The region's leading team of cardiologists and cardiac technicians at the Electrophysiology Laboratory within North Shore-LIJ Health System provide s the following state-of-the-art diagnostic tests, procedures and treatments to correct and control a wide variety of arrhythmias and problems with the heart's electrical system.
LARIAT (Left Atrial Appendage Occlusion) surgery is an innovative catheter-based procedure that uses sutures to tie off the left atrial appendage (LAA). This process helps to prevent blood clots that can lead to stroke in patients with atrial fibrillation, or "AFib" (an abnormal heart rhythm).
Lariat is the only minimally-invasive treatment option for patients that have AFib but cannot take blood thinners due to an underlying medical condition. Southside Hospital recently became the first certified center on Long Island to perform the lariat procedure, while LIJ Medical Center has begun performing the procedure as well. This accomplishment allows the North Shore-LIJ cardiac team to better manage and care for patients while reducing their risk of stroke.
In this test, insulated electric catheters are placed inside the heart to study its electrical system. A small catheter (hollow tube) is inserted through the groin or neck into the heart. This gives the physician the ability to find the origin of an arrhythmia (any abnormal electrical activity) within the heart tissue and determine the best way to treat it.
Cardiac ablation is a procedure done to treat heart arrhythmia, such as rapid or irregular heartbeat. Catheters are passed to the heart through blood vessels. The abnormal electrical conducting area is located, and a form of energy is delivered. The energy may be radiofrequency (heat), laser, or cryo (very cold). Cardio ablation scars the abnormal area, thus stopping the abnormal path of conduction.
Cryoablation involves the freezing of abnormal tissue in the heart in order to correct an arrhythmia. During this procedure, a catheter is inserted into the heart through a vessel in the groin or arm and moved to the site where the problem is occurring. An ultra-cold substance is then applied, freezing the tissue and destroying the site.
Radio Frequency Ablation
When an electrophysiology study reveals an arrhythmia, radio waves can be used to silence the abnormal activity. During radio frequency ablation, a catheter is inserted into the heart through a vessel in the groin or arm and moved to the site where the problem is occurring. Very high frequency radio waves are then applied, heating the tissue until the site is destroyed.
Cardiac Defibrillator Implantation
Similar to a pacemaker, an implantable cardioverter defibrillator (ICD) is a small device that is implanted under the skin, most often in the shoulder area just under the collarbone. An ICD senses the speed of the heartbeat and delivers a small electrical shock to slow the heart when it exceeds the programmed rate. Many newer ICDs can also function as a pacemaker by delivering an electrical signal to regulate a heart rate that is too slow.
Permanent Pacemaker Implantation
Irregular heart rhythms can be managed by a pacemaker, which sends electrical signals to stimulate the heart to beat according to the needs of the patient. Temporary pacemakers are external and reside outside of the body. Permanent pacemakers can be inserted and programmed in one of our electrophysiology labs. A permanent pacemaker is a small device that is implanted under the skin (most often in the shoulder area just under the collar bone) and sends electrical signals to start or regulate the heartbeat if the heart's natural pacemakeris not functioning properly.
Additional Electrophysiology Procedures for Arrhythmias
Electrophysiology procedures at North Shore-LIJ's Cardiac Services extend beyond ablations and pacemaker implantations to include many diagnostic tests and therapies to assist in the treatment of arrythmias.
Cardiac Resynchronization Therapy
Cardiac resynchronization therapy is a treatment given to heart failure patients. During the procedure a specialized biventricular pacemaker or ICD is implanted in order to re-coordinate the movements of the left and right ventricles of the heart and improve pumping ability.
Cardioversion therapy sends a precisely timed electrical shock to the heart through the chest to correct an abnormal heart rhythm. The patient is connected to an ECG monitor and a defibrillator. This synchronized electrical shock of the cardioversion procedure is delivered to the heart through special paddles that are applied to the skin of the chest and back.
A Holter monitor is a device that records your heart's electrical activity or electrocardiogram (ECG). Holter monitors give nonstop recordings of your ECG. You wear the Holter monitor in your pocket or in a small pouch over your shoulder for about 24 – 48 hours.Your doctor may order this test to look at how your heartrate and rhythm may change with different activities and symptoms.
Approximately the size of a stick of gum, the loop recorderis used to capture any irregular heartbeats. Th eloop recorder is inserted under the skin usually in the upper chest area in a procedure that usually takes less than 30 minutes.
Tilt Table Studies
To determine whether a patient is prone to sudden drops in blood pressure or slow pulse rates when his or her position changes, our electrophysiologist's perform tilt table studies. In these tests, a patient is strapped to a table that tilts from a lying to standing position, while an electrocardiogram (ECG) and blood pressure monitors continue to record any changes.
T-Wave Alternans Study
This study is used to determine if a patient is at increased risk for sudden cardiac death or cardiac arrest due to dangerous cardiac arrhythmias. A T-wave alternansstudy is a non-invasive test that uses an electrocardiogram (ECG) tracing.