Dr. Raul Weiss, Director of the William and Molly Ford Cardiac Electrophysiology Center in Key West and Miami Beach, joined Good Morning Keys on KeysTalk 96.9/102.5FM this morning to talk about the heart.
Electrophysiology is essentially care for the electrical parts of the heart.
Dr. Weiss said, “Exactly. I’m an electrician of the heart. Most people are familiar with the plumbers of the heart, which are the ones that fix that coronary artery disease. I’m more involved with the electrical system. So basically, it’s a very big field. We treat arrhythmias. The two most common ones called supraventricular tachycardia, the other one called atrial fibrillation. Some people have what is called atrial flutter. All those are non lethal arrhythmias, but we also deal with sudden cardiac death prevention, evaluation of passing out and of course, a prevention of stroke or trying to figure out if someone has had a stroke if it was related to atrial fibrillation.”
Do the holidays see increased issues?
Dr. Weiss said, “Number one, through the holidays, people travel, and people who have a pacemaker or defibrillator or implantable loop recorders, this is a question that always comes up. We say what happens when I get through an airport and I need to go through TSA? Certainly there is enough metal on those devices that will trigger the alarm. So after implantation of these devices, within two weeks, people get in the mail, a card which describes the type of devices. So if you get to a TSA agent and you tell them I have a pacemaker or defibrillator, as a matter of fact, any medical device, they will do what it’s called a manual check. That really doesn’t affect the device at all and you don’t have to go through the alarm system.”
Stress during the holidays could also exacerbate cardiac issues.
Dr. Weiss said, “Stress can worsen pre existing conditions. But also don’t forget this time of the year, people tend to drink a little bit more than they should, also eat more than we should. So in particular, adding salt, that salt load can translate in elevated blood pressure, fluid retention, and heart failure symptoms. So people tend not to not go to the doctors this time of the year. So usually in January, we are seeing much higher than other time of the year these sorts of problems, heart failure, fluid retention, hypertensive crisis. So this is a time of the year to enjoy, but also to take a little bit of care of yourself and your loved ones.”
Putting off care because it’s the holidays is not a good idea.
Dr. Weiss said, “The diseases don’t read the calendar or what time of the year it is. You have to take it like any other day.”
What are some symptoms that could be warning signs?
Dr. Weiss said, “One is the blood pressure, make sure you check your blood pressure. Make sure that you are within the normal parameters. If their blood pressure is elevated, there is no rush that needs to go to the emergency room or call your doctor if it’s only mildly elevated. Remember high blood pressure, it’s a chronic problem that needs to be treated chronically. But keep an eye on it because it may continue to creep up on you. So check your blood pressure. That’s number one. Number two, check your weight, in particular, if you have been diagnosed with heart failure, a weight gain of two or three pounds a day or weight gain of seven pounds a week, probably your doctor have already dealt with that situation and have you on what we call a sliding scale for diuretic or water pills. So you can get rid of that extra fluid. Finally, my third advice will be check your pulse. Make sure that make sure that your heart rate is within the acceptable parameters and not too fast. That may be a sign of atrial fibrillation.”
What are the treatments for these issues?
Dr. Weiss said, “If you have atrial fibrillation, the first things we focus on is to take care of the symptoms, but the other two that are as important is to prevent stroke. We do that with medication, or what we call left atrial appendage occlusion device. The third thing we worry about and we pay a lot of attention to, make sure that the heart muscle doesn’t get weak when you have atrial fibrillation.”
Pacemakers have come a long way over the years.
Dr. Weiss said, “There is amazing technology now. We can implant some of the pacemakers from the groin. They are very, very, very, very small. We deploy them inside the heart. Some batteries may last 12, 14, 15 years. The regular pacemaker can last 10 to 15 years. There is zero problem getting close to microwaves, for example, that doesn’t affect the pacemaker. Some pacemakers even sends motion, temperature and make the high rate goes up and down. It’s very, very sophisticated.”
What are the advances in the field?
Dr. Weiss said, “When it comes to pacemakers, we call it leadless pacemaker. Just for lack of better comparison, they are the size of a very small bullet that we can deploy in the heart. We can put two of them, one in the top chamber, one in the bottom chamber, and they communicate with each other. Again, the closure of the left atrial appendage to prevent strokes, that’s also amazing technology and as well as improvement overall. In radiofrequency ablation, we have new sources of energies that make the procedure time a little bit more predictable, probably a little bit safer. This is one of the fields in medicine that has been advancing the most. We have all the newest technology. Actually, I’m very proud of the services we offer. We can call up pacemakers and defibrillators remotely. So people don’t have to come to our office, they just have a receiver at the bedside, and the information gets transmitted to our office. So if there is a problem we can detect that earlier. Imagine that in in the snow belt area that people have to drive with snow. Probably the Keys that you have to drive with ocean on both sides it’s not that big of a deal, but for the rest of the country it is.”