Pacemakers and atrial fibrillation

Published in NJ Heart and Lung News

Atrial fibrillation, often referred to as arrhythmia, is defined as having an irregular heartbeat. It can cause various heart conditions, including heart attack, heart failure, and stroke. When the heart functions properly, the muscles in the atria (the upper chambers of the heart) completely empty the blood contained in them into the ventricles (the lower chambers of the heart). However, when the electronic signals that cause the atria to contract function in a chaotic manner, blood can remain in the atria. Blood that remains in the atria can form a life-threatening clot.

According to the Centers for Disease Control and Prevention, there are approximately 6 million adults in the United States currently living with atrial fibrillation. The condition is age-related: only 2% of people younger than 65 years old have atrial fibrillation, while 9% of people over the age of 65 have it. In general, the older the population, the greater the risk of atrial fibrillation.

The main risk factors for atrial fibrillation are:

  1. High blood pressure
  2. Cardiovascular disease
  3. Hyperthyroidism
  4. Obesity
  5. Diabetes
  6. Lung or kidney disease
  7. Sleep apnea
  8. Stress and anxiety

When atrial fibrillation cannot be controlled by medications or behavioral modification, a pacemaker may be required. A pacemaker is a small electronic device which adjusts the electronic pulses of the heart, causing the heart to beat in a steady, regular rhythm. The surgery required to insert a pacemaker is considered relatively minor and safe.

Since prolonged atrial fibrillation can cause permanent damage to an individual's internal organs, as well as increase their risk of a heart attack or stroke, the importance of a pacemaker cannot be overstated. As mentioned above, the procedure to implant a pacemaker is relatively simple — but the effect it can have on a person's life is profound. When a person has a pacemaker implanted, many of the symptoms they may have been experiencing — including fatigue, shortness of breath, general weakness, and chest pain — will disappear.

Although aging tends to turn atrial fibrillation into a lifelong condition, pacemakers are a highly effective treatment. They tend to be relatively risk-free, and can help individuals with afib lead longer, healthier, and happier lives.

At the NJ Heart and Lung Center™ of Regency Jewish Heritage, you will have an individualized plan, proven to prevent readmission to the hospital, and to improve your independence.  

Regency Jewish has partnered with the area's leading cardiologists and pulmonologists to create a program that:   

  • Reduces hospital readmissions and patient length of stay
  • Maximizes ability for patient to regain ADL skills and independence
  • Offers 24/7/365 physician coverage through on-site staff and advanced telemedicine program
  • Has an on-site sleep study program to unlock Medicare benefit for Bipap utilization upon discharge
  • Offers STAT availability of Labs, X-Ray and other diagnostic tools

Our Outcomes & Capabilities include: 

  • Cardiologist and pulmonologist on site daily for immediate intervention
  • Specialized rehab & nursing protocols developed in partnership with leading cardiologists & pulmonologists
  • A plan proven to prevent readmission to the hospital and improve patient independence and functionality
  • Regular Communication Between Patient, Family, Staff & Physicians
  • Collaborative care planning with other physician & therapy specialists
  • Advanced staff education & training
  • Transitional care nurse & enhanced discharge-to-home process
  • Follow-up home visit within 24-48 hours
  • Educational material provided to patients & families

Regency prides itself on offering the very best of care in a patient-centered environment. This means always listening to our residents and patients and respecting their capabilities, while helping them to achieve maximum functionality and independence. And always maintaining the highest professional and quality standards in our staff and our facilities. Our 25 years of excellent care have led to us being awarded a Best Nursing Homes award by US News & World Today, a 5-Star rating by USA Today, and an A+ rating by the Better Business Bureau, among many other awards.   Contact us by clicking here.

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Potassium and the Heart

Published in NJ Heart and Lung News

Among the many blood factors a cardiologist monitors in their patients is potassium. Either a low or high level of potassium is dangerous for the heart. But what is potassium, and why is it so important?  Potassium is the third-most common mineral in the body. It helps regulate the body’s fluid balance, the contraction of its muscles, and the transmission of nerve signals.  

About 98% of the potassium in our body is found inside our cells. Muscle cells contain 80% of this potassium, and the other 20% is in bone, liver and red blood cells.  In addition to helping other muscles move, nerves to work, and the kidneys to filter blood, potassium triggers the heart to beat. The body needs a proper balance of potassium to help muscles — particularly heart muscles — work properly.  Blood potassium levels should be between about 3.5 and 5 millimoles per liter (mmol/L). When levels are persistently higher, the resulting condition is called hyperkalemia.

Mild hyperkalemia typically causes no symptoms, but very high potassium levels can cause muscle weakness or dangerous heart rhythm.  In hypokalemia, the level of potassium in blood is too low. Hypokalemia is not an illness in itself, but is usually a symptom of an underlying illness or a side effect of a medication. A low potassium level usually results from vomiting, diarrhea, adrenal gland disorders, or use of diuretics. Low potassium can make muscles feel weak, cramp, twitch, or even become paralyzed, and can also cause abnormal heart rhythms.   

Although a slightly low potassium level may not be dangerous, any low potassium level requires medical attention. Potassium levels can be low without being so low that the heart stops contracting. Sometimes the low levels cause the heart to pump blood ineffectively in a condition known as heart failure. Blood clots that form or flow and get stuck in the coronary arteries could block the blood supply and cause a heart attack.   

If potassium levels drop below 2.5 mmol per liter, however, hypokalemia can be life-threatening.  When people have mild hypokalemia, they will usually experience no symptoms. If their hypokalemia is moderate or severe, they will often feel unwell and may experience other symptoms. This is especially true if the individual is elderly, or has heart or kidney problems.

The National Organization for Rare Disorders lists the following symptoms for hypokalemia: 
1. Muscle weakness, sometimes severe enough to cause paralysis 
2. Respiratory failure 
3. Low blood pressure 
4. Muscle cramping or twitching 
5. Extreme thirst 
6. Frequent need to urinate 
7. Loss of appetite 
8. Nausea 
9. Heart problems, in particular arrhythmia 

Nevertheless, people should be aware that it is uncommon to experience any of these symptoms even if their hypokalemia is severe. A study published in the European Journal of Emergency Medicine analyzed data from nearly 5000 individuals who were taken to the emergency room of a nearby hospital and diagnosed with hypokalemia, and discovered that only 0.5 percent of these individuals had any of the symptoms listed above. Further, only 1% of these individuals had severe hypokalemia, demonstrating that low potassium levels can cause an individual to feel unwell, even when their hypokalemia is not technically termed severe. 

According to a 2018 study, the main causes for potassium loss are:
1. Persistent diarrhea 
2. Prolonged vomiting 
3. Kidney disease 
4. A side effect of diuretics 
5. A side effect of other medications 

Generally, people diagnosed with hypokalemia are treated with potassium supplements, usually in the form of tablets. If an individual's hypokalemia is life-threatening, intravenous supplementation is often required.  The prognosis for an individual with hypokalemia depends on the underlying illness or side effect that caused the loss of potassium. In many cases supplementation with potassium will solve the problem. In other cases, medicines that may be causing the problem will have to be changed, or have their dosage lowered. However, if the individual is suffering from both heart and kidney disease, achieving a proper balance of potassium can be quite complicated.   

The most important way to assure proper potassium levels, especially in the presence of other medical conditions, is to put yourself in the care of the best cardiologists, like those at the NJ Heart and Lung Center™ of Regency Jewish Heritage.

Regency Jewish has partnered with the area's leading cardiologists and pulmonologists to create a program that:   

  • Reduces hospital readmissions and patient length of stay 
  • Maximizes ability for patient to regain ADL skills and independence 
  • Offers 24/7/365 physician coverage through on-site staff and advanced telemedicine program 
  • Has an on-site sleep study program to unlock Medicare benefit for Bipap utilization upon discharge 
  • Offers STAT availability of Labs, X-Ray and other diagnostic tools 

Our Outcomes & Capabilities include: 

  • Cardiologist and pulmonologist on site daily for immediate intervention 
  • Specialized rehab & nursing protocols developed in partnership with leading cardiologists & pulmonologists 
  • A plan proven to prevent readmission to the hospital and improve patient independence and functionality 
  • Regular Communication Between Patient, Family, Staff & Physicians 
  • Collaborative care planning with other physician & therapy specialists 
  • Advanced staff education & training 
  • Transitional care nurse & enhanced discharge-to-home process 
  • Follow-up home visit within 24-48 hours 
  • Educational material provided to patients & families 

We offer the very best of care in a patient-centered environment. This means always listening to our residents and patients and respecting their capabilities, while helping them to achieve maximum functionality and independence. And always maintaining the highest professional and quality standards in our staff and our facilities. Our 25 years of excellent care have led to us being awarded a Best Nursing Homes award by US News & World Today, a 5-Star rating by USA Today, and an A+ rating by the Better Business Bureau, among many other awards.   

Contact us by clicking here.

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Are you interested in The NJ Heart and Lung Center for yourself or someone you love? A member of our team will be happy to answer your questions and schedule an on-site tour. Of course, you can also call us anytime.

The NJ Heart and Lung Center at Regency Jewish Heritage
380 DeMott Lane, Somerset, NJ 08873
(732) 873-2000
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The NJ Heart and Lung Center at Regency Gardens
296 Hamburg Turnpike, Wayne, NJ 07470
(973) 790-5800
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