Electrophysiology (EP)
John Marceno, MD FACC
Sudhir Reddy, MD
Doctors John Marenco and Sudhir Reddy provide office consultation for common electrophysiologic problems such as palpitations, fainting, documented arrhythmias, and need for pacemaker and defibrillator implantation. They interpret a full variety of non-invasive tests including holter monitors, loop recorders, tilt table testing and both pacemaker and defibrillator interrogations.
As cardiac electrophysiologists they focus on the timing or electrical system of the heart, in particular the treatment of irregular heartbeats called arrhythmias. They are certified to perform a particular group of tests and procedures to help diagnose and correct abnormal heartbeats in an effort to help relieve patients of symptoms affecting their lives.
Doctors Marenco and Reddy perform hundreds of EP procedures each year at Baystate Medical Center, Mercy Medical Center and Saint Francis Hospital in Hartford, CT This includes defibrillator and pacemaker implantations, catheter and cryo- ablations, electrophysiologic (EP) studies, implantable loop recorder (ILR) placement, lead extractions, Watchman devices and leadless pacemakers.
- Cardiac Holter Monitor and Event Loop Recorder:
A Holter monitor is a battery-operated, portable device that measures and records your heart's electrical activity (ECG) continuously for 24 to 48 hours (holter monitor) or up to 30 days (event monitor), depending on the monitor used. Electrodes (small conducting patches) are placed on your chest and attached to a small recording monitor that you can carry in a pocket or in a small pouch worn around your neck. The recording is then analyzed, a report of the heart's activity is tabulated and irregular heart activity is correlated with a diary that you keep of your activity at the time. - A Loop Recorder:
A loop recorder is an implantable cardiac event monitor, a small device surgically placed under the skin of the chest. It allows for long-term heart rhythm monitoring. It can be worn for several weeks and may be a good choice for people who have symptoms that occur rarely, such as once every 6 months. An implantable cardiac event recorder makes a record of your electrocardiogram (ECG or EKG) when you have arrhythmias/events and feel the symptoms that make you feel dizzy or faint. The device records the electrical impulses of your heart (events and arrhytmias) and transmits them automatically to your doctor by way of the internet and wireless technology. An implantable loop recorder is invisible and doesn't interfere with your daily activities. It has no patches or wires, and you don't have to worry about getting the device wet while bathing or swimming. - EP Study:
An EP Study is a non-invasive procedure that provides information in treating heart rhythm disorders. The data collected provides your physician the information needed in diagnosing the source of the arrhythmia and in developing the best treatment plan for your condition. An EP Study is performed by one of our Electrophysiologists under conscious sedation in one of the local hospital settings. A catheter is inserted in through the groin or neck into a blood vessel and navigated to the heart with the aid of a fluoroscope. Electrodes at the tip of the catheter gather data and may also be used to induce the arrhythmia that is the cause of the heart rhythm problem. The procedure can take anywhere from 1-4 hours. - Tilt-Table Test:
A tilt-table test is used by doctors to determine why a patient feels faint, lightheaded or completely passes out. During the test you lie on a table that is slowly tilted upward, the goal of which is to see how changes in body position affect your blood pressure. This attempts to recreate your fainting symptoms while monitoring your blood pressure and heart rate.
- Cardioversion:
A Cardioversion is a treatment for heart rhythms that are irregular (arrhythmia). During cardioversion, a special machine is used to send electrical energy to the heart muscle to restore normal rhythm. The procedure restores the normal heart rate and rhythm, allowing the heart to pump more effectively. - Ablation:
A cardiac ablation is a non-surgical procedure used to correct irregular heartbeats by destroying the site of abnormal electrical pathways that may be causing an irregular heartbeat. One of our Electrophysiologists inserts a catheter into a blood vessel, usually through the groin or neck. The wire is then threaded through the blood vessel into the heart. Once the location of the faulty electrical site is pinpointed, energy is used to destroy a small amount of tissue, ending the disturbance of electrical flow and restoring a healthy heart rhythm. - Pacemaker:
A pacemaker is a battery-powered device that sends electrical signals to your heart to help it beat at a proper rate or "pace". For those with questions and concerns, there is no hard and fast rule about cell phones and pacemakers. It is felt that you can use a cell phone, but use the ear opposite the pacemaker or defibrillator. Metal detectors will not harm a pacemaker or defibrillator as long as you are passing quickly through the detector. If you are concerned you can notify the people at the detector, and they will usually allow you to pass around the detector. - Temporary Pacemaker:
A temporary pacemaker is a battery-powered device that stimulates the heart to beat when there is an impairment in the heart's own electrical conduction system. It is externally attached to a pacing lead that is inserted through a vein into the heart. - Implantable Cardioverter Defibrillator (ICD):
An implantable cardioverter defibrillator (ICD) is a battery-powered device placed under your skin, beneath the collarbone, that is connected to your heart by one or more wires (leads) and keeps track of your heartbeat. - Subcutaneous Implantable Cardiac Defibrillator (S-ICD):
A Subcutaneous Implantable Cardiac Defibrillator, S-ICD System, is a new generation of the ICD that does not require leads (wires) to be connected to the heart. Instead, the S-ICD System electrodes are inserted under the skin and outside of the ribcage. The S-ICD System is an alternative for most patients requiring protection from sudden cardiac arrest. - The LifeVest™:
The LifeVest™ is a wearable defibrillator. Unlike an implantable cardioverter defibrillator (ICD), the LifeVest™ is worn outside the body rather than implanted in the chest. This device continuously monitors the patient's heart with dry, non-adhesive sensing electrodes to detect life-threatening abnormal heart rhythms.
Coumadin (or its generic Warfarin) is an prescription anticoagulant or blood thinner, which helps prevent clots from forming in the blood. It is used to help reduce the formation and occurrence of blood clots in the legs and lungs. Patients who have irregular heartbeats (for example atrial fibrillation), heart valve replacements, and/or those who have experienced recent heart attacks, may be prescribed this drug. The most common side effect of Coumadin is bleeding. Therefore, careful monitoring of the drug's level in the bloodstream is required. Frequent blood test called INRs will assist your physician in the proper dosing of this medication. Your INR (INR = International Normalization Ratio)/Coumadin levels will be closely monitored by your Physician or APP.