When the electrical system of the heart fails, highly specialized examinations allow us to study and treat most cardiac electrical pathologies.
Diagram of cardiac electrical conduction
Oxygen-poor blood from the veins passes into the atrium and then the right ventricle (blue). Carried away by the pulmonary arteries, it will then fill up with oxygen in the lungs. The atrium and left ventricle (in red) receive oxygen-rich blood and then pump it into the overall bloodstream.
These contractions are triggered by electrical impulses induced by the sinus node, which thus sets the pace. The electrical activity of the heart can be visualized by surface electrocardiogram (ECG) or intracavitary electrocardiogarmmas measured by catheters.
Depending on the electrical pathology of the heart that concerns you, several treatments may be proposed to you, the list of which you will find below:
Implantation of a pacemaker
A pacemaker is a titanium tool composed of one or more probes, which is only a few centimeters and that the doctor implants under the skin, at the level of the chest (close to the left / right shoulder) of the patient. The pacemaker provides electrical impulses to the heart muscles and helps regulate the heart's pulsation, especially when the heart is too slow. This procedure is performed under local anesthesia, after insertion of a catheter at the level of the subclavian vein which makes it possible to bring the tip of the pacemaker probe into the heart, at the level of the right ventricle. If a second or third probe is needed, they will be attached in the right atrium for the second and close to the left ventricle for the third.
Implantation of a defibrillator
Defibrillation is a procedure for inducing, in patients suffering from malignant rhythm disorders, an electric shock in the heart. The defibrillator is implanted by the doctor for the purpose of recording heart rhythm disorders and acting only if a potentially lethal arrhythmia occurs. It is, like the pacemaker, placed under the skin and connected to the heart by electrodes.
Ablation of arrhythmias
It is usually arrhythmias in the atria that are targeted (for example atrial fibrillation) but those more complex in the ventricles can also be managed. The catheter is advanced to the precise place where the arrhythmia is generated through, most often, the vein of the groin fold. At the precise location of the arrhythmia, the rhythmologist uses low voltage energy (e.g. radiofrequency) to "burn" the focus causing the arrhythmia. This process makes it possible to stop intra-cardiac pathological short circuits so that electrical conduction is done through the natural pathways of the heart.
