Treatments and Interventions

Programs and Services

Treatments and Interventions

Heart Failure

Heart failure is a serious condition that develops when the heart becomes weakened (from a variety of causes). It means the heart is not pumping effectively enough to meet the body’s needs. However, people with heart failure may live for many years after diagnosis. Treatment is aimed at helping people with heart failure live a full life.

In congestive heart failure (CHF), decreased heart function is accompanied by a buildup of fluid in the lungs and elsewhere in the body. Traditional treatment has involved the use of drugs (diuretics) that help the body excrete more water. Over time, however, diuretics become ineffective. Now, patients with CHF can benefit from Aquapheresis™, a filtration system that removes excess fluid from the body. Froedtert & The Medical College of Wisconsin are among only two centers in this region using this technology.

Arrhythmias

The Electrophysiology Lab is equipped to treat common and complex electrical disturbances of the heart (arrhythmias). Medical College of Wisconsin cardiologists with special training and board certification in cardiac electrophysiology specialize in treatment of arrhythmias. Physiologists are on call 24 hours a day for emergencies. In addition to performing inpatient procedures and arrhythmia management, they provide long-term management of outpatients with complex rhythm problems, pacemakers or defibrillators.

Treatment for an arrhythmia (irregular heart beat) may include:

Medications — depending on a person’s symptoms and type of arrhythmia, various medications may be prescribed.
Radiofrequency ablation can cure common rhythm problems using radiofrequency energy to eliminate the source of an irregular heart rhythm. An electrophysiologist guides a catheter with an electrode at its tip to the area of heart muscle with the abnormal rhythm. The electrode supplies a burst of radiofrequency energy to eliminate the source of the irregular rhythm.
Defibrillator implant — a cardioverter defibrillator (ICD) is implanted to prevent cardiac arrest. An ICD continuously monitors the heart’s rhythm and recognizes rapid arrhythmias. It delivers a high-voltage electrical shock, when needed, to restore a normal heartbeat. If a person’s heart beats too slowly, a pacemaker (built into all ICDs) sends a low electrical pulse to the “remind” the heart to beat. An ICD is implanted in a minimally invasive procedure.

Medical College of Wisconsin arrhythmia specialists use a sophisticated technique called computerized electro-anatomical mapping to precisely locate scar tissue causing the rhythm problem in the heart. Using a catheter probe, electrical readings are recorded in the heart chamber to generate a three-dimensional “map” of scar tissue.
Pacemaker implant — a pacemaker is a small device that helps the heart beat in a regular rhythm. In a minimally invasive procedure, a small incision is made in the chest. The pacemaker is placed under the skin, and leads (wires) are placed in the heart and connected to the pacemaker. The pacemaker is then programmed to the precise needs of the patient.
Cardiac resynchronization therapy (CRT) — heart failure is severe in people who have bundle branch block, a condition that makes the heart word harder to pump blood. CRT is performed to treat bundle branch block, by implanting a specialized pacemaker to re-coordinate the action of the right and left ventricles.

Coronary Artery Disease

To open blocked coronary arteries, a variety of interventional catheterization procedures may be performed in the Cardiac Catheterization Lab. Angioplasty procedures include:

Balloon angioplasty, performed by advancing a balloon-tipped catheter from an artery in the groin to an artery of the heart. The balloon is then inflated, compressing the plaque and widening the artery so that blood can flow more easily.
Cryoplasty, a treatment for peripheral artery disease (narrowed arteries in the legs). The vessels are cooled and dilated at the same time to help prevent the arteries from reclogging.
Cutting balloon angioplasty, which combines balloon angioplasty with microsurgery. Tiny blades mounted on the balloon cut into the plaque inside the vessel, and the balloon compresses the plaque into the vessel wall.

Stents

During angioplasty, a stent is often placed in an artery after it is opened by the balloon; stents are flexible, wire mesh tubes that prop arteries open.

Atherectomy

A minimally invasive procedure to open an artery by removing the plaque produced by the build-up of cholesterol and other fatty substances inside an artery from atherosclerosis (“hardening of the arteries”). A catheter is inserted into the artery and, using special devices placed in a catheter, the physician is able to cut, grind, ablate or vaporize plaque from inside arteries or veins.

Thrombolysis

A catheter-based treatment that removes abnormal blood clots that restrict blood flow. Thrombolytic therapy dissolves blood clots using medication given directly into the clot through a catheter. Mechanical thrombolysis breaks up a blood clot using various mechanical devices.

Structural Problems

To treat structure problems of the heart, minimally invasive treatment include:

Balloon valvuloplasty — a procedure to widen a narrowed heart valve; a catheter is advanced through a blood vessel through the aorta and into the heart; the catheter is placed in the valve, and a large balloon at the tip of the catheter is inflated until the flaps of the valve open, restoring normal blood flow. This procedure is performed by an interventional cardiologist.
PFO and ASD closures — patent foramen ovale (PFO) and atrial septal defect (ASD) are holes or defects in the wall (septum) between the atria, the two upper chambers of the heart. A catheter is inserted into a large vein and advanced into the heart, using imaging to guide the catheter. A special closure device is placed on a cable, inserted through the catheter and moved to site of the hole. The closure device is then released to cover the hole. Froedtert & The Medical College of Wisconsin were the first in Milwaukee to perform ASD and PFO closure without open surgery.

Author: Marla Fraunfelder

Last Review Date: Nov. 10, 2008