Electrophysiology

Electrophysiology Dr. Corbisiero

Deborah’s electrophysiology (EP) department specializes in the electrical activity of your heart — diagnosing and treating heart arrhythmias, or abnormal heartbeats. Electrophysiologists can test what type of an arrhythmia you have and where it is coming from. Treatments include medications, cardioversions, device therapy (ICD and/or pacemakers) or ablations.

Deborah physicians use robotic navigation and 3-dimensional technology to complete a detailed substrate map of the heart, identifying sick tissue. This provides a precise roadmap for treatment, leading to better outcomes than standard approaches.

Deborah physicians use robotic navigation and 3-dimensional technology to complete a detailed substrate map of the heart, identifying sick tissue. This provides a precise roadmap for treatment, leading to better outcomes than standard approaches.

A heart arrhythmia occurs when your heart beats too fast (tachycardia, when your heart beats at more than 100 beats/minute), too slow (bradycardia, when your heart beats fewer than 60 beats/minute), or irregularly. Signs and symptoms may be related to your heart not pumping effectively due to the fast or slow heartbeat. These could include shortness of breath, weakness, dizziness, lightheadedness, fainting or near fainting, and chest pain or discomfort. Arrhythmias, however, may not cause any signs or symptoms. In fact, your doctor might find you have an arrhythmia during a routine examination. If you do have noticeable signs and symptoms, it doesn’t necessarily mean you have a serious problem.

Symptoms and Causes of Heart Arrhythmias

  • A fluttering in your chest
  • A racing heartbeat (tachycardia)
  • A slow heartbeat (bradycardia)
  • Chest pain
  • Shortness of breath
  • Lightheadedness or dizziness
  • Sweating
  • Fainting (syncope) or near fainting
  • Fatigue
  • Some patients with arrhythmias may not have symptoms

Causes of arrhythmias include:

  • A heart attack
  • Changes to your heart’s structure
  • Blocked arteries in your heart
  • High blood pressure
  • An overactive or underactive thyroid
  • Smoking, illegal drug use, or drinking too much alcohol or caffeine
  • Stress
  • Certain medications and supplements, including over-the-counter supplements
  • Diabetes
  • Sleep apnea
  • Genetics

Diagnosing an Arrhythmia

  • Electrocardiogram (ECG)
  • Holter monitoring
  • Event monitoring
  • Loop recorder
  • Stress testing
  • Tilt table testing
  • EP study

The above testing can be performed on an outpatient basis, with the potential ability to treat the arrhythmia at the same visit.

Types of Arrhythmias

  • Atrial fibrillation
  • Atrial flutter
  • Supraventricular tachycardia
  • Wolff-Parkinson-White syndrome
  • Ventricular tachycardia
  • Ventricular fibrillation
  • Long QT Syndrome
  • Atrial tachycardia
  • Brugada syndrome
  • Sick sinus syndrome
  • Conduction block

Atrial fibrillation

Also called afib or AF, atrial fibrillation is a common type of abnormal heartbeat. The heart rhythm is fast and most often irregular.

Atrial flutter

A type of abnormal heart rate occurring when the upper chambers of your heart beat faster than the bottom ones, causing your heart rhythm to be out of sync.

Supraventricular tachycardia

These are a group of abnormally fast heart rhythms.

Wolff-Parkinson-White syndrome

A condition in which there is an extra electrical pathway in the heart. The condition can lead to periods of rapid heart rate.

Ventricular tachycardia

This is a rapid heartbeat that starts in the lower chambers of the heart.

Ventricular fibrillation

A severely abnormal heart rhythm that is life threatening.

Long QT syndrome

This is a heart rhythm disorder that can potentially cause fast, chaotic heartbeats.

Atrial tachycardia

This occurs when too many electrical impulses are sent from the upper heart to the lower heart.

Brugada syndrome

This condition causes a disruption of the heart’s normal rhythm, leading to irregular heartbeats in the heart’s lower chambers.

Sick sinus syndrome

This is a relatively uncommon heart rhythm disorder which is not a specific disease, but a group of signs or symptoms that indicate the sinus node, the heart’s natural pacemaker, is not working properly.

Conduction block

Also known as heart block this is a disorder in the heart’s rhythm due to a fault in the heart’s natural pacemaker caused by an obstruction in the heart’s electrical conduction system.

Treatment Options

  • Medications
  • Cardioversion
  • Pacemakers (including leadless pacemakers)
  • Implantable cardioverter-defibrillators (ICD)
  • Ablations
  • Lead extractions

Medications

For many types of tachycardia, you may be prescribed medication to control your heart rate or restore a normal heart rhythm, as well blood-thinning medications in order to help keep blood clots from forming.

Cardioversion

A procedure in which a shock is delivered to your heart through paddles or patches on your chest. The current affects the electrical impulses in your heart and can restore a normal rhythm.

Pacemaker

Pacemaker A pacemaker is an implanted device that controls abnormal heart rhythms with a device placed under the skin in a surgical procedure. An insulated wire is attached from the device to the heart. When a pacemaker detects an abnormal heart rate it sends electrical energy to the heart to regulate its rhythm.

Leadless Pacemaker

Small pacemaker which regulates bradycardia patients with a minimally-invasive procedure from the device implanted directly into the heart’s ventricle chamber where it delivers electrical stimulation.

Implantable Cardioverter-Defibrillator (ICD)

A battery-powered device that is implanted under the skin. Electrode-tipped wires threaded to the heart allow the ICD to continuously monitor your heart rhythm. If it detects an abnormal heart rhythm, the device sends out energy shocks to reset the heart to a normal rhythm.

Ablation

In this procedure, catheters are threaded to your heart via the femoral vein, and radiofrequency energy is delivered to the precise site of the electrical pathway that is causing your arrhythmia.

CardioMEMS™

CardioMEMS is a miniature implantable remote sensoring device offering continuous monitoring of pulmonary artery pressure, serving as an early indicator of a patient’s worsening heart failure.

Complex Ablations for Ventricular Tachycardia Treatment

Currently, many patients at risk for ventricular tachycardia (VT) have implantable cardiac defibrillators, 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 Remote Navigation System, offering significant benefits by not only preventing uncomfortable ICD shocks, but also allowing for a gradual reduction of many anti-arrhythmic medications.

Epicardial Ablations

In addition to going into the heart with Deborah’s sophisticated robotic navigation system to deliver radiofrequency energy, Deborah specialists are now able to perform epicardial ablations, which targets radiofrequency energy to not only the inside of the heart, but also the outside, which can treat some complex ventricular tachycardias, which previously were difficult to manage.

Why Deborah Heart and Lung Center?

Deborah Heart and Lung Center is the region’s preeminent heart, lung and vascular hospital, offering leading-edge surgical techniques and non-surgical alternatives for treating a multitude of cardiac conditions. The Hospital is consistently recognized as a leader in patient care and innovative healing, and has won numerous awards.

Some ablations, when indicated, utilize the Stereotaxis Remote Navigations System, a remote system that offers safe and precise delivery of radiofrequency energy to a small spot of heart tissue, which creates an electrical block along the pathway that’s causing your arrhythmia. This technology is only available at a few select hospitals in New Jersey and the Delaware Valley Region.

Deborah also has highly experienced specialists who are involved in cutting-edge clinical research, providing Deborah’s patients with access to the latest technologies and techniques. As well, Deborah’s Advanced Heart Failure Center offers additional treatment options if you develop congestive heart failure.

Deborah Heart and Lung Center also remains an excellent resource for patients seeking a second opinion. Its specialists work closely with community cardiologists and primary care physicians in order to deliver coordinated care. Second opinions are frequently sought to both confirm a current diagnosis and treatment plan, as well as learning about other treatment options.