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Cardiologist examining smiling girl with stethoscope

Electrophysiology Service

ColumbiaDoctors electrophysiology service provides diagnosis and treatment of heart rhythm disorders in infants, children, and young adults, and is the largest service of its kind in the New York metropolitan area. We have performed more than 1,000 invasive procedures in the last decade. Our cardiologists are experts in:

  • Ablation of cardiac arrhythmias
  • Arrhythmias related to genetic abnormalities
  • Assessment of family members of victims of sudden death
  • Brugada syndrome
  • Catecholoaminergic polymorphic ventricular tachycardia
  • Fetal arrhythmias
  • Heart block
  • Hypertrophic and dilated cardiomyopathy
  • Long QT syndrome/Short QT syndrome
  • Management of children with pacemakers and implantable defibrillators (ICD)
  • Supravenetricular tachycardia
  • Ventricular tachycardia
  • Wolff – Parkinson – White syndrome

Our doctors use state-of-the-art technology to maximize outcomes and minimize risks of cardiac procedures, including:

  • Wireless heart rhythm monitoring
  • 3-D imaging in ablation procedures
  • Implantable cardiac devices

Heart rhythm monitoring

Current technology has allowed us to more efficiently diagnose and monitor patient’s heart rhythm problems. In formulating a management plan, we need to record the rhythm at the time of symptoms to either reassure patients of no abnormality or to define the nature of the issue. Traditionally, this meant carrying a dedicated monitor or wearing a cumbersome monitor with wires attached to stickers on the chest for days or weeks at a time.

As cellular phones have become ubiquitous, we have incorporated their capabilities into our daily practice. We are able to remotely monitor our patients with a smartphone case, recording a single lead electrocardiogram at the time of symptoms and transmitting it to our doctors for review.

We also employ skin patch technology to record rhythms at the time of symptoms. This technology makes the monitors less obtrusive and improves the patient experience.
In some cases, we still use wired devices, however, we usually do so by pairing them with cellular technology that visualizes patient episodes almost immediately after symptoms start and eliminates the time delay to diagnosis.

For patients who need more definitive long-term rhythm observation, we use a small monitor implanted under the skin on the chest. The procedure takes about 5 minutes and requires a small incision, which is done while the patient is under local anesthesia. These devices can record heart rhythm for a few years, allowing us to “never miss a beat” when more extended monitoring proves necessary.

3-D imaging in ablation procedures

When patients need treatment for arrhythmias, we use a state-of-the-art electrophysiology lab for the ablation procedure. The lab is equipped with technology to create 3-D images of the heart in real time, minimizing risks to patients and improving the likelihood of eliminating the arrhythmia. To this end, we have more than a 95 percent acute success rate in curing arrhythmias over the past several years.

Implantable cardiac devices

Patients with a slow heart rate or episodes of life-threatening fast arrhythmias often need a permanent cardiac pacemaker or implantable cardiac defibrillator. Our doctors have pioneered the use of 3-D imaging technology for implanting cardiac devices in children with only a minimal amount of exposure to X-rays. We often use devices that are wireless and compatible with MRI technology.