting to open up narrowed or blocked segments of a coronary artery may occur. This will help improve blood flow to the heart muscle for area that have significant blockages.
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PACEMAKERS
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Pacemakers are small devices implanted to help control your heartbeat. There are two main parts: a generator and wires (leads). It produces the electrical impulses that stimulate your heart to beat. It is different from an ICD or defibrillator, as it cannot shock or treat dangerous arrhythmias.
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Most commonly, the generator may be implanted under your skin through a small incision. The generator is connected to your heart through tiny wires that are implanted at the same time. In some cases only a small pacing capsule in the right ventricle with no leads. The impulses flow through these leads or capsule to your heart and are timed to trigger heart beats at more regular intervals just as impulses from your heart's natural pacemaker would.
You may need a pacemaker if your heartbeat is too slow from the sinoatrial (SA) node which is the heart's natural pacemaker, or if there is heart block in the atrioventricular (AV) where the signal is not transmitted down to the ventricles to cause a heartbeat or pulse. It watches your native heart beat and signals and only replaces the heart's defective natural pacemaker functions when needed. Rhythm problems also can occur because of a blockage of your heart's electrical pathways. The pacemaker's pulse generator sends electrical impulses to the heart to help it pump properly.
Depending on your condition, you might have one of the following types of pacemakers. A single chamber pacemaker. This type usually carries electrical impulses to the right ventricle of your heart. A dual chamber pacemaker which carries electrical impulses to the right atrium and the right ventricle to help control the timing of contractions between the two chambers. Or a biventricular pacemaker called cardiac resynchronization therapy, for people with heart failure with abnormal electrical systems to make the heart beat more efficiently. Newer devices are MRI compatible as well.
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Be sure to ask if you hospital allows the doctor to place the most current and up to date model to benefit you the most.
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RIGHT HEART CATHETERIZATION
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A right heart catheterization is a procedure used to see how well your heart is pumping and to measure the blood pressure in your heart and the main blood vessels in your lungs. The test is also called pulmonary artery catheterization. A right heart catheterization is different than a left heart catheterization (coronary angiography), which is used to check for blockages in your arteries and assess valves.
It can be used to find out if you have high blood pressure in your lungs, called pulmonary hypertension. The test can help find the cause of pulmonary hypertension and show how severe it may be. It can also be used if you are being evaluated for a heart, lung or other organ transplant.
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SECOND OPINION
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A second opinion is a valuable resource for every patient with heart disease. It's an important way for you and your family to ask questions about your condition and explore your various treatment options. Getting a second opinion does not mean you think the first diagnosis is necessarily wrong or that you doubt your doctor. Instead, it help confirm your original diagnosis and may provide more choices or offer other options.
Our cardiac second opinion services provides you with confidence in knowing you are making the right choices about your heart care
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TILT TABLE
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A tilt table test can be used to evaluate the cause of unexplained episodes of lightheadedness, dizziness or fainting (called syncope). The test can help determine if the cause is related to significant changes to your heart rate or blood pressure called vasovagal syncope.
During the test, you lie on a table that is slowly tilted upward to around 70 degrees. The test measures for abnormal changes in your blood pressure and heart rate and how they respond to the force of gravity. A nurse or technician keeps track of your blood pressure and your heart rate (pulse) to see how they change during the test. You may be given some medications during the study as well to further test for a significant change.
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TRANSESOPHAGEAL ECHOCARDIOGRAM
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A transesophageal echo (TEE) test is a type of echocardiogram that takes ultrasound images from another view than the regular echocardiogram. It uses a long, thin, tube (endoscope) to guide the ultrasound transducer just a short way down the esophagus that goes from the mouth to the stomach.
This lets the doctor see pictures of the heart without the ribs or lungs getting in the way. A TEE is done when your doctor needs a closer look at your heart or does not get the information needed from a regular echo.
It gives better views and is used to evaluate your heart valves and can look for problems, such myocardial disease, pericardial disease, infective endocarditis, cardiac masses and congenital heart disease. It is also used to look for a thrombus or blood clot for patient with atrial fibrillation or flutter before a cardioversion procedure or ablation.
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VASCULAR STENTING AND REPAIR
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Vascular disease is any abnormal condition of the blood vessels (arteries and veins). The body uses blood vessels to circulate blood through itself. Problems along this vast network can cause severe disability and death.
The most common vascular diseases outside the heart can result in stroke, peripheral artery disease (PAD), abdominal aortic aneurysm (AAA), carotid artery disease (CAD), arteriovenous malformation (AVM), critical limb-threatening ischemia, pulmonary embolism (blood clots), deep vein thrombosis (DVT), chronic venous insufficiency (CVI), and varicose veins.
For PAD, a peripheral angiogram is a test that uses X-rays and dye to help your doctor find narrowed or blocked areas in one or more of the arteries that supply blood to your legs. These blockages can lead to serious conditions from poor circulation like poor wound healing, gangrene, and leg amputation. The angiogram evaluates for a surgical procedure or stenting that may be needed to open the blocked arteries and improve blood flow may result in a small stent to help keep it open. Bypass surgery is another procedure. This re-routes blood around the blocked arteries.
Symptoms of blocked leg vessels include claudication or leg pain and numbness with walking, discoloration and poor wound healing from decreased blood flow.
Also you carotid arteries can be effected. These are located on each side of your neck and extend from your aorta in your chest and supply blood to your brain. Symptoms of these being blocked include dizziness, weakness, and trouble seeing, speaking or moving from TIAs or stokes.
Carotid artery stenting is a procedure in which a vascular surgeon inserts a slender, metal-mesh tube, called a stent, which expands inside your carotid artery to increase blood flow in areas blocked by plaque.
Vein occlusions and clots can form from several risk factors and are often treated with blood thinners or anti-coagulation.
Treatment of these vascular conditions also includes proven medications, risk factor changes like diabetes and cholesterol control and stopping smoking.
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