Electrophysiology/Arrhythmia Management

The Electrophysiology and Arrhythmia Management Program at The Children's Hospital at Montefiore's (CHAM) Pediatric Heart Center offers comprehensive diagnostics and treatment for the full spectrum of cardiac rhythm disorders. From fetal stages through adulthood, patients diagnosed with an arrhythmia can benefit from our unparalleled pediatric electrophysiology experience, state-of-the-art diagnostic tools and therapeutic solutions for all arrhythmias. Additionally, our team of expert electrophysiologists works in a pleasant, child-friendly environment designed to make the experience as comfortable as possible.

What Is Electrophysiology Testing and Why Would A Child Require It?

An electrophysiology (EP) study is a non-surgical test conducted on patients suspected to have an abnormal heart rhythm. Cardiac catheters and sophisticated computers generate electrocardiogram (EKG) tracings and electrical measurements from within the heart chambers. The test is used for diagnostic purposes or to pinpoint the precise location of electrical impulses that impact the heart's ability to pump blood.

Your cardiologist may recommend an EP examination if a standard EKG, Holter monitor, stress test, echocardiogram or angiogram does not provide sufficient information to assess an abnormal heart rhythm (arrhythmia). An EP study offers more detailed information about the electrical activity in the heart than other tests because electrodes are placed directly onto heart tissue. Many times, the cardiologist can correct the abnormality during this same procedure.

Prominent Electrophysiology Team at CHAM

CHAM's electrophysiologists are some of the most experienced nationally and around the globe. Robert Pass, MD, Director of CHAM's Interventional Cardiology and Pediatric Electrophysiology Program, has performed more than 1,000 radiofrequency ablations and over 200 cryoablations-more than any other physician in the New York metropolitan region-on patients as young as six weeks of age. Additionally, our multidisciplinary team of extraordinary cardiac interventionists, pediatric nurses and technicians, trained in this subspecialty as well as pediatrics, possess the diverse skills needed to successfully treat children with arrhythmias. 

Advanced Treatment Options

Thanks to various treatment options, most children with arrhythmias are able to lead active lives. Certain arrhythmias may be effectively managed with medication, while others may require an ablation procedure or implantable pacemaker. At CHAM, our team of experts will customize your child's treatment plan in order to maximize his or her quality of life. Some of the treatment options offered at CHAM include the following:

• Intracardiac ablation (radiofrequency ablation or cryoablation): Sometimes when an EP study shows that an arrhythmia is stemming from a specific point in the heart, it is possible to ablate — or treat — the area in such a way so that the abnormal tissue can no longer produce irregular rhythms. During this procedure, a thin catheter (tube) is inserted into a vein and then into the heart. The tip of the catheter carries a special device that emits a low level of radiofrequency waves (or extremely cold, thermally conducted fluids in the case of cryoablation), which destroys the abnormal electrical path in the heart. Children who were dependent on drug therapy have often been "able to move forward with life without the need for medications or athletic restrictions after undergoing this procedure," notes Dr. Pass.
• Pacemaker: A pacemaker is a small battery-powered implantable medical device that regulates the heart rate through electrical impulses. When the beat slows below an acceptable level, the pacemaker emits impulses to resynchronize the heart and improve blood flow.
• Implantable cardioverter defibrillator (ICD): Similar to pacemakers, an ICD is a small device implanted beneath the skin near the collarbone and is programmed to regulate the heartbeat. However, ICDs are capable of treating both slow and fast heart rhythms and are typically prescribed for the latter. When the heart beats faster than the acceptable level, the implantable defibrillator device emits a small shock to transiently slow the heart and restore the normal rhythm.