Q&A With Heart Rhythm Expert Eric Braunstein, MD

Cardiac electrophysiologist Eric Braunstein, MD, who joined the Smidt Heart Institute at Cedars-Sinai late last year, recently published a first-of-its kind case study in the peer-reviewed medical journal Heart Rhythm Case Reports. The case study showed, for the first time, that it’s possible to cure arrhythmias in patients with a complex mix of heart conditions who have undergone other treatments.   

Braunstein recently spoke with Cedars-Science about this case and common treatments for heart rhythm disorders. 

Newsroom: How did you become interested in cardiac electrophysiology?

Braunstein: When I was exposed to electrophysiology as a medical resident, I really liked that it was procedural. However, it’s not 100% procedural, so you're still able to see patients and follow them to see how what you do helps them. It's a good mix of the fundamentals of internal medicine—taking care of patients—but also doing procedures and getting to work with a lot of cool technology.

Newsroom: How common are heart rhythm problems, and why is it important to intervene early?

Braunstein: One of the most common heart rhythm problems is atrial fibrillation, an irregular and often rapid heart beat . As people get older, up to one third of them may develop atrial fibrillation. Intervening early is important because the longer you have atrial fibrillation, the harder it gets to treat.

Newsroom: What are common risk factors for heart rhythm problems?

Braunstein: High blood pressure and high cholesterol, having blockages in the arteries, or having a weak heart muscle can all put someone at risk. For atrial fibrillation, sleep apnea is a big one.

Newsroom: What are common treatments for heart rhythm disorders?

Braunstein: The treatment for heart rhythm disorders can be highly variable depending on the exact rhythm problem and the patient. Anything from watchful waiting to medications to complex ablation procedures that destroy aberrant heart cells causing electrical disturbances or implantation of cardiac devices may be recommended.

Newsroom: You recently published a case report about a woman who arrived at the hospital with a cardiac arrhythmia. Can you talk about why this case may be helpful to the field?

Braunstein: The case report is about a patient who was admitted because of fatigue and tachycardia, an abnormally fast heart rate. She had a condition known as heart failure with preserved ejection fraction, which occurs when the heart’s left ventricle becomes stiff and difficult to fill with blood. These patients can be especially symptomatic from arrhythmias.

She also had a disorder called tricuspid regurgitation, in which a valve in the heart doesn’t close properly, causing blood to pump backwards. The patient had recently undergone an experimental procedure known as transcatheter tricuspid valve replacement, during which this heart valve was replaced.

The patient underwent the ablation procedure that we do regularly and recovered well. As far as we know, this was the first time that someone with this new type of valve had undergone an ablation procedure to treat a heart rhythm problem. This case shows it is possible to do this in a person who has undergone transcatheter tricuspid valve replacement.

Newsroom: What is recovery like for people treated for abnormal heart rhythms?

Braunstein: It varies from person to person. If they have a procedure done in their heart and they get anesthesia, they may feel not quite themselves for a couple of days to a week. Most people feel back to normal within a week. 

Read more on the Cedars-Sinai blog: Atrial Fibrillation: Know the Warning Signs