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The Cardiac Electrophysiology (EP) Program, which provides the highest-quality care in a rapidly growing subspecialty of cardiology, has greatly expanded its portfolio of therapies in only a few years. In addition, the program’s new geographic availability in Rockland, Ulster and Dutchess counties, complementing its base at Westchester Medical Center, attracts patients from this area and beyond.
Heart Arrhythmia Treatment Technology
The Electrophysiology Program uses the latest technologies to diagnose and treat the full spectrum of heart arrhythmias, irregular rhythms caused by abnormalities in the heart’s electrical system. Symptoms of an arrhythmia vary but can include palpitations, shortness of breath, fainting – and in extreme cases, a loss of heart function (cardiac arrest).
Director of Cardiac Electrophysiology Sei Iwai, MD, said WMCHealth’s specialized services include:
- Catheter ablation to target and destroy tissue causing abnormal heart rhythms
-
Left atrial appendage occlusion
- Pacemaker and implantable cardiac defibrillator (ICD) implantations and extractions
- Implantation of biventricular pacing devices for treatment of congestive heart failure
Treatment for Complex Heart Arrhythmias
The Cardiac Electrophysiology Program offers every treatment approach for complex arrhythmias has experienced tremendous growth in recent years while maintaining a track record of quality and safety that equals or surpasses what is available in similar quaternary care academic medical centers in Manhattan.
Recent improvements in catheter ablation technology have vastly increased the types of arrhythmias that can be treated effectively. Jason Jacobson, MD, Director of the Complex Arrhythmia Ablation Program, along with Dr. Iwai, leads a collaborative team of specialists from across the WMCHealth Heart and Vascular Institute, which treats the full spectrum of arrhythmias. These include:
- Atrial fibrillation
- Ventricular tachycardia
- Supraventricular tachycardia
- Other arrhythmias in patients with and without structural heart disease.
The Ablation Program features increased use of three-dimensional mapping, intracardiac ultrasound and other advanced imaging modalities to improve outcomes. Epicardial ablations, performed from outside the heart, are a recent addition to the regimen of care.
Additional Areas of Specialization
Cardiac implantable electronic devices include pacemakers, ICDs, cardiac resynchronization (bi-ventricular) therapy devices, leadless pacemaker implants contained within the heart, and subcutaneous ICDs that are implanted at the side of the chest with an electrode placed along the breastbone.
Left atrial appendage occlusion, an emerging area of treatment, reduces the risk of bleeding and stroke for patients with atrial fibrillation by reducing the need for blood thinners and limiting blood clots’ entrance into the bloodstream. The implantation of these devices by Dr. Iwai and the EP service as part of a collaborative team including interventional cardiologist Srihari Naidu, MD, and echocardiographer Mala Sharma, MD, is an alternative to anticoagulants as a therapy.
T
he Remote Device Monitoring Program decreases morbidity, hospital admissions and mortality rates by improving early detection of patient and device abnormalities. It wirelessly connects the implanted device with a transmitter at a patient’s home. The transmitter then sends data to EP physicians and allied health professionals, who are alerted by email or phone call, as clinically indicated. A dedicated team oversees the program, which results in fewer in-office visits for patients but increased surveillance of device function and the patient’s health.
Providers also offer laser extraction of pacemaker and ICD leads, a technique used to remove chronically implanted leads and sever scar tissue.
Expertise Throughout the Hudson Valley Region
In addition to Westchester Medical Center in Valhalla, electrophysiology services are available in:
- Kingston, at HealthAlliance Hospital: Consultations are provided and device implantations are performed.
- Poughkeepsie, at MidHudson Regional Hospital: Outpatient examinations are offered, and the hospital is adding EP laboratory services.
- New Windsor: Outpatient consultations are provided.
A Commitment to Research
A commitment to research helps differentiate Westchester Medical Center’s EP Program. The service is involved in clinical research that includes multi-center trials and investigator-initiated research. Dr. Jacobson and Dr. Iwai are involved with translational research in conjunction with New York Medical College, the academic affiliate of Westchester Medical Center, to better define underlying mechanisms of arrhythmias.
For example, the Electrophysiology team recently contributed to development of antibiotic-impregnated pouches that can be placed around an implanted device, a technique that reduces the risk of infection. An account of this evolution of care was published
in The New England Journal of Medicine. In addition, the EP team was integrally involved in demonstrating the utility of a novel ICD lead that improves detection of arrhythmias such as atrial fibrillation. Translational research seeks to build on basic scientific research
to create new, clinically relevant therapies, i.e., to bring therapies “from bench to bedside.”
Examples of our research include investigation of the role of various cell receptors after a heart attack in limiting development of scar tissue and cardiac arrhythmias, investigation of the circuits of arrhythmias involved with damaged heart muscle, and the utility of intracardiac ultrasound and advanced-imaging modalities to improve outcomes.
Elsewhere in the realm of research, “We collaborate with industry to develop products and work on improving healthcare provider training,” Dr. Iwai said.
In addition, by providing advanced training, the Electrophysiology Program is committed to helping train the next generation of experts in this field by offering a cardiac electrophysiology fellowship through the Division of Cardiology’s Graduate Medical Education Program.
Appointments, Referrals and Information
866.WMC.HEART (866.962.4327)
Ambulatory Care Pavilion, Westchester Medical Center
100 Woods Road
Valhalla, NY 10595
Learn more about the Cardiac Electrophysiology program at Westchester Medical Center.
HealthAlliance Hospital
111 Mary’s Avenue, Suite 3
Kingston, NY 12401-5853
845.339.3663
845.339.3629
MidHudson Regional Hospital
1 Webster Avenue, The Atrium, Suite 202
Poughkeepsie, NY 12601
845.483.5934
New Windsor
575 Hudson Valley Avenue, Suite 200
New Windsor, NY 12553
845.561.2773