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Calming restless hearts

Dr. Sohrab Lutchmedial, Interventional Cardiologist and Medical Director New Brunswick Heart Centre Research Initiative

When people think of heart complications, they often think of blocked arteries, cholesterol, and fatty build-ups causing problems.

But for Dr. Satish Toal, electrophysiologist at the New Brunswick Heart Centre, the heart problems he sees could affect top athletes with perfectly clear arteries, young children, or just about anyone else.

Electrophysiology, introduced at the Heart Centre in 2007, is the branch of cardiac care dealing with rhythm problems of the heart.

Dr. Toal

Dr. Satish Toal, Electrophysiologist

"These could be conditions where the heart races in people with otherwise normal hearts, with no previous history of heart attack," said Toal. 

The pumping action of the heart is co-ordinated by electrical activity, he explains.  "It is like a machine.  The heart is designed to pump efficiently and provide blood to the lungs and body as needed."

The electrical activation co-ordinates how many times a minute the heart will beat as well as coordinating the movements between the chambers of the heart.

In some patients, right from the time they are born, there may exist extra focus or pathways which can result in very fast heart beats, well over 200 beats per minute. They may manifest later in life.

"If your heart is pumping very fast, it does not get time to collect all the blood and pump it to your brain."

You may become dizzy, and become weak. If the problem originates in a ventricle, a lower chamber of the heart, it can result in cardiac arrest.

Sometimes the issue is genetic, while other times it is due to a previous heart attack, causing scarring in the heart and changing its ability to beat properly.

Toal offers a number or treatments to solve these problems. Some issues are resolved by inserting a catheter and destroying an extra pathway or focus in the heart. Others require installing a permanent defibrillator that can shock the heart (in the case of cardiac arrest). Toal can even install a device that synchronizes the chambers of the heart, ensuring an efficient pump.

Toal sees about 300 patients a year, and in about 90 per cent of cases, he and his team can resolve the problem. For those patients, the result is often a much higher quality of life.

"Many of the patients are young and they want to do physical activities, such as playing hockey," said Toal. Sometimes the heart problem can be a barrier to employment, he said, noting one police officer who was experiencing heart rates of more than 250 beats per minute. A good resting heart rate is in the range of 60 beats per minute.

Toal notes that about 95 per cent of all electrophysiology treatments are now available at the New Brunswick Heart Centre, bringing a service to the province that just five years ago meant travelling and staying far from home.

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