Cardiac electrophysiologist Dr. Karthik Ramaswamy

About 5 million people in the U.S. have some type of an arrhythmia, or abnormal heart rhythm, and the most common type is atrial fibrillation, explains electrophysiologist Dr. Karthik Ramaswamy, the director of the new Arrhythmia Center at Missouri Baptist Medical Center.

“An arrhythmia is a situation where the heart is either going too fast, too slow, or beating irregularly— out of its regular synchronized rhythm,” Ramaswamy says. “Sometimes a person may feel palpitations, like their heart is racing or fluttering. In other cases, people have fainting spells, shortness of breath or chest pain.” Although an arrhythmia may be present from birth, a patient may not display any symptoms, he adds. “Sometimes it is just detected incidentally when a patient has other health issues.”

Ramaswamy says not all arrhythmias require the same treatment. “Atrial fibrillation is more challenging, because it’s not caused by one specific circuit—there are generally multiple areas of the heart that are causing it. Traditionally, it has been somewhat difficult to treat with medication, but ablation (a procedure that blocks defective pathways) can be curative.” Treatment depends on what type of arrhythmia a patient has, he adds.

“Ablation uses catheters, advancing them into the heart under X-ray. We can identify the area—where the ‘the short circuit’ is—and an ablation catheter will deliver energy, either heating or freezing the tissue.” The treatment often will cure certain type of arrhythmias, Ramaswamy notes. “That’s the exciting thing— we’re not just treating or suppressing.”

Ramaswamy is a pioneer in the use of stereotaxis magnetic navigation, a robotic technology developed in St. Louis for the treatment of arrhythmias. “With this technology, we manipulate the catheter inside the heart with robotic magnetic navigation,” he explains. “External magnets are directed by a computer, and we’re able to direct the positioning and the movement of the catheter through the computer software. Essentially, the robotic system moves the catheter for me, while I tell it where to go and what to do. In some cases, we can get to areas of the heart we could not reach manually.” The technology has other advantages, he adds. “The patient gets less radiation and the catheter is very soft and flexible, so it’s less likely to cause harm.” Ramaswamy was among the first to demonstrate the technology’s advantages of reducing radiation exposure. “When we move a manual catheter, we absolutely have to look at the X-ray throughout the procedure, to determine where the catheter is going, and make sure it’s doing what we want it to do. But with stereotaxis navigation, that’s not necessary.”

Ramaswamy is very enthusiastic about the lifesaving potential of stereotaxis at the new Arrhythmia Center. “Missouri Baptist is one of just two area hospitals utilizing this technology, and any time you’re able to improve a technique like ablation, and help a patient who couldn’t benefit from the procedure before, that’s exciting!”