Ablation

In the broadest sense, any medical procedure which destroys a small amount of tissue to correct a medical problem. In cardiology, ablation destroys tiny areas of the heart associated with rhythm or electrical problems. Ablation typically used a thermal or temperature-based approach to destroy tissue. The leading types of cardiac ablation use either heat (radiofrequency, microwave, laser, or ultrasound energy) or freezing (cryoablation).

Ablation Catheter

The specialized tube or catheter inserted into the heart to destroy tiny areas of the heart muscle associated with an electrical problem. There are many different types of ablation catheters depending on where they are used in the heart and what type of ablation energy is used.

Anticoagulation

A type of medical therapy often administered to atrial fibrillation patients to help reduce coagulation (clotting). Drugs that offer anticoagulation are sometimes nicknamed blood thinners. A blood thinner is useful in patients who may be prone to clotting in order to reduce the risk of stroke and heart attack.

Arrhythmia

The medical term for a rhythm disorder of the heart. Arrhythmias include atrial fibrillation, bradycardia, tachycardia, and heart block. Rhythm disorders are electrical problems of the heart.

Artery

A blood vessel in the body that carries oxygen rich blood from the heart into the body. This contrasts with veins.

Atria

The two small upper chambers of the heart. The role of the atria is to help pump as much blood as possible into the larger pumping chambers (ventricle) right before each heart beat. Singular atrium.

Atrial Contribution To Ventricular Filling

The purpose of the atria in the healthy heart, namely to help pump in the maximum amount of blood into the heart’s lower pumping chambers right before the blood is pumped out into the body or into the lungs. Nickname - “atrial kick.”

Atrial Fibrillation (AF)

A rhythm disorder characterized by very rapid erratic beating of the heart’s upper chambers at rates that can approach or even exceed 300 beats a minutes (five times per second). Atrial fibrillation diminishes the ability of the upper chambers to help fill the ventricles, so it is associated with a lower cardiac output. In addition, the heart’s lower chambers may beat more rapidly but usually irregularly to try to keep up with the atria and the rapid ventricular rate can cause symptoms. Atrial fibrillation is associated with a five-fold increased risk of stroke as clots can form in the upper chambers with the irregular heart beat.

Atrial Flutter

A rhythm disorder characterized by a rapid but regular atrial rate but not as high as atrial fibrillation. In many cases, atrial flutter appears on an ECG with a “sawtooth” type pattern of “flutter waves.” The heart rate of the ventricle may be fast but is usually regular.

Atrial Kick

See atrial contribution to ventricular filling.

Atrial Tachyarrhythmia

A general term for any rhythm disorder characterized by a too-rapid heart rate that originates in or near the atria. Atrial fibrillation and atrial flutter are types of atrial tachyarrhythmias.

Atrial Tachycardia (AT)

In common use, the term for a rapid atrial rate above 100 beats per minute. Ranges commonly occur from 150 to 180 beats a minute to as high as 200 or 250 beats a minute. AT is a rhythm disorder that may cause symptoms , most notably fatigue.

Atrium

One of two small upper chambers of the heart. Plural atria.

Blood Thinners

See anticoagulation.

Bradycardia

An arrhythmia characterized by a heart rate less than 60 beats per minute. Bradycardia is not treated unless it leads to symptoms. Many athletes have bradycardia from a very conditioned heart.

Cardiac Catheterization Lab Sometimes Called Just Cath Lab

A room or department of a hospital or clinic where cardiac catheterization procedures take place. A cath lab has an area that functions as an operating room (where procedures are performed) and a control area where monitors may be observed away from the procedure by some members of the cath lab team. A cath lab is typically run by a cardiologist and may handle a wide range of cardiac catheterization and other related procedures (such as pacemaker implantation).

Cardioversion

A therapy to treat atrial fibrillation which involves changing or “converting” the atrial fibrillation into a normal rhythm. There are two main types of cardioversion: chemical (using intravenous drugs) or electrical. Electrical cardioversion is similar to defibrillation in that paddles and electrical energy are administered to the chest area to “jolt” the heart back to a normal rhythm.

Catheter

In the broadest sense, any medical-grade type of tube (usually plastic) inserted into the body for medical purposes. Many catheters are designed to be inserted into the body and maneuvered into the heart. These cardiac catheters include diagnostic catheters (to figure out what is wrong in the heart), navigational catheters (to help find the proper area of the heart for examination), mapping catheters (to help create a map or diagram of cardiac activity), and interventional catheters (for medical procedures inside the heart). Ablation catheters are a type of interventional catheter.

Coagulation

The ability of healthy blood to clot when necessary to help restrict blood flow, stop bleeding, and close wounds.

Continuous Atrial Fibrillation

A type of atrial fibrillation in which the AF is sustained greater than one year duration. Continuous AF is also known as "longstanding persistent AF" and is a category of Persistent AF which indicates AF is sustained beyond seven days, or lasting less than seven days but necessitating pharmacologic or electrical cardioversion as noted in the HRS/EHRA/ECAS Report 2007.

Contrast

Dye used to visualize body organs and vessels with an x-ray.

Coronary Vessels

Any of a network of veins and arteries that are located on the exterior of the heart. The coronary vessels supply the blood to the heart muscle.

Coumadin

Brand name of warfarin which is the medication commonly used in pill form to anticoagulate (“thin”) the blood.

Cryoablation

A type of cardiac ablation that destroys small areas of cardiac tissue by freezing it.

Dyspnea

A medical term for shortness of breath.

Echocardiogram

An image of the heart using echocardiography or soundwave-based technology. An echocardiogram (nicknamed “echo”) shows a three-dimensional shot of the heart. Doctors frequently rely on this type of image to better understand the individual anatomy of the heart.

Electrocardiogram or ECG (sometimes EKG)

A graphical representation of the heart’s electrical activity in the form of wavy lines. An ECG is taken from electrodes on the skin surface. Depending on the type of ECG, as many as 12 electrodes may be used.

Electrode

A small metal device on certain types of catheter through which electrical energy flows. An electrode may be used to pick up electrical signals from the heart (called “sensing”) or send electrical energy to the heart. In cardiac ablation, the heat energy to perform the ablation is sent through one or more electrodes.

Electrophysiology

The medical science specializing in the electrical system of the heart. May be abbreviated EP.

Electrophysiology (EP) study

A type of medical test performed in an electrophysiology (EP) lab by or under supervision of an electrophysiologist. An EP study might be performed to diagnose an arrhythmia, to determine appropriate drug therapy for an arrhythmia or to evaluate other electrical properties of the heart.

Electrophysiologist

A physician who is board certified in the specialty of electrophysiology. An electrophysiologist is not the same as a cardiologist although both specialize in heart problems. A cardiologist mainly treats coronary artery disease, heart attacks, valve problems, heart murmurs, and performs many types of heart surgery. An electrophysiologist treats arrhythmias.

Fibrillation

An extremely rapid and erratic arrhythmia, usually characterized by the heart’s attempting to beat at rates of 280 or 300 beats a minute or more. Although the heart tries to beat that fast, it cannot fully contract and relax at such speeds. The result is that the heart quivers rather than pumps and blood in the heart sloshes around inside the heart rather than being pumped out. Fibrillation is described by its general point of origin: atrial fibrillation originates in or near the atria or upper chambers while ventricular fibrillation originates in the ventricles. Fibrillation is a serious medical condition but ventricular fibrillation is potentially lethal in a matter of minutes. Atrial fibrillation is not dangerous in the same way but is associated with a five-fold increased risk of stroke and symptoms that can range from mild to debilitating.

Fluoroscope

A “real time” x-ray view frequently used in cardiac catheterization procedures. A fluoroscope (or “fluoro”) is often a large piece of equipment with a C-shape that can be maneuvered over the patient on a table in such a way that live-action x-ray shots are obtained, and viewed on a screen in multiple projected angles.

Generator

A piece of equipment used in radiofrequency ablation procedures which produces the heat energy.

Incidence

A term used in medical statistics to refer to how many people are diagnosed or develop a particular condition in a given year. Incidence is different than prevalence, which refers to how many people have that condition in a given year. See also prevalence.

Induction

The ability to provoke (or induce) an arrhythmia in a controlled setting such as an EP lab. Arrhythmia induction is useful to test drug or device therapy or to determine what types of arrhythmia might occur in a patient.

INR - International Normalized Ratio

Blood measurement to determine how much blood thinning is occurring. Frequent blood test for patients taking Coumadin (warfarin).

Intracardiac Electrogram (IEGM) or Electrogram

Similar in concept to an ECG, this is a graphic representation of the electrical activity of the heart in the form of wavy lines. While an ECG is taken from the electrodes placed on the skin, an IEGM is obtained from electrodes positioned inside the heart, such as might occur during a catheterization procedure.

Myocardial Infarction (MI)

The medical term for a heart attack, often stated just as MI. A myocardial infarction occurs when a coronary vein is blocked and a portion of the heart muscle is starved for oxygen-rich blood. The oxygen-starved heart muscle dies. Depending on how much of the heart is affected, heart attacks can be mild, severe, or even fatal.

Myocardium

The heart muscle.

Paroxysmal

A medical term for sudden or something that starts suddenly.

Paroxysmal Atrial Fibrillation (PAF)

A type of atrial fibrillation in which the rhythm disorders starts suddenly, without warning, and stops on its own. An episode of PAF can be very brief, even just a few seconds. PAF is considered the most treatable type of AF.

Permanent Atrial Fibrillation

A type of atrial fibrillation in which cardioversion has either failed or not been attempted as noted in the HRS/EHRA/ECAS Report 2007.

Prevalence

A term used in medical statistics to refer to how many people have a condition in any given year. Prevalence is different than incidence, which refers to how many people were diagnosed or developed that condition in a given year. See also incidence.

Pulmonary

A medical term meaning having to do with the lungs.

Pulmonary Vein (PV)

One of several blood vessels near the heart which carries blood from the lungs to the heart. Some forms of atrial fibrillation are caused by “drivers” originating in the pulmonary veins (and not the heart, as once believed).

Radiofrequency (RF) Energy

A source of heat energy used in certain types of ablation.

Rate Control of AF

A medical approach to treating atrial fibrillation which does not treat the AF itself, but rather attempts to slow the rapid ventricular response to the fibrillating atria. Since the ventricular rate is what is most associated with symptoms, this provides symptomatic relief. See also rhythm control of AF.

Refractory

Unresponsive. If atrial fibrillation is drug refractory it means that drugs are not effective in treating it.

Rhythm

The pattern of cardiac activity. Strictly speaking, the heart has both a rate (how fast it beats) and a rhythm (the pattern of activity). Rhythm includes the ratio of atrial to ventricular activity.

Rhythm Control of AF

A medical approach to treating atrial fibrillation which attempts to change the rhythm (that is, to stop the AF). See also rate control of AF.

Sinus Rhythm

A commonly used medical term for a normal heart rhythm. The sinus in this expression refers to the sinoatrial node in the high right atrium which initiates the heart beat in a healthy heart.

Stroke

A medical condition which is now referred to as a “brain attack” where the brain is deprived of oxygen. Blockage of blood flow can be created when a blood clot breaks free, travels through the circulatory system and gets lodged in blood vessel long enough to cause a section of the brain to die. Ruptured blood vessels can create a similar injury. Strokes can vary in severity from transient (TIA) to very mild (some strokes can even go undetected) to severe and even fatal.

Syncope

A medical term for passing out from lack of oxygen going to certain areas of the brain. A sensation of dizziness and lightheadedness known as pre syncope progress unless blood supply is restored.

Vein

A name for any of many blood vessels in the body that carry oxygen depleted blood from the body back towards the heart. This contrasts with arteries.

Ventricle

One of two larger lower chambers of the heart. The ventricles are responsible for pumping blood out of the heart to either the lungs for oxygenation or back into the body.

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