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Electrophysiology

What is electrophysiology? Electrophysiology is a subspecialty of cardiology that addresses the "electricity” of the heart or its rhythm. This specialty can help address abnormal heart rhythms, the cause of these irregularities, and the best course of treatment for addressing problematic heart rhythms.

The skills and equipment for treating irregular heart rhythms are highly specialized, but must be tightly integrated with the patient's overall health and treatment for other conditions. Our services specialize in conditions and procedures that require a high level of expertise, and offer a wide range of diagnostic and treatment options for patients who suffer from an abnormal heart rhythm.

Electrophysiology Procedures

  • Complex Atrial Fibrillation (A Fib) Ablation - An ablation procedure using either cold (cryo) or heat (radiofrequency) energy to create scar tissue in the left atrium to stop atrial fibrillation. Typically this involves stopping rapid triggers coming from the pulmonary veins that have been shown to cause atrial fibrillation. The procedure is often referred to as pulmonary vein isolation or "PVI".
  • Convergent Ablation for Atrial Fibrillation - This is a procedure for patients with more advanced and/or longstanding atrial fibrillation. It is a two step procedure. The first procedure is performed by a cardiothoracic surgeon and involves performing RF ablation of the posterior wall of the left atrium through a small incision under the ribs. The second procedure typically performed 6 weeks later by an electrophysiologist, involves pulmonary vein isolation using 2-3 small IVs placed in the femoral vein. The procedure offers the potential advantage of improved success rates and lower complication rates for patients with atrial fibrillation. Please talk to your doctor to see if you may be a candidate for this procedure.
  • Diagnostic EP Study - Special catheters are placed into the heart which allow the physician to diagnose abnormal heart beats.
  • RF Ablation Including SVT - Radiofrequency ablation is a procedure using a catheter which heats abnormal heart tissue, creating a small scar and eliminating the source of arrhythmias (abnormal rhythms). Supraventricular tachycardia (SVT) are fast heartbeats originating in the upper half of the heart.
  • Pacemaker - An implanted device which makes sure the heart beats at a specific rate. Small wire(s) are advanced through the vein under your collarbone down to the heart, then attached to a small device placed under the skin of the upper chest.
  • Implantable Cardioverter Defibrillator (ICD) - An ICD Implant is an implanted device which can detect and treat very rapid (life threatening) heartbeats. All ICDs also function as pacemakers. As with pacemakers, small wires are advanced through a vein under the collar bone to the heart, then attached to a device implanted under the skin of the upper chest.
  • Leadless Pacemaker - This is a pacemaker that is about the size of a large medication capsule. It is implanted in the right ventricle of the heart through an IV in the femoral vein. Some of the potential advantages of leadless pacemakers are: no visible scar or lump under the skin, less post op restrictions such as restricting arm motion or keeping an incision dry, less overall complications. Since there is no pocket and there are no leads, many complications of conventional pacemakers such as pocket infections, lead fractures or dislodgements are reduced. Ask your doctor if you may be a candidate for a leadless pacemaker.
  • Pacemaker and ICD Lead Extraction - This procedure involves removal of pacemaker and/or ICD leads. Some indications for lead extraction include: Infection, lead fracture, need to add more leads with an occluded vein. Over time leads can become attached to the inner wall of the venous system between the implanted device in the upper chest and the heart. Extraction usually involved using mechanical tools and/or lasers to help free up the leads from the vein so they can be removed. This procedure is done in collaboration with a cardiothoracic surgeon usually in the Operating Room.
  • Cryoablation - This is a procedure that freezes abnormal heart tissue responsible for abnormal heart beats (arrhythmias). Most often used as a treatment for atrial fibrillation.
  • PVC Ablation - This is an RF Ablation treatment for extra heartbeats which originate in the lower half of the heart.
  • Complex Ventricular Tachycardia (VT) Ablation - A VT Ablation is a treatment for a sustained rapid heartbeat originating in the lower heart.
  • Cardioversion - Cardioversion is a procedure that can be used to correct abnormal timing when the heart beats unusually fast. Click here to learn more.
  • Catheter ablation - This procedure corrects a disturbance in the heart rhythm by curing short circuits. Click here to learn more.
  • Implantable electrocardiographic monitoring device - Some patients can benefit from continuous, ongoing electrocardiogram monitoring, which can be accomplished using a device implanted under the skin.
  • LifeVest™- Patients at risk of sudden heart attack could benefit from use of the LifeVest™, a personal defibrillator that provides continual monitoring of the heart and can deliver life-saving shock treatment.
  • Transesophageal echocardiogram (TEE) - The TEE is an advanced test that produces images of the patient’s heart using ultrasound technology. The images produced by a TEE are more advanced and clear than those possible from a regular echocardiogram.

Electrophysiology Conditions

  • Atrial fibrillation - Atrial fibrillation is a condition that affects the heart’s electrical system. It is a type of arrhythmia that usually occurs when the heart’s upper chambers are driven rapidly by a renegade timer or timers. Click here to learn more about this condition.
  • Bradycardia - Bradycardia means a slow heartbeat. There can be a number of underlying causes, such as an electrical problem, anorexia, sleep apnea, or a heart attack. Your doctor can diagnose bradycardia using an electrocardiogram (ECG or EKG).

Medications

  • Amiodarone - This medication may be used to treat abnormal heartbeats. It is a drug with dangerous side effects, and for this reason it is always started in a hospital setting so a doctor can closely monitor the patient’s initial response. Click here to learn more about Amiodarone.
  • Apixaban - Apixaban is a blood thinner medication that is used to prevent blood clots. It is also known by the brand name Eliquis. Click here to learn more about Apixaban.
  • Warfarin - Also known by the brand names Coumadin and Jantoven, Warfarin is used to prevent blood clots by thinning the blood, thereby lowering the risk of stroke or cardiac arrest. Click here to learn more about Warfarin.

Telehealth Now Available! Telehealth is now available for electrophysiology services.

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