Diagnostic Electrophysiology Procedures
Electrophysiology is a subspecialty of Cardiology. Most of the patients we see for heart rhythm disorders have already been seen by the cardiologist and have also had several tests of the heart performed already. However, there are specialized tests that can help us to diagnose the cause of your heart rhythm problems.
One of the most valuable pieces of information that we need includes an ECG (a recording of your heart's electrical rhythm) during symptoms. We will often prescribe a heart monitor that you can wear at home for up to 30 days. This is called a loop recorder. This device allows you to record your own ECG at the time that you are experiencing your symptoms. At times, we need to monitor your heart for longer periods of time. In this case we can implant a tiny heart monitor under your skin which can provide ECG monitoring for up to 2-3 years. These devices, called implantable loop recorders, are monitored wirelessly and allow you to make recordings at the time you are experiencing symptoms. However, if your heart goes too slowly or too quickly, the monitor will automatically record your ECG so that we can review them at a later time.
Sometimes we need to observe a specific symptom or heart rhythm directly. In patients who have fainting spells, we often perform a tilt table test. This is a test designed to elicit a fainting spell while we are observing your heart rhythm and blood pressure. This not only helps us to make a diagnosis, but may also help to guide treatment. Similarly, electrophysiology tests are invasive tests of the heart's electrical system. By placing special wires called catheters through the veins into the heart, we can record electrical activity associated with every heartbeat. We can also measure the timing of the electrical signals traveling from the top of the heart to the bottom of the heart. Finally, we can test to see if the heart is prone to rapid or dangerous heart rhythms. This test provides a lot of diagnostic information about your heart's electrical system. This test can also help us to decide upon an appropriate treatment.
Therapeutic EP Procedures
We are have extensive experience with cardiac ablations for many different heart rhythm disorders including SVT, WPW, atrial flutter, ventricular tachycardia and atrial fibrillation. We have access to the most advanced technology including state of the art three dimensional cardiac mapping systems and intracardiac ultrasound imaging. We are the only Electrophysiology group using the Stereotaxis system which allows us to perform ablations safely and with robotic precision.
Our atrial fibrillation ablation program is one of our safest and most successful programs. We perform pulmonary vein ablations as well as FIRM mapping which allows us to map and ablate rotors in the heart during atrial fibrillation. We are the only group in the Northeast capable of doing all ablations, including complex atrial fibrillation ablations, completely without fluoroscopy. This means that even complex ablations can be performed without exposure to radiation.
Cardiac Implanted Devices
Many of our patients come to us because they need an implanted device. There are several types of cardiac implanted devices, but they can be broadly divided into two categories: pacemakers and defibrillators. Pacemakers are used to keep the heart from going too slowly. Defibrillators are used to protect against sudden death from a cardiac arrest (ventricular fibrillation and ventricular tachycardia). Defibrillators (also known as ICDs) also have pacemakers built in. Some ICDs and pacemakers have special pacemaker systems used to help a weak heart beat more effectively. These pacemakers and defibrillators are called biventricular devices.
We have extensive experience in prescribing, implanting, managing and programming all types of implanted cardiac rhythm devices including defibrillators, pacemakers, and biventricular devices for patients with congestive heart failure. We were the first in the region to implant the new leadless pacemaker and we are pioneers in establishing a multidisciplinary laser lead extraction program.
We see patients with heart rhythm disturbances everyday in our office. Because most of our patients have already seen a Cardiologist and have gone through an extensive evaluation already, our office visits are focused on you and your heart rhythm. When we see a new patient, we will spend some time reviewing the records sent by the Cardiologist and PCP. This generally includes ECGs, echocardiograms, stress tests and perhaps even results of cardiac catheterizations. During the visit, we will explore symptoms related to heart rhythm abnormalities. We discuss the problems associated with arrhythmias as well as options for treatment.
Some of our patients require ongoing care for their heart rhythm issues. This includes patients with implanted devices such as pacemakers and defibrillators. Other patients requiring follow up visits include those with chronic arrhythmias requiring ongoing monitoring and treatment such as atrial fibrillation.
We offer full consultations and follow up visits for ongoing management of heart rhythm disturbances, antiarrhythmic drug thereapy and cardiac rhythm device management. We are fully equipped with ambulatory heart rhythm monitors including wireless patient activated monitors for the evaluation of heart rhythm symptoms as well as mobile cardiac telemetry. Our main office is conveniently located on the campus of St. Francis Medical Center. We also see patients in Middletown, CT.