Cardiology: Electrophysiology Program

The treatment of electrical problems of the heart has progressed dramatically. Knowledge, skill and advanced technology allow physicians at the UF Health Cardiovascular Center – Jacksonville to offer the most comprehensive program of treatment for electrical disturbances of the heart. The Cardiac Electrophysiology Program at UF Health Jacksonville is led by University of Florida cardiologists, as well as a team of skilled nurses trained and specialized in the care of patients with cardiac electrical problems.

As a complement to the clinical skill provided, the program at UF Health Jacksonville offers the newest interventional technology available in the field of electrophysiology. The program encompasses our inpatient diagnostic and interventional services as well as the outpatient clinical services of doctor visits for electrophysiological management and device follow up.

The Cardiac Electrophysiology Lab at UF Health Jacksonville offers comprehensive diagnostic testing for the evaluation of dizziness, palpitations, loss of consciousness resulting from insufficient blood flow to the brain, slow heart rate, fast heart rate, abnormal or irregular heart rhythm, atrial fibrillation and heart failure treatment. Upon completion of diagnostic evaluation, the lab is also able to perform the necessary intervention immediately. Elective intervention is also available on an outpatient basis for your convenience.

Evaluation and Diagnosis

Diagnostic procedures may include:

  • Electrophysiology Study
    An electrophysiology study is a test of the electrical conduction system of your heart. The study is done by threading catheters into a vein were the leg connects to the abdomen to measure the electrical signals generated by your heart. The reason for conducting the study may be to determine:

    • If you need a pacemaker
    • Why you're fainting
    • If you're prone to a fast heart rhythm and guide the appropriate treatment for the abnormal heart rhythm
    • Whether past treatment for a fast heart rhythm has been successful
  • Event Monitoring
    Like holter monitoring, cardiac event monitoring is used to diagnose symptoms that are infrequent or sporadic; however, the monitor is worn for a longer period of time, about 30 days, to monitor heart rhythm and to record symptoms.

  • Holter Monitoring
    Holter monitoring is a continuous recording of a patient's heart rhythm, usually for 24 hours, during typical daily activities. It is especially useful in diagnosing abnormal heart rhythms called arrhythmia. For this test, small conducting patches called electrodes are placed on your chest and attached to a small digital recording monitor that you can carry in a pocket or in a small pouch worn around your neck. Most current holter monitors and recorders are equipped with an event recorder or marker. When symptoms such as dizziness or palpitations occur, you simply press a button to note the time of the symptoms. This marks the tape so that the symptoms and electrocardiogram ECG recording can be correlated during analysis.

  • Tilt Table Study
    The tilt table test is used to determine the cause of your fainting spells. During a tilt table study, you'll be connected to an EKG, oxygen monitor and blood pressure monitor and then strapped to a bed that's tilted in different directions. Your blood pressure and pulse are measured and symptoms are recorded while in various positions. The test is designed to cause a fainting spell in a controlled environment and shows how your heart rate and blood respond to changing positions.

Treatment Options

Physicians at UF Health Jacksonville strive to assist in the clinical outcomes of patients by developing a comprehensive plan of care, helping return the patient to a thriving, healthy way of life. Treatment of arrhythmia may include medication, interventional procedures or surgical procedures.

  • Automatic Implantable Cardio-Defibrillator Insertion
    The automatic implantable cardio-defibrillator (AICD) is a small, lightweight electronic device that is placed inside the body, constantly monitoring heart rhythm. If it detects a fast, abnormal rhythm, it delivers energy to the heart muscle. While the device is not a cure for a heart rhythm problem, it can save a life by quickly bringing a dangerously fast heart rhythm under control.

  • Cardioversion
    Cardioversion is the conversion of one cardiac rhythm or electrical pattern to another, almost always from an abnormal to a normal one. This conversion can be accomplished by using medications or by electrical cardioversion using a defibrillator, which delivers a low-energy shock at the same time as the heartbeat, to restore a normal heart rhythm.

  • Laser Lead Extraction
    Laser lead extraction is a method of removing worn or infected pacemaker and defibrillator wires from patients' hearts before implanting new ones. The lead, which passes through a major vein in the heart and attaches to the pacemaker or defibrillator, grows into the wall of the vein over time and becomes difficult to remove. Laser lead extraction involves sliding a sheath over the lead containing a laser light that removes the fibrous growth that holds the lead to the wall of the vein. The laser has very low tissue penetration, so it only burns the fibrous tissue directly around the lead, sparing injury to the surrounding vein. Once the lead is no longer attached to the vein wall, it may be pulled out with less risk of damage to the vein.

  • Loop Recorder Implantation
    An insertable loop recorder is used to determine the cause of fainting or near-fainting spells. The recorder is a small device put inside the body to record heart rhythm during fainting or near-fainting episodes. It is activated by a hand-held device used during or after an event to store the event into the recorder's memory. The device is removed after one or more episodes have been stored into memory.

  • Maze Procedure for Atrial Fibrillation
    The maze procedure is offered for patients suffering from atrial fibrillation, a serious abnormality of the normal heart rhythm which affects a large population of patients. Usually, a cardiothoracic surgeon will perform a modified maze procedure in which radio frequency applicators are used to eliminate the abnormal heart rhythm. While most maze procedures are performed in conjunction with heart valve surgery, it is also possible to eliminate atrial fibrillation in patients having no heart valve disease.

    Physicians with UF Health Cardiothoracic Surgery have received formal training in the surgical treatment of atrial fibrillation and have begun a successful program to address this important disease. This advanced procedure serves as a key addition to non-surgical treatment of atrial fibrillation.

  • Permanent Pacemaker Insertion
    A permanent pacemaker is used to correct disturbances to the normal rhythm of your heart by analyzing the function of the heart's own electrical system and, when necessary, sending tiny, precisely-timed electrical signals to the heart to correct certain abnormalities in the heart's electrical system.

    Pacemaker implantation is minimally invasive surgery often performed under local anesthesia, and generally takes less than 45 minutes to perform. After the area under the collarbone is numbed, a small incision is made and a "pocket" is fashioned in the tissue overlying the muscle. The leads (made of flexible insulated electrical wire) are inserted through a vein near the site of the pocket, and advanced into the heart using x-rays for guidance. The leads are then attached to the generator (about the size of a 50-cent piece and approximately three times as thick), the generator is placed in the pocket and the incision is closed.

    Once the incision completely heals, patients can generally return to a completely normal life and many find they are able to do even more after a pacemaker is implanted.

  • Radio-Frequency Ablation
    Radio frequency ablation is a non-surgical treatment for people with an abnormal heart rhythm, or arrhythmia, in which a long, flexible wire is passed into the heart to eliminate the precise area of the heart causing the arrhythmia. An arrhythmia can at times be controlled by medications, but if these are unsuccessful, or if the side effects of the medication or taking the medication itself become troublesome, radio frequency ablation may be recommended.

  • Resynchronization Therapy through Biventricular Pacemaker Insertion
    A biventricular pacemaker is an artificial pacemaker or implantable cardio-defibrillator designed to treat congestive heart failure. In many heart failure patients, the walls of the left ventricle - the heart's main pumping chamber - are no longer synchronized, or pumping together as they normally would. A biventricular pacemaker is designed to resynchronize the pumping action of the left ventricle.

Device Follow-up and Management

Patients are offered the added benefit of having their pacemaker or defibrillator evaluated, tested, and maintained in our comprehensive clinic. The device follow-up clinic provides services to manage most brands of pacemakers and defibrillators.

Electrical management of these patients is provided to effect the greatest quality of life possible for each patient. This is done by providing the most complete evaluation of the patients needs electrically and matching that with the most technologically advanced care of the patient needing pacing and/or defibrillation therapy and/or ablation therapy.

Providers

  • John N. Catanzaro, M.D., FACC, FESC, FHRS
    Assistant Professor
    Associate Medical Director, Electrophysiology Program; Associate Program Director, Electrophysiology Fellowship
    Specializes in Cardiovascular Disease; Clinical Cardiac Electrophysiology
  • Steve S. Hsu, M.D.
    Associate Professor
    Medical Director, Electrophysiology Program; Program Director, Cardiac Electrophysiology Fellowship
    Specializes in Cardiovascular Disease; Clinical Cardiac Electrophysiology
  • Robert J. Kim, M.D.
    Assistant Professor
    Specializes in Cardiovascular Disease; Clinical Cardiac Electrophysiology

Locations

  1. UF Health Cardiovascular Center – Jacksonville

    5th Floor, Ambulatory Care Center
    655 West 8th Street
    Jacksonville, FL 32209

  2. UF Health Cardiovascular Center – North

    Suite 3600
    15255 Max Leggett Parkway
    Jacksonville, FL 32218

  3. UF Health Multispecialty Center – St. Marys

    201 B Lakeshore Point
    St. Marys, GA 31558