Electrophysiology Procedures

Choosing whether to manage a rhythm disorder with medications or procedures is a personal decision, as well as a medical one. Our specialists consult with you to explain the pros and cons of each approach and help guide you through the decision. If and when you are scheduled for a procedure, your physician will provide you with detailed information on what to expect.

Ablation

Abnormal electrical pathways in the heart that disrupt the cardiac electrical signal cause certain types of rapid or irregular heartbeats, known as tachycardias or arrhythmias. An ablation procedure is a treatment that uses a specialized catheter placed inside the heart. The catheter delivers energy to destroy the abnormal pathways, restoring the normal heart rhythm. Our state-of-the-art electrophysiology (EP) Lab allows us to offer the latest ablation technologies, including both cryoablation and radiofrequency ablation. In some patients, ablation can be used to treat common conditions such as supraventricular tachycardia (SVT) and atrial fibrillation (AF) and premature ventricular complexes (PVCs).

Our electrophysiologists also have particular expertise in the mapping and ablation of complex arrhythmias such as ventricular tachycardia (VT), including VT in a structurally compromised heart. We use epicardial and endocardial approaches, and specialized pumps to support the blood pressure during mapping. We have the latest tools for arrhythmia mapping and imaging to make these procedures safe and effective.

Cardioversion

Cardioversion is a way to restore the heart’s normal rhythm. Arrhythmias are problems with the rate or rhythm of the heartbeat. During an arrhythmia, the heart can beat too quickly, too slowly, or with an irregular rhythm. Medications are usually the first treatment used to correct arrhythmia. If medications don’t work, cardioversion may be the next step. During this procedure, patients are moderately sedated for comfort and then given a small, brief electric shock that can jolt the heart into a normal rhythm.

Pacemaker and Defibrillator Implantation

A pacemaker is a small, lightweight electronic device that’s implanted in the body to keep the heart from beating too slowly (bradycardia). The pacemaker keeps track of your heartbeat and, when necessary, generates electrical signals that keep your heart beating at the right pace. Newer pacemakers can monitor blood temperature, breathing rate, and other markers. They also can adjust your heart rate to changes in your activity.

Types of Pacemakers

  • Single-chamber and Dual-chamber Pacemakers
    These monitor and prompt one to two chambers of the heart to beat (generally the right atrium and right ventricle). This is accomplished via leads placed in the heart chamber(s) and attached to the generator box of the pacemaker.
  • Rate-adaptive Pacemakers
    Single- or dual-chambered, these devices change the rate of the heartbeat in cases where the heart rate does not speed up naturally with physical activity. Our program was the first in the Bay Area to offer the entirely leadless single chamber pacemaker for appropriate patients. This device is a miniaturized pacemaker that can be inserted through the leg, leaving no scar and providing many advantages compared to traditional pacemakers with leads.
  • Biventricular Pacemakers
    These are used for cardiac resynchronization therapy. Leads in both the right and the left ventricle allow the pacemaker to literally resynchronize the action of the two chambers. This often results in notable improvement of cardiac function and a reduction in the severity of symptoms.
  • Defibrillator Devices
    These devices are mechanically similar to pacemakers, however, they are used to monitor for certain potentially lethal arrhythmias, and provide prompt, up-front pacing and/or shock therapy to restore a normal rhythm. They can be lifesaving in appropriate patients. We offer both transvenous defibrillator device implantations (which are performed much like pacemaker implantations) and entirely subcutaneous (under the skin) defibrillator implants.

Ambulatory External Electrocardiogram (ECG ) Monitoring

Cardiac arrhythmias may occur infrequently and last for a short amount of time. Some arrhythmias occur only during exertion. By the time a patient seeks help, the arrhythmia may have stopped, making a diagnosis impossible. Ambulatory ECG monitoring is used to record heart rhythm over days or even weeks in order to capture and record brief, intermittent arrhythmias.

A variety of patient-wearable devices, monitors, and implantable devices are now available to us. Even for the most well informed patient, the variety in device selection can be difficult to navigate. Our experts are happy to consult with you about whether your situation is best managed through the use of a device, and if so, which one would be best for you.