Heart & Vascular – Leo Polosajian, MD Video
Announcer: Electrophysiology is a highly specialized type of cardiology, which focuses
on diagnosis and correction of the pacing of the heart, its electrical
impulses and arrhythmias.
Visuals: Announcer is a male, wearing a suit. He is in front of a news studio background
with glass and wood panels and a large monitor with the title “Heart
Arrhythmias” displaying a motion graphic of a beating heart; heart
rate monitor displaying heart rhythm numbers including 65, 75, 88, 71, and 136.
Announcer (V.O.): We went to Valley Presbyterian Hospital in the San Fernando Valley and
spoke to Dr. Leo Polosajian, a cardiac rhythm specialist and asked him
about his specialty, electrophysiology.
V.O. visuals: Main exterior entrance of Valley Presbyterian Hospital; Dr. Polosajian
speaking with a senior male patient.
Leo Polosajian, MD: Electrophysiology specifically is to study the electrical system of the
heart. So, for instance, when someone passes out, or for example, when
someone has an extremely rapid heart rate, or palpitations, shortness
of breath because of palpitations, per se, or dizziness, lightheadedness,
syncope, passing out…
V.O. visual: Dr. Polosajian, wearing a suit and tie, is being interviewed in a studio
in front of a brightly colored abstract background. He is introduced with
the title “Leo Polosajian, MD – Valley Presbyterian Hospital”
in the lower-third.
Polosajian (V.O.): …then we basically need to look at their electrical system.
V.O. visual: Motion graphic diagram of a machine scanning a human with a heart and arteries
on view (images below).


Announcer (V.O.): Dr. Polosajian talks about atrial fibrillation or AFib.
V.O. visuals: Close-up of heart and arteries diagram; motion graphic of a heart beating
normally with the title “Normal" (images below).


Polosajian (V.O.): AFib is the most common arrhythmia. AFib is when the upper chamber of the
heart starts to fibrillate, starts to quiver. And one risk factor of that
is…
V.O. visuals: Motion graphic of heart beating irregularly with the title “Atrial
Fibrillation,” followed by a description “Disorganized atrial
signals” indicating an area of the diagram where the heart is quivering
(images below).


Polosajian: …if you get a stroke, in the event that you’re in AFib for
longer than 48 hours, constantly. Sometimes AFib can present itself…
Polosajian (V.O.): …as paroxysmal, it comes and goes, then it may be persistent, then
it may be chronic.
V.O. visual: Polosajian in his office talking on the phone.
Polosajian: This is the pulmonary artery. This goes toward the lung, this vessel.
This vessel is connected to the right side of the heart, the pulmonary
because it takes the oxygen, the blood, brings it to the lungs in order
for the blood to get oxygenated, then from there it turns from the lungs
and comes through the pulmonary vein. From the pulmonary vein it enters
into the left atrium, from the left atrium into the left ventricle, from
the left ventricle into the aorta, and the aorta to the body. So the reason
this pulmonary vein is important is because when you have atrial fibrillation,
and especially if it is paroxysmal, or persistent, many times, the majority
of the time, it starts from the pulmonary vein and the electricity starts
from there and it shoots into the left atrium, from the left atrium into
the right atrium and arrhythmia continues.
V.O. visuals: Polosajian in studio holding up a 3rd model of a heart, pointing at various parts of the heart as he describes
it in the audio. Camera zooms in for a close-up view. When he talks about
atrial fibrillation, the title “Dr. Polosajian discusses Atrial
Fibrillation” appears in lower-third.
Polasajian (V.O.): AFib, in the past, we could not cure it. (inaudible) Then surgical procedures
came about where they did basically a maze procedure. They actually had
to do an open heart surgery and take the left atrium…
V.O. visuals: Healthcare worker pulling a paper with a patient’s test results
from an EKG machine; close-up of page with results; surgery team working
in operating room working on a patient; close-up of a maze procedure;
motion graphic of white lines being drawn on the atrium area of the heart.
Polasajian: … cut it in pieces, resuture it together, kind of like make a maze
out of this. And when they did that, they discovered that the electrical
system could not fibrillate any longer and sinus rhythm, which is a normal
rhythm, took over.
Polasajian (V.O.): Nowadays what we do is ablation. Same technique in a way but without open
heart surgery. The procedure is done as an outpatient. The patient comes
and gets it done in approximately three hours and stays one night, overnight
for observation, goes home the next day. Recovery is so fast they go back
to work in three days or two days.
V.O. visuals: Motion graphic of the inside of the body in the heart area with an ablation
tube; motion graphic close- up of an ablation tube near the opening of
the skin (images below):


(V.O. visuals continued) healthcare worker preparing the cath lab room;
close-up of the equipment dashboard; close-up of the computer monitor
screen with test results; close-up of monitor with heart rate.
Polasajian: This is a pacemaker. As you can see it is very small.
V.O. visual: Polasajian holds up a small oval device, about 2 inches diameter and about
1/4 inch in depth.
Polasajian (V.O.): Pacemakers are implanted to prevent slow heart rates.
V.O. visuals: A motion graphic, “Courtesy of the American Heart Association”
shows a heart with wires extended into it from a pacemaker that is attached
to the inside of the chest near the shoulder. The graphic starts with
the title “Sensing” with the description “The pacemaker
is a device that can sense this abnormal beat when it occurs.” The
heart is beating slowly and an inset of a “Sick Sinus ECG”
displays a slow rate. The title then changes to “Pacing” with
the description “The pacemaker corrects the abnormal heartbeat by
firing electrical signals to restore a normal heart beat.” The heart
is beating at a normal speed and an inset of a “Normal ECG”
displays a normal rate (images below).


Polasajian: Not rhythm. Rates. So when the heart rate goes down, for example, at less
than sixty beats per minute and the pacemaker is set at sixty, the pacemaker
is a demand pacemaker. It will kick in, in order to restart the heart,
per se, electrically, to pace the heart.
Annoucer (V.O.): The doctor tells us what he sees for the future in treating heart arrhythmias.
V.O. visuals: Polasajian explains information on a monitor to his senior male patient;
monitor next to the cath lab patient room with heart scan, rate and other
detailed information.
Polasajian (V.O.): I believe that ablation will stay because it is helping a lot of people
fairly quickly. Outpatient procedures. I believe medications may grow,
specifically for arrhythmias but if…
V.O. visuals: Camera pans the cath lab patient room to reveal a bed, equipment and monitors;
close-up of the monitor showing a heart graphic with arrows moving in
a circular motion; female healthcare worker sitting in front of a monitor
reviewing the data.
Polasajian: …you catch the arrhythmia early on you can definitely help that
patient and prevent many other symptoms from coming.