As the only full-service electrophysiology laboratory in the borough of Queens, we are committed to providing patient centered comprehensive care from office consultations to procedures that are all performed in our laboratory. Our team of cardiac electrophysiologists and care providers strive to offer the most leading-edge technologies available in elecrophysiology, and are dedicated to the treatment of all types of cardiac rhythm disturbances to alleviate suffering, improve quality of life.
Our electrophysiologists are experts at the diagnosis and treatment of palpitations, fainting, and symptoms attributable to abnormal cardiac rhythms. We provide consultation on inherited cardiac conditions associated with sudden cardiac death, including Brugada syndrome and long QT syndrome, among others. At the Arrhythmia Center, we offer numerous types of cardiac monitoring, including Holters, event monitors, and continuous cardiac monitoring in traditional and leadless formats.
The Arrhythmia Center at NewYork-Presbyterian Queens is the only center in Queens, and one of the few centers in New York, to offer the leadless pacemaker, the WATCHMAN procedure, Direct His-bundle pacing (DHBP), and Hybrid Surgical/Endocardial Ablation of Atrial Fibrillation.
The Leadless Pacemaker– The advanced technology of the leadless pacemaker eliminates many potential complications of a traditional pacemaker including infections and broken leads. Unlike most pacemakers, the leadless pacemaker is a self-contained device. The device is placed in the patient’s heart muscle through a vein in the leg, eliminating potential medical conditions arising from a chest incision and wires running from a conventional pacemaker to the heart.
The WATCHMAN Procedure– The WATCHMAN procedure helps patients who have atrial fibrillation reduce their risk of stroke. Patients with atrial fibrillation are at risk of stroke due to the fact that blood clots may form in a small appendage of the heart and then be pushed out and travel to the brain. Typically, these patients are treated with blood thinners. Named after the WATCHMAN device, the procedure closes off the left atrial appendage, reducing the risk of stroke and eliminating the need to take life-long blood thinners.
Clinical Cardiac Electrophysiology Services
Our team of electrophysiologists provides comprehensive care for arrhythmia-related symptoms and disorders. We offer a broad spectrum of diagnostic and therapeutic services including:
- Evaluation of Palpitations
- Evaluation of Fainting (Syncope)
- Risk Assessment for Cardiac Arrest
- Outpatient Telemetry Monitoring
- Remote Monitoring of Implanted Devices
- Electrophysiologic Testing
- Implantation of Pacemakers and Defibrillators (ICDs)
- Cardiac Resynchronization Therapy
- Removal (Extraction) of Pacemakers and Defibrillators
- Treatment of Supraventricular Tachycardia
- Treatment of Ventricular Tachycardia
- Comprehensive Atrial fibrillation Management
- Ablation of Cardiac Arrhythmias
The Device Management Center
Our electrophysiologists feel strongly that patients with pacemakers, defibrillators, and implanted loop recorders should be monitored in the most convenient and safest way possible.
We offer dedicated services for device management, including office-based device interrogation and programming. We encourage all our patients to enroll in patient-centered home monitoring, in which device information can be reviewed remotely. This offers patients more convenient, timely, and safe monitoring of their cardiac rhythm and device function.
Coupled with NewYork-Presbyterian’s Telehealth Service, we are able to schedule “virtual” office follow-up visits using secure video conferencing software installed on any smart phone. This patientcentered approach allows us to collaborate with individual patients to minimize disruption to their daily schedule and maximize quality communication between our providers and patients.
The Comprehensive Atrial Fibrillation Center
NewYork-Presbyterian Queens’ Comprehensive Atrial Fibrillation Center is the only center in the borough of Queens that provides a complete arrhythmia service line from pacemakers and implantable defibrillators, to advanced catheter ablations and left atrial appendage closures.
Atrial fibrillation is the most common cardiac arrhythmia, affecting one in 10 individuals by age 80. Risk factors include age, other cardiac problems, sleep apnea, hypertension, and diabetes. It can also occur in otherwise healthy people and leads to an irregular and often rapid heart rhythm, which can cause symptoms of palpitations, shortness of breath, dizziness, chest discomfort, and fatigue. In addition to causing symptoms, atrial fibrillation increases the risk for major stroke.
We take a comprehensive approach to diagnosing and treating atrial fibrillation by first identifying risk factors that can be modified to reduce and treat symptoms. This can include weight loss, medical treatment of other cardiac and non-cardiac conditions, and the identification of patient-specific triggers. Our electrophysiologists have expertise in the use of antiarrhythmic drugs, sometimes coupled with a cardioversion procedure, to help keep the heart in normal rhythm. Some patients are candidates for ablation where a catheter is utilized to create a set of lesions in the heart at the source of the atrial fibrillation in an effort to cure it.
Advanced Treatment and Prevention
Convergent Ablation Procedure– Advanced catheter ablations and left atrial appendage closure is offered to patients with advanced cardiac disease. Our heart surgeons and electrophysiologists partner in a convergent ablation procedure, also known as hybrid ablation, to treat atrial fibrillation, reduce stroke risk, and eliminate the use of blood thinners in select patients. This minimally invasive procedure closes the left atrial appendage of the heart and combines cardiac catheterization and surgical ablation in a single operative setting.
Stroke Prevention – – We are committed to improving the heart health of our community and counsel our patients on treatment options for stroke prevention in atrial fibrillation. Our group has expertise in direct oral anticoagulants and newer medications that can dramatically reduce stroke risk with a better safety profile than traditional medication.
Arrhythmia Research Updates
Recent clinical trials and advancing technology have fundamentally changed best practice care for patients with atrial fibrillation. Perhaps one of the most surprising findings is that patients with chronic systolic heart failure stand the most to gain by undergoing catheter ablation of atrial fibrillation. This patient population was previously considered least likely to remain in sinus rhythm following ablation. Results from CASTLE AF have turned this conventional thinking upside down. Investigators randomly assigned patients with symptomatic paroxysmal or persistent AF to either catheter ablation (179 patients) or medical therapy (rate or rhythm control – predominantly with amiodarone) (184 patients), in addition to guidelines-based therapy for heart failure. All patient had NYHA Class II, III or IV heart failure. After a medial follow-up of 37.8 months, patients who underwent catheter ablation were significantly less likely to have died from any cause, hospitalized for worsening heart failure, or died from cardiovascular causes.
Take Away: Patients with heart failure and atrial fibrillation receive both improvement of symptoms of heart failure as well as a reduction in mortality from undergoing AF ablation. These benefits did not occur in patients who were treated with amiodarone. Preliminary findings from CABANA Trial presented at the Heart Rhythm Society’s annual scientific session in May, 2018, support similar findings. CABANA will be published in the coming months in the Journal of the American Medical Assocation.