Cardiac Electrophysiology is the field of heart care that diagnoses and treats heart rhythm abnormalities (arrhythmias). At Children’s National, our pediatric electrophysiology experts have dedicated their careers to diagnosing, treating and managing arrhythmias and syncope (unexplained fainting) in children.
We use the latest and safest technologies, such as cryoablation therapy, with success rates close to 98 percent.
Choosing Children's National for Electrophysiology
Our electrophysiologists (heart rhythm specialists) are national leaders in pediatric electrophysiology. In fact, Children’s National has become a destination for families around the country for diagnosis and treatment of complex arrhythmias and congenital heart diseases.
Features of our electrophysiology program include:
- Highly-specialized team. In addition to our electrophysiology physicians, our team includes specially trained pediatric arrhythmia nurses.
- Advances in research. We are committed to advancing the field of pediatric arrhythmias, and served as an enrollment center for many investigations, including the Implantable Cardioverter Defibrillator (ICD) Sports Safety Registry.
- Care for all patients. We have the resources, skills and experience to evaluate and provide care for patients of all ages, from fetuses to adults with congenital heart disease.
- Successful outcomes. Our procedures include cryoablation, 3-D mapping without X-ray radiation, and implanting pacemakers and defibrillators. Each procedure involves multiple physicians, ensuring the most successful outcome possible. Our success rate is close to 98 percent.
- Care close to where you are. In addition to the services we provide at our main campus, you can visit our outpatient clinics. We have pediatric arrhythmia and pacemaker clinics across the region in the District of Columbia, Maryland and Virginia.
lnterventional Electrophysiology Services
One common treatment for heart rhythm abnormalities is ablation, which destroys the small area of heart tissue causing the abnormality. Our approach brings together multiple physicians to perform the ablation, resulting in a success rate of 98 percent. In addition, there is a very low recurrence rate, meaning the arrhythmia usually does not come back.
Ablation procedures we perform are:
- Radiofrequency ablation. We have been performing radiofrequency ablation techniques for more than 20 years to treat arrhythmias. We send a small dose of radiofrequency (heat) energy to destroy the abnormal heart tissue.
- Cryoablation. Cryoablation is a similar technique, but instead of heat, it freezes the heart tissue. It is used for procedures that require more delicate management.
- 3-D mapping. We use 3-D mapping in conjunction with ablation procedures to ensure that we precisely locate the area of the arrhythmia. This also helps us reduce radiation exposure for your child.
Pacemaker and Defibrillator Implantation
The goal of devices such as pacemakers or implantable cardioverter defibrillators (ICDs) is to sense when the heart is beating erratically and send a signal that corrects and regulates the heartbeat. These are safe, effective treatment methods that provide long-term management for our patients.
Our team has been at the forefront of pacemaker and ICD innovation:
- Implantation techniques: We developed and perfected techniques for pacemaker and defibrillator implantation in children, utilizing several approaches:
- Transvenous. We thread the electrode through a vein to access the heart.
- Broken lead extraction. Part of ICD and pacemaker management is removing broken pacing leads, the small wires that attach to the heart. We have been on the forefront of developing techniques to extract broken leads using laser and mechanical techniques.
- Resynchronization therapy. We are leading the way in resynchronization therapy, a specialized pacemaker for patients with heart failure who develop arrhythmias.
Innovative Electrophysiology Research
Our team participates in many national research efforts to improve the standard of arrhythmia care. One area of investigation is developing new methods that lower the radiation exposure during procedures. We are also researching innovative techniques for less invasive ways to implant pacemakers and defibrillators in small children.
Our trials include:
- Implantable Cardioverter Defibrillator (ICD) Sports Safety Registry. This registry studies the safety of young athletes with ICDs who participated in high-intensity sports.
- National Cardiovascular Data Registry ICD Registry™. This database of ICD patients is intended to help hospitals track and improve their care.
- Pediatric Lead Extractability and Survival Evaluation study. This is a multi-center exploration of the durability of ICD leads in young patients.
A Collaborative Approach to Electrophysiology Care
Collaboration among our heart specialists is central to what we do. We work with other departments and clinics throughout the heart center to ensure our patients receive the most comprehensive, specialized care possible. Some examples of our multidisciplinary efforts include:
- Cardiac catheterization. Joint procedures with the interventional cardiac catheterization team allows us to implant pacemakers in patients whose heart disease would normally make it difficult to insert the pacemaker. Using a catheter-based approach, we can implant the device safely and avoid the need for surgery.
- Prenatal cardiology. For fetuses diagnosed in utero with complex arrhythmia issues, we work with the Prenatal Heart Program team in the delivery room to care for newborns with life-threatening conditions.
- Inherited Arrhythmia Clinic. This clinic combines the electrophysiology team and the genetics team to manage patients with conditions including long QT syndrome, Brugada syndrome and catecholamine-sensitive polymorphic ventricular tachycardia. Together, we can offer advanced genetic studies for families.
- Other specialists. We work with specialists outside the heart center as well, to provide personalized care and improve our patients’ quality of life. These departments include: