Electrophysiology (Abnormal Heart Rhythm)

Electrophysiology is an area of medicine that focuses on heart rhythm, or heartbeat. A person’s heartbeat is controlled by electrical signals sent by nerve cells in the heart. If there is a malfunction in the electrical signals, it disrupts the normal rhythm, causing an arrhythmia — a heartbeat that is too fast, too slow or irregular.

It is not unusual to experience an arrhythmia from time to time, but it may need treatment if it interferes with the heart’s ability to pump blood and oxygen to the rest of the body. Arrhythmias don’t always have signs, but more serious arrhythmias can cause symptoms such as:

• Chest pain
• Dizziness
• Fainting
• Fatigue
• Shortness of breath
• Weakness

As an integrated health network, Hackensack Meridian Health offers comprehensive cardiovascular services delivered by a highly skilled, multidisciplinary team of heart and vascular specialists. Patients receive innovative electrophysiology procedures and, if needed, minimally invasive heart surgeries at two renowned academic medical centers in New Jersey.

We provide a variety of cardiovascular services, coordinated at community hospitals throughout the state. This means families can access top-quality heart care close to home, where healing happens.

Leading Arrhythmia Care From Cardiovascular Experts in New Jersey

Our highly skilled electrophysiology teams of specialists, nurses and technologists perform more than 3,000 procedures every year, including advanced, minimally invasive approaches. Our outstanding results reflect our experience and commitment to patient safety.

Types of Arrhythmias We Treat

Most arrhythmias do not require treatment, but some can be serious and need medical attention. Types of arrhythmias include:

• Premature beats – The most common type of arrhythmia most often caused by exercise, stress, nicotine or caffeine and does not usually require treatment
• Bradyarrhythmias – Slower-than-normal heartbeats (fewer than 60 beats per minute) that cause insufficient blood supply to the brain
• Supraventricular arrhythmias – Very fast heart rate as with atrial flutter, atrial fibrillation (AF or AFib), paroxysmal supraventricular tachycardia (PSVT), and Wolff-Parkinson-White (WPW) syndrome
• Ventricular arrhythmias – Very fast heart rhythms as with ventricular tachycardia and ventricular fibrillation (v-fib), which need urgent medical attention

Expert Diagnosis and Treatment for Arrhythmias

When patients receive care at one of our academic medical centers, they see physicians and specialists who participate in research to improve care for people with heart disease.

In addition to non-invasive cardiac diagnostic tests — such as electrocardiography (ECG or EKG), heart monitoring and tilt table testing — we perform a variety of sophisticated, minimally invasive procedures to diagnose and treat arrhythmias in state-of-the-art electrophysiology labs.

Electrophysiology Study (EPS)
An electrophysiology study is a minimally invasive test to find the electrical malfunction in the heart and determine the best way to treat it. An EPS uses 3-D mapping technology and catheter-based approaches to evaluate abnormal heart rhythm and introduce different medicines to see which one controls it.

During the test, electrophysiologists use advanced, image-guided technology to insert a catheter — a thin, hollow tube — through a puncture in the wrist or upper leg and into the heart.

Catheter-based techniques are relatively painless. The area of the puncture is numbed, and patients receive medicine to relax.

Catheter Ablation
This minimally invasive procedure uses a catheter to apply heat or cold (cryoablation) to disrupt or destroy heart tissue that causes the arrhythmia. Electrophysiologists often perform ablation during an electrophysiology study, effectively diagnosing and treating the arrhythmia in a single procedure.

Ablation can significantly improve or even stop the symptoms in several types of arrhythmias, including atrial fibrillation, supraventricular tachycardias and ventricular arrhythmias. It requires a short hospital stay and offers a quick recovery.

Implanted Electronic Cardiac Devices
Implanted cardiac devices automatically deliver an electrical signal to control heartbeat, such as pacemakers and cardiac resynchronization therapy (CRT) devices. These small, battery-powered devices are connected to one or more wires placed under the skin below the collarbone, called leads.

Patients with a pacemaker require lifelong management and follow-up care. Hackensack Meridian Health offers comprehensive pacemaker care and monitoring, providing personalized attention and remote monitoring technology that saves unnecessary office visits.

Lead Extraction
Sometimes, the leads from implanted cardiac devices need to be removed due to infection or damage. Our electrophysiologists have the expertise to safely perform this procedure.

WATCHMAN™ Left Atrial Appendage Closure
This advanced surgery can significantly reduce the risk of stroke in people with atrial fibrillation by blocking the area in the heart where most stroke-causing blood clots form, called the left atrial appendage.