Methodist Willowbrook Hospital - Leading Medicine - Winter 2008

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Preventing

John Isaac, MD
Medical Director of
Cardiac Services

When most folks think of heart disease, they tend to think about clogged arteries and heart attacks. But there is another type of heart condition dealing with the electrical circuits of the heart that can lead to what is known as sudden cardiac arrest. In the U.S., over 400,000 people die of sudden cardiac arrest each year. "Only 5% of people survive sudden cardiac arrest; therefore, identifying and treating people at risk is extremely crucial," explains Tapan Rami, MD, a cardiac electrophysiologist specializing in heart arrhythmias at Methodist Willowbrook Hospital and the Methodist DeBakey Heart Center.

How Electrophysiology Helps
"Electrophysiology (EP) is the study of the electrical system of the heart, including abnormal heart rhythms that can lead to sudden cardiac arrest," explains Lyle Muhammad, RRT, BBA, director of Cardiology Services. "There are two main types of cardiologists in the medical field: Some are like plumbers, working to fix clogged arteries for better circulation. Others act as electricians, dealing with the electrical circuits of the heart. These heart 'electricians' are called electrophysiologists."

"Sudden cardiac arrest occurs most commonly in people with significant underlying heart disease," says Nadim Nasir Jr., MD, a cardiac electrophysiologist with Methodist DeBakey. Dr. Nasir stresses the importance of distinguishing sudden cardiac arrest from a heart attack. "Heart attack happens when there is 100% blockage of an artery, with reduction of blood flow to the heart muscle. Sudden cardiac arrest is the occurrence of a dangerous heart rhythm. Sometimes a heart attack can trigger cardiac arrest, but that is not always the case," he states.

Muhammad adds, "Sometimes irregular arrhythmias may only be present during exertion, as is the case with young athletes collapsing in sudden cardiac arrest. You can be in the best shape of your life and still have an irregular arrhythmia. The good news is that arrhythmias can be detected early and treated with electrophysiology, if you pay attention to the symptoms."

Recognizing Heart Problems
Common symptoms of irregular arrhythmia include fatigue, dizziness, heart palpitations, chest pain and shortness of breath. The purpose of EP is to diagnose and treat abnormal arrhythmias or heartbeats, and to help prevent cases of sudden cardiac arrest.

Advanced Diagnostics and Treatment
Methodist Willowbrook has invested in systems that enhance EP diagnostics with technology. "We are the only hospital in the area with a full electrophysiology program with the most advanced technology and Methodist DeBakey electrophysiology experts," explains Muhammad. Dr. Nasir adds, "The Methodist Willowbrook administrators, staff and nurses in the cardiology division have a real passion for perfection and delivery of quality care."

"Methodist has a reputation for delivering cutting-edge technology and quality care with uncontested outcomes."
– Tapan Rami, MD

An initial test for patients with symptoms of arrhythmia is an electrocardiogram (EKG), a simple test that detects and records electrical activity of the heart. An EKG can reveal a number of heart problems, including signs of a heart attack, lack of blood flow to the heart and an irregular heartbeat (too fast, too slow or too weak).

"More advanced testing may include a diagnostic electrophysiology study that evaluates the internal function of the heart's electrical activity," states Dr. Nasir. "One example of this advanced testing is called ‘biplane fluoroscopy' – which is an advanced diagnostic test that allows us to image the heart from multiple angles so we can more rapidly diagnose and treat problems."

If a heart arrhythmia is diagnosed, there are various treatments. Medicine may be used to suppress abnormal rhythms. Pacemakers and defibrillators may be implanted to regulate heart rhythms. And, in addition, the latest state-of-the-art procedure called cardiac ablation may be performed to identify the area of the heart producing irregular heartbeat and "fix" the irregular circuit. "Ablation localizes and eliminates abnormal circuits by pinpointing the affected area of the heart and using electrical energy to heat and neutralize the heart tissue so it is no longer capable of producing an irregular heartbeat," explains Dr. Rami.

Seek Expert Care
Methodist Willowbrook Hospital is pleased to offer Medical Center quality of care close to home. For more information about electrophysiology, please call 281-477-1044.

Nadim Nasir Jr., MD Cardiac Electrophysiologist	Nadim Nasir Jr., MD, FACC, cardiac electrophysiologist, is triple boardcertified in internal medicine, cardiology and clinical cardiac electrophysiology by the American Board of Internal Medicine. Dr. Nasir is a native Houstonian educated at the University of Houston with medical training and residency at the University of Texas Southwestern Medical School, and cardiology and electrophysiology fellowship training at the Baylor College of Medicine. Dr. Nasir performs all types of EP procedures and his interests are in surgical and device therapy for prevention and treatment of sudden cardiac arrest.

Tapan Rami, MD Cardiac Electrophysiologist	Tapan Rami, MD, cardiac electrophysiologist, is triple board-certified in internal medicine, cardiology and clinical cardiac electrophysiology by the American Board of Internal Medicine. Dr. Rami attended the University of California Riverside with medical training at the University of California, Los Angeles (UCLA) and residency and cardiology fellowship at the Baylor College of Medicine. He completed further sub-specialization in complex ablation therapies at the University of Pennsylvania in Philadelphia. Dr. Rami performs all types of EP procedures and has an interest in complex ablation therapy.

		Methodist Willowbrook Hospital Andrew Cochrane – Chief Executive Officer Jan Stano – Chief Nursing Officer Jim Levermann – Chief Financial Officer Janice Conklin – Director of Marketing and Business Development Sarah Qualls – Community Relations Amie Silcio-Smith – Community Relations
	Leading Medicine in Northwest Houston is published by Methodist Willowbrook Hospital. The information is intended to educate the public about subjects pertinent to their health, not as a substitute for consultation with a personal physician. All rights reserved. ©2008.