Complex Ablations for Ventricular Tachycardia Treatment
Currently, many patients at risk for Ventricular Tachycardia (VT) have implantable cardiac defibrillators (ICDs), which can rescue them from this life-threatening arrhythmia by delivering electric shocks to the heart to restore its rhythm. However, Deborah’s complex ablation procedure is a treatment strategy to prevent recurrence of VT and ICD shocks. This ablation therapy uses radiofrequency energy delivered through the Stereotaxis System, offering significant benefits by not only preventing uncomfortable ICD shocks, but also allowing for a gradual reduction of many anti-arrhythmic medications.
Stereotaxis, in the hands of the skilled specialists at Deborah, represents the safest and most effective way to deliver this therapy. With the enhanced safety offered by the robotic procedure, Deborah is also able to perform epicardial ablation, an even more complex procedure which targets radiofrequency energy to not only the inside of the heart, but also the outside.
Deborah is one of only four centers in New Jersey with this life-saving technology, and the only South Jersey center offering comprehensive and complex ablations using Stereotaxis for treatment of all types of VTs.
Arrhythmia Evaluation and Treatment
Deborah’s electrophysiologists perform a comprehensive diagnostic evaluation using EKG, electrophysiology studies, tilt table testing, and Holter monitoring. These tools assist the physician in identifying the arrhythmia and appropriate treatment for any basic or complex arrhythmia. The treatment may be as simple as medication, or more complex, such as pacemaker/AICD therapy or radiofrequency ablation. This evaluation is done on an inpatient as well as outpatient basis.
Increased Patient Safety
Deborah offers the “Stereotaxis Gentle Touch Magnetic System,” allowing our specialist to navigate catheters by a robotic system gently and precisely through delicate areas of the heart, preventing any potential damage during an ablation.
Stereotaxis Gentle Touch Magnetic System
Deborah’s Electrophysiology suite includes one of the region’s first Stereotaxis GentleTouch Magnetic Systems, as well as new enhanced imaging equipment and a specifically-designed mapping system. The Stereotaxis GentleTouch Magnetic System allows doctors the ability to view the inside of the heart, both anatomically and electrically. This new machine also enables them to perform remote-controlled, image-guided computerized heart procedures, combining robotics and a 3D mapping system to create a map of the heart.
The Stereotaxis system allows doctors to use magnets to steer catheters gently and precisely through delicate areas of the heart. Because the catheters are driven by a magnetic steering system, they exert an even and steady pressure which removes the potential for damage to the heart. The Stereotaxis system is able to navigate into the most remote areas of the heart, uncovering hidden damage and problems to provide the most comprehensive look at the heart’s electrical anatomy. These benefits are accomplished in a much shorter time, which means that patients spend less time involved in a procedure.
Deborah performs radiofrequency ablation, a procedure used to treat adults and children with complex cardiac arrhythmias. Included in these services are atrial and supraventricular tachycardia, Wolff-Parkinson-White Syndrome, atrial fibrillation and flutter.
For 40 years, Maria Jelonek suffered from abnormal heart rhythms. Doctors in her native Poland—and later in the United States—insisted her dangerous condition had no obvious or immediate cure. As the problem continued and worsened, Maria confronted serious, life-threatening complications.
But her story wasn’t over. Maria and her family found a cure by Demanding Deborah, where renowned cardiologist Dr. Raffaele Corbisiero ablated the problem beat to restore her heart’s natural rhythm. This video tells her true story.
Heart Failure Evaluation and Management
Deborah’s electrophysiology services are devoted to the evaluation, consultation, and treatment of complex cardiac arrhythmias, including:
- Atrial fibrillation and flutter
- Supraventricular tachycardia including Wolff-Parkinson-White-Syndrome
- Ventricular tachycardia
Electrophysiology studies assist Deborah’s doctors in determining where rhythm disturbances originate and to identify the specific type of arrhythmias involved.
Comprehensive device therapy is also included in the EPS service. Pacemaker and defibrillator implants as well as lead extractions are offered for standard indications. Biventricular devices are available for emerging indications including congestive heart failure. Deborah provides an outpatient service dedicated to both pacemaker and defibrillator evaluation and complex programming.
The section offers a complete work-up for neurogenic syncope, including tilt table testing. Electrophysiologists read and interpret Holter monitors and report these findings to referring physicians.
Deborah’s electrophysiologists specialize in the implantation of sophisticated programmable pacemakers and defibrillators to treat a variety of rhythm disturbances. The major diagnoses are brady and tachy arrhythmias. Pacemakers are implanted in a patient with a slow heart rate, while an Implantable Cardioverter Defibrillator is a treatment option for patients who suffer with ventricular tachycardia and ventricular fibrillation. The electrophysiologists are also performing lead extractions on patients when indicated. This service treats ambulatory care patients as well as inpatients.
Deborah’s electrophysiologists specialize in the evaluation and treatment of complex cardiac arrhythmias. The physicians also specialize in the implantation of sophisticated programmable pacemaker, defibrillator, and biventricular devices.
The reading and interpretation of Holter monitor reports are another service provided by the electrophysiologists.
The section also offers a work-up for neurogenic shock, including tilt table testing. All of the electrophysiology services are available to patients on an inpatient and outpatient basis. Deborah offers a full spectrum of electrophysiologic services to its patient population.
Unify CRT-D and Fortify ICD
Deborah is the first hospital in the region to implant new defibrillators recently approved by the FDA—the Unify CRT-D and the Fortify ICD, both manufactured by St. Jude Medical. An ICD is an implantable device that treats potentially lethal, abnormally fast heart rhythms which can lead to sudden cardiac death. With the ability to deliver 40 joules, the new devices hold the highest amount of energy found in any defibrillator and are specially designed to prevent unnecessary defibrillation. They are smaller in size, allowing physicians to implant them using a smaller incision with subsequent less scarring.
Approximately five million Americans suffer from heart failure and about 325,000 die from sudden cardiac death each year. The new devices are major advances in improving electrical interface to correct heart rhythm.
A CRT-D device resyncs the beating of the heart’s lower chambers, which often beat out of sync in heart failure patients. CRT therapy can greatly improve the quality of life for patients suffering with heart failure.
The additional energy capability found in the smaller CRT-D and ICD devices are especially important for patients who have an enlarged heart, low ejection-fraction, advanced heart failure, or those who require a higher amount of energy to shock their hearts to a normal rhythm.
The new devices increase the possibilities of heart failure patients and those with abnormal heart rhythms to live a longer, better quality of life. These devices also improve patient comfort with less bulk, reducing the need for set screws and lead connections to the device.
ENERGEN CRT-D and ICD Device
The ENERGEN cardiac resynchronization therapy defibrillator (CRT-D) and implantable cardioverter defibrillator (ICD) are used to treat heart failure and sudden cardiac death. The system is designed to simplify and reduce the time needed for the implant procedure by combining three separate lead terminals into one integrated connector and reducing the number of connections and set screws needed in the device header. In addition, some patients will receive a remote monitoring system where an at-home communicator will allow physicians to monitor the patient’s device and vital signs, such as blood pressure and weight, in order to better manage this complex disease.
QuickOpt Technology is software technology that allows pacemaker patients to receive a “tune-up” check-up in less than 2 minutes when they come to Deborah’s Pacer Clinic for routine follow-up visits. The QuickOpt technology was pioneered by Dr. Raffaele Corbisiero, Director of Deborah’s Electromechanical Therapy Institute, and came to the market after more than two years of clinical research trials. It replaces a traditional echocardiogram, which is time-consuming and costly, and offers greater flexibility for Deborah doctors to quickly optimize devices (making sure they are working up to full potential) as often as necessary.
“Many patients may not have their devices optimized,” said Dr. Corbisiero, “meaning that they recognize some of the benefits, but may not realize all of the benefits these sophisticated devices can deliver. It’s like running an air conditioner on a hot day with the windows open.” Dr. Corbisiero’s ground-breaking research has now brought the new software program to a national market.
The Holter monitor section performs 24-hour Holters, ambulatory event monitoring, and signal average ECG testing. Cardiologists and/or electrophysiologists read and interpret the tapes, and report the findings to the referring physician.
Tilt Table Testing
This test is used to evaluate neurally mediated syncopal syndromes. The test helps to distinguish between a vasodepressor response and cardioinhibitory response, thereby establishing the most appropriate treatment program for the patient.
MultiPoint Pacing Technology
Deborah has long been a pioneering regional leader in introducing quadripolar pacing (versus traditional bipolar) in its cardiac resynchronization therapy defibrillators and pacemakers. The new MultiPoint Pacing technology is the next step in this evolution. MultiPoint Pacing allows the device to pace at two left ventricular sites, giving an added time dimension, as well as increasing the amount of cardiac tissue being stimulated at one time. The increased stimulation can enhance cardiac performance and also allows a wider circle of patients to benefit from this new technology.