Doylestown Hospital offers a wide range of treatment options to restore
normal rhythm, reduce complications and eliminate symptoms.
LIFESTYLE CHANGES & MEDICATION
Lifestyle modifications and medications sometimes control symptoms of AFib, but some patients
may require a medical procedure to control their AFib. Electrophysiologists at The Richard A. Reif Heart Institute of Doylestown Hospital use highly advanced equipment to map a patient's heart to find and
eliminate the irregular electrical signals.
CARDIOVERSION
Cardioversion is a method to restore an abnormal heart rhythm back to normal. For this
outpatient procedure, your heart is given low-energy shocks to restore a normal rhythm.
CARDIAC RESYNCHRONIZATION THERAPY
Pacemakers are implanted under the skin just below the collarbone to treat a heartbeat that
is too slow. A wire going from the pacemaker to the heart delivers a stimulus if the heart misses
a beat. Pacemakers can allow your physician to start or increase medication used to control
atrial fibrillation.
Implantable cardioverter defibrillators (ICDs) are placed in people who are at high risk of
sudden cardiac death from dangerous arrhythmias such as ventricular tachycardia or ventricular
fibrillation.
Bi-Ventricular Implantable Carioverter Defibrillator (ICD)
ABLATION
Electrophyisiologists with The Heart Institute of Doylestown Hospital perform a high volume of AFib and Ventricular tachycardia catheter ablations with excellent long-term results and a safety profile comparable to the best institutions across the country.
Catheter ablation is a safe, effective treatment for many types of arrhythmias. But as with any cardiac procedure, experience matters. Doylestown Hospital cardiologists have been performing catheter-based ablations for nearly a decade.
During ablation, small catheters are inserted through veins in a patient's leg and guided to the heart.
Epicardial VT ablation
RF ablation - Radio wave energy (heat) is sent through the wire to destroy abnormal
tissue that may be disrupting the normal flow of electrical signals.
Doylestown Hospital electrophysiologist Robert Sangrigoli, MD, performed
the first RF catheter ablation in Bucks County in April 2002.
Cryoablation - This balloon-based technology ablates, or destroys, cardiac tissue through
the use of a coolant for freezing.
Electrophysiologists Robert Sangrigoli, MD, and John Harding, MD, performed the first
cryoablation procedure in Bucks County in September 2011. They were among the first
in the nation to use this innovative procedure.
Ablation of Ventricular tachycardia - At Doylestown Hospital, electrophysiologists also
perform ablations on patients who have severe weakening of the bottom chambers of the
heart, called cardiomyopathy. Often these patients are prone to having life-threatening
arrhythmias from the bottom chambers of the heart called ventricular tachycardia (VT).
Our physicians have extensive expertise performing ablations of ventricular tachycardia.
Epicardial VT ablation - While most of these abnormal rhythms start on the inside of the heart,
they can also start on the outside of the heart. During percutaneous Epicardial VT ablation,
electrophysiologists target the abnormal rhythms on the outside of the heart without open-heart
surgery. They use a small needle placed through the chest wall and into the pericardium (the sack
that surrounds the heart). Then, special catheters are placed through this needle and burns are
accomplished on the outside of the heart to eliminate the dangerous arrhythmias.
In November, 2008 Doylestown electrophysiologist John Harding, MD, performed the first
Epicardial VT Ablation in Bucks County. This procedure is otherwise only available at a few
dozen large teaching institutions across the country.
AVN Ablation - In patients in whom a catheter ablation of AFib is contraindicated, often with
better control of the speed of their heartsymptoms of AFib can improve. This procedure can control
the heart rate of patients who are not responding to medications that control the speed
of the heart.
Inappropriate Sinus Tachycardia (IST) Ablation
Premature Ventricular Contraction (PVC) Ablation - This procedure targets an arrhythmia that
can weaken the heart in some patients and affects quality of life in certain patients who are not
responding to medication.
Supraventricular Tachycardia (SVT) Ablation - Supraventricular tachycardia or SVT is a common,
treatable problem that often significantly affects quality of life. Catheter ablation of SVT has
excellent success and safety profile and is an excellent option for patients who have significant
side effects from medication or in whom medications are not controlling the problem.
SURGICAL OPTIONS
Maze surgery - For this procedure, the surgeon makes small cuts or burns in the atria. These cuts or burns prevent the spread of disorganized electrical signals. This procedure requires open-heart surgery, so it is usually performed at the time of surgery for other problems such as coronary artery disease (CABG) or heart valve disease, which can increase the risk of AFib.
Convergent Maze Procedure for AFib
Physicians with The Heart Institute of Doylestown Hospital were the first in Bucks County to perform a convergent maze procedure on September 25, 2012 to treat an advanced case of the most common form of arrhythmia. The convergent maze procedure is used for patients with chronic, more permanent or advanced cases of AFib who have failed other therapies, including medications and other catheter-based ablation procedures.
The patient benefits from a single minimally invasive procedure that combines the expertise of the cardiothoracic surgeon and the electrophysiologist to destroy the faulty ‘wiring’ causing the arrhythmia in the heart in a single procedure. The convergent maze procedure takes advantage of the cardiothoracic surgeon's ability to more easily reach and treat areas of the heart that can be more challenging for electrophysiologist's catheters. The surgeon reaches the heart via a 1-inch incision in the upper abdomen using a video-assisted scope. The surgeon is able to ablate, or destroy, arrhythmia-generating areas by applying radiofrequency energy on the outer surface of the heart.
The procedure is completed by the electrophysiologist using more traditional catheter procedures to reach and treat areas on the inner surface of the heart, areas that cannot be reached by the minimally invasive surgical approach. The electrophysiologists used cryoablation, or freezing technology, to destroy the faulty tissue inside the heart.
The procedure Is performed in the hybrid room at The Heart Institute of Doylestown Hospital. The room combines the capabilities of an operating room with those of a cath lab, including ultra-high-tech imaging.
The AFib Center of The Richard A. Reif Heart Institute of Doylestown Hospital
215-345-2850
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