Electrophysiology Services at Connecticut Children’s The Electrophysiology Laboratory provides state-of-the-art care for children and adults with congenital heart disease. Our program is Connecticut’s first accredited center for the care of adults with congenital heart disease and arrhythmias. The program is led by Irfan Warsy, MD, one of the most experienced pediatric electrophysiologists in Connecticut, and Shailendra Upadhyay, MD, division head of cardiology. Both Dr. Warsy and Dr. Upadhyay are certified by the International Board of Heart Rhythm Examiners (IBHRE). What is Electrophysiology? Electrophysiology is a branch of cardiology that diagnoses and treats heart rhythm disorders. Interventions include an electrophysiology (EP) study or the placement of a cardiac implantable electronic device (CIED). An EP study assesses the heart’s electrical activity by inserting electrical catheters through blood vessels into the heart and eliminates the source of arrhythmia with an ablation procedure. Abnormally slow heart rates (sinus node dysfunction or heart block) are treated by implanting a cardiac pacemaker, a form of a CIED. Life-threatening rapid heartbeats (ventricular tachycardia) can be treated with an EP study or by inserting an implantable cardioverter defibrillator, which may shock the heart to restore a regular rhythm. Arrhythmia Conditions We Treat Supraventricular tachycardia Wolff-Parkinson White (WPW) syndrome Ectopic atrial tachycardia Atrial flutter and atrial fibrillation Ventricular tachycardia and ventricular premature beats Inherited arrhythmia disorders including, but not limited to, long QT syndrome, short QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia (CPVT), and arrhythmogenic right ventricular dysplasia (ARVD) Sinus node dysfunction Heart block Unexplained syncope or loss of consciousness Electrophysiology Procedures Catheter ablation of supra-ventricular tachycardia/ventricular tachycardia 3D mapping systems used to perform catheter ablation with little-to-no radiation use Trans-esophageal electrophysiology studies Implantation of patient-activated loop monitors (heart rhythm monitors) Implantation of cardiac pacemakers Implantation of implantable cardioverter-defibrillators Complex ablation procedures and device implants in adults with congenital heart disease (including patients with Fontan procedure, Mustard/Senning operation, and Tetralogy of Fallot repair) We offer inpatient management of heart rhythm disorders, metabolic exercise stress testing, and a dedicated pediatric pacemaker and implantable cardioverter defibrillator clinic led by a pediatric electrophysiologist and dedicated nurse. We submit our procedural data and outcomes to the American College of Cardiology’s IMPACT Registry to closely monitor and ensure quality. Electrophysiology procedures at Connecticut Children’s average 1 minute of X-ray exposure; the national average is more than 5 minutes of X-ray exposure. Center for Autonomic Dysfunction in the Young The Center for Autonomic Dysfunction in the Young (CAD-Y) is the only center in Connecticut dedicated to the care of children and young adults with dysautonomia. Irfan Warsy, MD, is an expert in the diagnosis and management of patients with autonomic dysfunction, including postural orthostatic tachycardia syndrome (POTS), orthostatic hypotension, inappropriate sinus tachycardia, and vasovagal syncope. Cardio-Pulmonary Stress Testing The stress test laboratory within the Division of Cardiology offers simple exercise testing as well as metabolic stress testing for children and adults with congenital heart disease. The service, led by Shailendra Upadhyay, MD, and staffed by a dedicated exercise physiologist, performs over 500 stress tests annually, enabling the diagnosis and management of heart rhythm disorders and various forms of congenital heart disease. Hybrid Cardiac Catheterization and Electrophysiology Procedures Connecticut Children’s offers the only hybrid lab in Connecticut dedicated to the management of children and adults with congenital heart disease. Our interventional cardiology and electrophysiology teams collaborate routinely in performing combined cardiac catheterization and arrhythmia procedures in select patients with complex heart disease. These include, but are not limited to, closure of septal defects (holes) in the heart followed by pacemaker implant, as well as stenting or balloon dilation of blood vessels followed by catheter ablation. Our Electrophysiology Team
