Heart rhythm problems, or arrhythmias, can be frightening because they are unpredictable. Some arrhythmias can be harmless while others can be life-threatening. Stony Brook's Heart Rhythm Center is here to help you navigate through the fear and uncertainty. We offer comprehensive arrhythmia management that relies on minimally invasive, outpatient procedures to quickly provide the correct diagnosis and the appropriate treatment options. Our electrophysiology team uses a collaborative, multidisciplinary approach to your care. We stress open communication, and will fully discuss your diagnosis and treatment options with you and your family. We also work closely with your cardiologist to ensure you receive the best care possible.
What is Electrophysiology?
An electrophysiologist is a physician who specializes in the diagnosis and treatment of heart rhythm disorders (arrhythmias). Your heart has a complex electrical system that keeps it beating at the right speed and in an orderly rhythm. An arrhythmia is a disturbance in the rate (the number of times in which the heart beats per minute) or rhythm (if the heartbeat is orderly or disorderly) of the heart beat. Electrophysiologists use minimally invasive techniques to diagnose and treat heart rhythm problems. Minimally invasive interventions use catheters (thin, flexible tubes) that are inserted through a small incision in your groin area and guided to the place in your heart where the arrhythmia originates. The catheters typically have special tips on them that are used to diagnose and treat arrhythmias. Minimally invasive procedures have largely taken the place of open surgery. The smaller incision means less pain, healing time and infection risk. Electrophysiologists perform other procedures as well, such as cardiac defibrillator and pacemaker implantations, and cardiac resynchronization therapy for heart failure.
Our highly skilled physicians will work with you and your primary care physician or cardiologist to accurately diagnose your condition and determine the best course of treatment for you. Our services include:
- Comprehensive arrhythmia consultation: We offer complete arrhythmia consultation, which includes diagnostic procedures and medication management.
- Electrophysiology study: Ours doctor will use catheters and electrodes (small electrical conductors) to record the electrical activity in your heart.
- Catheter ablation: Catheters, most frequently with electrodes at their tips, are heated with radiofrequency energy to destroy (ablate) a tiny spot of heart tissue and create an electrical block along the pathway that is causing the arrhythmia. Physicians can use other forms of energy as well, including cold (called cryoablation). Our electrophysiologists use advanced 3D mapping systems such as CARTO and NAVX, intracardiac echocardiography, and pulsed fluoroscopy, to precisely locate the heart tissue that is causing the arrhythmia, while limiting radiation exposure. We are the only center in Suffolk County that performs ablation procedures for complex arrhythmias such as atrial fibrillation and ventricular tachycardia.
- Evaluation of syncope (tilt table testing): Syncope (fainting) can be diagnosed by using tilt table testing in which the physician measures blood pressure while positioning the patient at different angles on a tilting examination table.
- Implantable devices:
- Implantable cardioverter-defibrillator (ICD): An implantable cardioverter-defibrillator, or ICD, is a small device that is implanted under the skin in the upper chest and connected to the heart with wires called leads. When the device senses an arrhythmia, it delivers a shock to restore the heart's proper rhythm.
- Pacemaker: Pacemakers are electronic devices that correct or prevent an abnormally slow heartbeat, turning on when the heartbeat is too slow (called bradycardia) and turning off once the heartbeat returns to normal. For people with bradycardia who can be treated with a pacemaker in just one of the four heart chambers, Stony Brook offers the Micra pacemaker, which is 93 percent smaller than traditional pacemakers and and is a single unit that fits entirely inside the heart chamber.
- Biventricular defibrillator (cardiac resynchronization therapy/CRT): In some people with heart failure, the electrical impulses that travel through your heart are delayed, which can make your heart failure symptoms worse. Physicians can restore the synchronization through CRT, which is the placement of a biventricular ICD. A biventricular ICD differs from a standard ICD in that it has the ability to pace both the left and the right ventricles, which resynchronizes your heartbeat and allows the heart to contract more efficiently.
- Watchman device (left atrial appendage closure implant): If you have AFib that is not caused by a heart valve problem, and you’re at high risk for a stroke but need an alternative to the long-term use of blood thinners, Watchman may be right for you. Watchman is an FDA-approved implant that permanently closes off your heart’s left atrial appendage (LAA), which is where more than 90 percent of stroke-causing blood clots arise.
- Long-term device monitoring: Remote monitoring enables you to have your ICD checked from home rather than having to travel to Stony Brook for an appointment. The remote monitor is made up of a small battery-powered box with a detachable wand. At a scheduled time, the patient connects the monitor to the home telephone, and places the wand on the skin over the ICD. The wand reads the ICD information and transmits the information securely to our offices. Some devices can communicate with the monitor box wirelessly. After the data are transmitted, the physician can review the data to ensure the device is performing properly.
- Device lead extraction: In this procedure, electrophysiologists remove nonfunctioning ICD and pacemaker leads assisted by a laser to detach the leads from the blood vessels and the heart. The laser allows the leads to be removed more easily than with manual tools. Common reasons for lead extraction include infection, malfunctioning or fractured leads, and to get access to the vascular system to place new leads when the veins are blocked.
The Stony Brook Difference
Stony Brook's Heart Rhythm Center is a recognized leader in the diagnosis and treatment of heart arrhythmias. Led by Dr. Eric Rashba, our team includes five electrophysiologists, three nurse practitioners and two physician assistants, who practice in two state-of-the-art electrophysiology laboratories. Our Heart Rhythm team combines medical expertise, advanced technologies and personalized care that stresses open communication between us and you, your family, and your cardiologist and your primary care physician. We stay on the cutting edge of electrophysiology through our deep involvement in heart rhythm research. Much of our research is practical and focuses on improvements in treatments that are already available. This means that we can provide you with access to tomorrow's treatments today.
At Stony Brook Medicine, our electrophysiology team focuses on your treatment and comfort. We work collaboratively with each other, your referring physician, and — most importantly — you to develop the best treatment plan for you. We stress a continuum of care as well as care coordination with your cardiologists and primary care physician. Our team offers decades of training and experience, insight from cutting-edge research, state-of-the-art facilities, and a patient-focused environment to provide you with superior outcomes and a positive patient experience.
Our Heart Rhythm Center team:
- Eric Rashba, MD, Director, Heart Rhythm Center
- Ibrahim Almasry, MD
- Roger Fan, MD
- Abhijeet Singh, MD
- Stephen C. Vlay, MD
Click here for a list of Frequently Asked Questions (FAQs).