Arrhythmia & Pacemaker Center

	Ever since we established the Arrhythmia & Pacemaker Center at St. Francis Hospital in 1988, we have been pioneers in shaping developments in electrophysiology. Read More Hide
We were among the first in the nation to offer implantable defibrillators and to offer radiofrequency ablation as an alternative to cure certain arrhythmias. It was our idea to use the defibrillator as a tool to prevent an initial sudden cardiac death. These eventually led to more permanent cures and improved management of cardiac rhythm abnormalities. Our physicians continue to be among the nation’s leaders in developing new technologies and applications. We also led the approach to using heat to ablate heart tissue to cure arrhythmias. Today, we are one of the leaders in performing radiofrequency cardiac ablation to permanently cure atrial fibrillation, the most common form of arrhythmia which affects 2.2 million people in the U.S. and is associated with a stroke rate that is five to eight times higher than average. Our extensive experience allows us to diagnose with accuracy, recommend and perform the appropriate treatment with the best results, and provide substantial follow-up in every case. We find that our health education and screening services are an added benefit to patients in helping them better understand risk factors and ways to improve their health beyond the medical care we offer. The results show that experience really matters, especially in this complex specialty. We are proud to be a center of choice for patients from across the country and around the world. We remain committed to exploring options with you to help you achieve an improved quality of life. An overview of our services is provided on this site, however, I also welcome you to call us to request additional information or schedule a consultation.
- Joseph H. Levine, M.D., Director Arrhythmia & Pacemaker Center For a consultation, call us at (516) 562-6672.

Palpitations, syncope and/or fainting caused by a cardiac arrhythmia, such as:

• Fibrillation (fast, unsynchronized beats)
• Tachycardia (fast heart rate)
• Bradycardia (slow heart rate)

Congestive Heart Failure

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Key Treatments

Electrophysiology (EP) study

The EP study provides information to help diagnose and locate the source of an arrhythmia. Electrophysiologists guide thin catheters to the heart through small incisions. The catheters are used to deliver and record electrical signals in certain locations of the heart muscle during the procedure. The patient is awake and able to report how they are feeling throughout the procedure. The electrophysiologist uses information gathered during the EP study to determine the location of the irregularity and recommend the best course of treatment for a patient. St. Francis Hospital is one of the nation’s leading centers by volume and has unparalleled safety rates for EP studies, making it as safe as many non-invasive tests.

Catheter-based radiofrequency ablation

This approach to restoring normal heart function has been performed for over 20 years by physicians at St. Francis Hospital. Because it is catheter-based, the procedure is usually well-tolerated and does not require stitches or significant incisions. Performed in the electrophysiology lab, radiofrequency ablation is usually performed in conjunction with an EP study (detailed above). It also uses small catheters directed to the heart to deliver radiofrequency energy that burns through and eliminates the tissue where the arrhythmia originates. New three-dimensional mapping system technology available at St. Francis Hospital provides an exceptional level of precision and accuracy in treating patients with more complex conditions. St. Francis Hospital’s experienced staff performs the procedure with high safety and success rates. They have the shortest procedure times of any center in the nation, which safeguards the patient from excessive x-rays during the procedure.

Surgical ablation

Known as mini-maze, the surgical ablation technique uses radiofrequency energy to create lines of ablation along the exterior of the heart during a minimally invasive surgical procedure. The scar tissue that results from this process interrupts the faulty electrical pathway that was causing an irregular rhythm. The mini-maze procedure offers a new option to patients with a history of atrial fibrillation who are already undergoing cardiac surgery, those who haven’t been responsive to drug therapy, or those who are at high risk for blood clots.

Pacemaker and Defibrillator Implantation

Small devices implanted under the skin, such as pacemakers and automatic implantable cardioverter defibrillators (AICDs), can help manage cardiac rhythm, especially in patients at risk for sudden death. Since the 1960s, these devices have evolved, from pacemakers used to prevent fainting in patients with slow heartbeats and defibrillators to prevent sudden death as a result of a rapid heartbeat, to a new generation of pacing devices that are used in the treatment of congestive heart failure. Over the past 20 years, St. Francis Hospital has helped to create guidelines and perform research that shaped the development of these devices. The St. Francis Hospital Arrhythmia & Pacemaker Center pioneered the use of transvenous lead systems and was the first in New York to introduce cardiac resynchronization therapy (CRT), which uses the latest pacing devices to resynchronize the heart’s electrical system in patients with congestive heart failure. The Arrhythmia & Pacemaker Center at St. Francis Hospital has one of the region’s highest volumes for implanting pacemakers and defibrillators. Most important is the Center’s high level of safety and low risk for complications.

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Research & Clinical Trials

The Center’s involvement with medical research helps to facilitate patient care by providing access to a broader range of diagnostic and treatment options. Its physicians have led or contributed to many published research studies, including:

1. Patients with Recently Diagnosed Nonischemic Cardiomyopathy Benefit from ICD Implantation (Journal of American College of Cardiology 47 (12): 2477-82, 2006)
2. Are ICD Shocks a Surrogate for Sudden Cardiac Death in Patients with Nonischemic Cardiomyopathy (Circulation: 113 (6): 776-82, 2006)
3. Effects of Acute Mental Stress and Exercise on T Wave Alternans in Patients with Implantable Cardioverter Defibrillators and Controls (Circulation 109 (15): 1864-9, 2004)
4. Prophylactic Defibrillator Implantation in Patients with Nonischemic Dilated Cardiomyopathy (New England Journal of Medicine 350:2151-8, 2004)
5. Gender Differences in Patients with Non-Ischemic Cardiomyopathy Enrolled in the Defibrillators in Non-Ischemic Cardiomyopathy Trial (DEFINITE) (Journal of Heart Failure 203: 9:5:575)
6. Defibrillators in Nonischemic Cardiomyopathy Treatment Evaluation (Pacing and Clinical Electrophysiology 200:23:338-43)
7. Improved Survival with an Implanted Defibrillator in Patients with Coronary Disease at High Risk for Ventricular Arrhythmia (New England Journal of Medicine 335: 1933-40, 1996)
8. Intravenous Amiodarone for Recurrent Sustained Hemodynamic Destabilizing Ventricular Tachyarrhythmias (JACC 27:67-75, 1996)
9. Cardioverter Defibrillator: Use in High Risk Asymptomatic Individuals (American Heart Journal 131: 59-65, 1996)
10. Double Sequential Shocks for Refractory Ventricular Fibrillation (Journal of American College of Cardiology 23:1141-5, 1994)
11. The Effect of Pregnancy on Paroxysmal Supraventricular Tachycardia (American Journal of Cardiology 72: 838-840, 1993)
12. Multi Center Automatic Defibrillator Implantation Trial (MADIT): Design and Clinical Protocol (PACE 14: 920-927, 1991)
13. Predictors of First Discharge and Subsequent Survival in Patients with AICD (Circulation 84: 558-566, 1991)
14. Clinical Interactions Between Pacemakers and Automatic Implantable Cardioverter Defibrillators (Journal of American College of Cardiology 16: 666-673, 1990)
15. An Experimental Study of Transvenous Defibrillation Using a Coronary Sinus Catheter (Journal of Electrophysiology 3: 253-260, 1989)
16. Follow-up of Patients with Ventricular Tachyarrhythmias Treated With the Automated Implantable Cardioverter Defibrillator: Programmed Electrical Stimulation Results Do Not Predict Clinical Outcome (Electrophysiology 3: 467-476, 1989)
17. The Automatic Cardioverter Defibrillator: T Wave Sensing in the Newest Generation (PACE 11:1584-1591, 1988)
18. Impending Sudden Cardiac Death, Treatment with Myocardial Revascularization and the Automatic Implantable Cardioverter Defibrillator (Annals of Thoracic Surgery 46:13-19, 1988)
19. The Automatic Cardioverter Defibrillator: Success of Chronic Defibrillation and the Role of Antiarrhythmic Drugs (American Journal of Cardiology 60: 1061-1064, 1987)
20. The Cellular Electrophysiologic Changes Induced by Ablation: Comparison Between Laser Photoablation and High Energy Electrical Ablation (Circulation 76: 217-225, 1987)
21. The Characterization of Human Transmyocardial Impedance During Implantation of the Automatic Internal Cardioverter Defibrillator (PACE 9: 745-755, 1986)
22. The Cellular Electrophysiologic Changes Induced by High Energy Electrical Ablation in Canine Myocardium (Circulation 73: 818-829, 1986)
23. Treatment of Multifocal Atrial Tachycardia with Verapamil (New England Journal of Medicine 312: 12-25, 1985)
24. A Toxic Effect of Theophylline (Lancet 8419: 12-14, 1985)

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