How Does eMedica Removes Heart Blockages

1.??What is Heart Block??

Atrioventricular (AV) block commonly known as heart block is an interruption or delay of electrical conduction from the atria to the ventricles due to conduction system abnormalities in the AV node or the His-Purkinje system. Conduction delay or block can be physiologic if the atrial rate is abnormally fast or pathologic at normal atrial rates. AV block is generally defined based on a regular atrial rhythm.?

?2.??What is the Electrical System of the Heart?

?Cells in the cardiac conduction system (cardiomyocytes) can generate electrical impulses and then distribute the signal throughout your heart. While all cells in your heart can conduct electricity, the cells in this system conduct it at very specific speeds.

?The purpose of the electrical system of the heart is to coordinate the pumping of the four chambers of the heart and to control the heart rate so that the heart speeds up and slows down as the demands of the body change.

?Sino Atrial Node : ?

?The sinoatrial node (SA node): It is a specialised myocardial structure that initiates the electrical impulses to stimulate contraction, and is found in the atrial wall at the junction of superior caval vein and the right atrium.

?Internodal Pathway :Internodal pathways are the connecting pathways that form a direct connection between the sinoatrial node and the atrioventricular node in the right atrium of the heart.??

?The atrioventricular node (AVN) :The atrioventricular node or AV node electrically connects the heart's atria and ventricles to coordinate beating in the top of the heart; it is part of the electrical conduction system of the heart.?The AV node lies at the lower back section of the interatrial septum near the opening of the coronary sinus, and conducts the normal electrical impulse from the atria to the ventricles It is a complex structure that performs a variety of functions in the heart. The AVN is primarily an electrical gatekeeper between the atria and ventricles and introduces a delay between atrial and ventricular excitation, allowing for efficient ventricular filling.

The atrioventricular bundle (A-v bundle) :It is the extension of the atrioventricular node from the atrium across the fibrous skeleton of the heart to?the ventricles. It passes from the anterior and inferior part of the AVN as a group of specialised myocytes within an insulating sheath of connective tissue.

??The left bundle branch: The left bundle branch of the cardiac conduction system is the continuation of conducting fibres from the atrioventricular bundle of His. It forms within the interventricular septum at the junction of the membranous and muscular parts.

?The right bundle: The right bundle branch of the cardiac conduction system is the continuation of conducting fibres from the atrioventricular bundle of His. It forms within the interventricular septum at the junction of the membranous and muscular parts. It runs to the right within the muscular part of the septum as a fine tract.

?Bundle of His: The bundle of His is named after its discoverer, German cardiologist Wilhelm His (1836–1934).They are specialised heart muscle cells that transmit electrical impulses from the AV node in the heart to the muscle cells of the heart wall, which contract in response producing the heart beat.

Purkinje fibres: Also known as Purkinje cardiomyocytes are part of the whole complex of the cardiac conduction system, which is today classified as specific heart muscle tissue responsible for the generation of the heart impulses.

?3.??How does the heart create a “Beat”?

???In normal hearts, a natural pacemaker that tells the heart when to beat is present.?The master pacemaker called the sinoatrial (SA ), or sinus node is located in the right atrium and acts like a spark plug that fires in a rhythmic, regular pattern to regulate the heart’s rhythm.??It sends signals to the rest of the heart so the muscles will contract properly.

??First, as soon as the signal is sent, the atrium contracts.??The electrical signal from the sinus node spreads through the atria, like a pebble dropped into a pool of water.??

??Next, the signal travels to the area that connects the atria with the ventricles.??This connection is critical because without it, the signal would never reach the ventricles, the main pumping chambers of the heart.

??The electrical signal then reaches another natural pacemaker called the atrioventricular node (AV node).?As the signal continues and crosses to the ventricles, it passes through the bundle of His.??

??The bundle divides into wire-like thin structures called bundle branches that extend into the left and right ventricles.??The electrical signal travels down the bundle branches to thin fibres.?

??Finally, these fibres send out the signal to the muscles of the ventricles, which cause them to contract and pump blood into the arteries

??In a normal heart, these electrical signals occur about once every second, and maintain the steady, rhythmic pattern of the heart’s beat.

Although the heart generates its own beat, the heart rate and strength of contraction of the heart are modified by the sympathetic and parasympathetic divisions of the autonomic nervous system.

?The sympathetic system acts as an accelerator, speeding up and increasing the contractile force of the heart. Whenever oxygen demands increase, e.g., during exercise or if blood pressure drops, the sympathetic input increases, causing heart rate and strength of contraction to increase. Sympathetic influence increases during inhalation.

?The parasympathetic input acts like a brake, slowing down the heart. When you relax, the parasympathetic input becomes dominant and the heart rate slows. Parasympathetic influence increases during exhalation.

4.????How is the Heart Able to Generate its Own Electric Potential??

Cardiomyocytes are the cells responsible for generating contractile force in the intact heart. Specialised cardiomyocytes (Pacemaker cells) have the unique property of being able to generate action potentials??spontaneously (i.e. without input from the nervous system). They can generate an action potential because their resting membrane potential (- 60mV) is unstable.

Electrophysiology of the heart:?

The normal sequence and synchronous contraction of the atria and ventricles require the rapid activation of groups of cardiac cells. An activation mechanism must enable rapid changes in heart rate and also respond to the changes in autonomic tone. The propagating cardiac action potential fulfils these roles.?

?Because the membrane potential never "rests" it is called a pacemaker potential.?

This potential exists because the pacemaker cells have unusual channels that are permeable to both Na + and K+.?

When the channel opens, the influx of Na+ exceeds the efflux of K + and the net influx of positive charges slowly depolarizes the cell.?

?As the membrane potential becomes more positive, the channels close and the Ca++ (L and T) channels open transiently, which further depolarizes the cell.?

When the threshold potential is reached, a burst of Ca++ L channels open, more Ca++ rushes in, and a steep phase of depolarization occurs.?

At the peak of the action potential, K+ channels open, K+ rushes out of the cell and the cell repolarizes.??

5.????What is a “block” in the Heart ?

?Heart block, also called AV block, is when the electrical signal that controls your heartbeat is partially or completely blocked. This makes your heart beat slowly or skip beats and your heart can’t pump blood effectively.?

Degenerative changes (eg. fibrosis, calcification, or infiltration) are the most common cause of nonischemic AV block. Idiopathic fibrosis or calcification of the AV conduction system, commonly seen in the elderly, can cause complete AV block.

?OTHER CAUSES INCLUDE :?? Ischemia

???Degenerative changes

???Infection (myocarditis) and infiltrative processes such as Lyme disease and sarcoidosis

???Drugs (beta blockers, calcium antagonists) that slow AV nodal or block His-Purkinje (eg, procainamide, flecainide) conduction or lengthen AV node refractoriness

???Bezold-Jarisch reflex: An inferior myocardial infarction may cause a temporarily increased vagal tone leading to transient Mobitz I or complete AV block.?

Types of heart block :?

i.?First-degree heart block. This is the least severe. The electrical signals slow down as they move from your atria to your ventricles. But they continue to reach the ventricles?

ii.?without interruption. You generally don't need any treatment for first-degree heart block.

iii.?Second-degree heart block. This means that the electrical signals between your atria and ventricles can intermittently fail to conduct. There are 2 types of second-degree heart block:

a.????Mobitz type I. The electrical signals get slower and slower between beats. Over time your heart drops a beat and then the process repeats.

b.????Mobitz type II. The electrical signals sometimes get to the ventricles, and sometimes they don't. There is no progressive slowing of the electrical signal. This type of heart block can often progress to third-degree heart block.

iv.??Third-degree heart block (complete heart block). This is the most severe. In this type of block, electrical signals don't pass from your atria to your ventricles at all for periods of time. There is a complete failure of electrical conduction. This can result in no pulse or a very slow pulse if a backup heart rate is present.

?6.????What are the Symptoms of Heart Block?

Symptoms depend on the type of heart block you have: First-degree heart block may have no symptoms.

Second-degree heart block might cause:

??Dizziness

??Fainting

??The feeling that your heart pauses for a beat

??Trouble breathing or shortness of breath

??Nausea

??Severe tiredness (fatigue)

?Third-degree heart block can be fatal. In addition to the symptoms above, it might cause:

??Intense tiredness

??Irregular heartbeats

??Cardiac arrest

?7.????How does E-Medica Help in Treating Heart Block?

E-Medica sends a mild pulse of negative electrons which maintains the resting membrane potential of the heart.?

It is important to note here that the ongoing current and charge flowing during the healing process is designed to work on the cardiovascular system by the scientist. It causes no side effect to the heart rate in any manner.

E-Medica is an electronic medical device, which sends very low and optimal voltage & a mild current with dedicated frequency to charge the cardiomyocytes.?

E-Medica, with its very low electric current of about 20 mA, increases the temperature of the blocked signal, which burns the deposited plaque (either made of cholesterol, calcium or fibrin) and clears the pathway of the electrical stimulation. Thus, reducing the block percentage and maintaining optimum cardiac output.

?It maintains optimum blood flow to the heart and the electrolyte balance of the blood by maintaining the pH of the blood. It is a very important role as all the important electrolytes working as ions, Na+, k+ Mg+ and Ca+ are necessary for maintaining the heart rhythm, thereby the risk of heart attack is reduced in patients with heart block. (Electrolytes are substances that help trigger and sustain the heart's electrical impulses. Potassium, sodium, calcium, and magnesium are necessary electrolytes in the blood that are vital to cell function)

It controls the influx of calcium channels thus avoiding the extended depolarization of the heart. (Due to external supply of negative electrons, the overall time required for the cycle is maintained in cardiovascular patients)

E-Medica detoxifies the blood from the free radicals by adding electrons to these free protons, thus neutralising them, it will simultaneously increase the antioxidants and oxygen capacity of the cells , thus revitalising the cells of the heart.?