Electrophysiology

Experts in Arrhythmias – Irregular Heartbeats

Eric Prystowsky, MD


According to Eric Prystowsky. MD, St. Vincent Heart Center Cardiac Electrophysiologist, one of the most sought-out authorities on atrial fibrillation (AFib) in the world, preventing strokes is the prime objective of AFib treatment.


There are four categories of AFib:

  1. Stops on its own
  2. Persistent AFib
  3. Longstanding AFib
  4. Permanent AFib

“These terms can be confusing for patients and there are no cut and fast rules as to the time period for each category,” says Dr. Prystowsky. “That is why patient education is always a priority. It builds confidence and actively involves the patient in his or her care.” Dr. Prystowsky and his colleagues offer a wide range of AFib treatments and therapies. AFib nurse educators are onsite and available by phone for questions.

A cardiac electrophysiologist is a cardiologist with additional expertise treating abnormalities, or arrhythmias in the electrical system of the heart. At St.Vincent Heart Center we have a nationally recognized group of specialists who treat patients with an irregular heartbeat (arrhythmia) and identify the abnormal tissue in the heart. Our AFib Center of Excellence is a total care approach that includes:

  • Diagnostic testing and expert evaluations (including electrocardiograms (ECG) and 3D heart mapping systems)
  • A full spectrum of treatments including catheter ablation
  • AFib Nurse Educator
  • Cardiac rhythm home monitoring programs
  • AFib follow-up services in outlying St.Vincent Hospitals close to home

Atrial fibrillation (or AFib) represents a large number of the patients we treat at the St.Vincent Heart Center; however, we also provide care for all cardiac rhythm disturbances, including pacemakers, defibrillators, identification of patients at risk for sudden death, and ablation procedures to cure a variety of tachycardias from the upper and bottom heart chambers. Our colleagues in Pediatric Cardiology also treat children and adolescents with arrhythmias, and have specialists in pediatric cardiac electrophysiology.

Too often we hear patients say...
“My AFib condition was discovered by accident during a routine physical. I just knew I didn’t feel quite right, always tired and kind of lightheaded at times.”

One of the biggest fears is that AFib will lead to a heart attack, but actually AFib is a bigger risk factor for stroke. Yet, with proper treatment many with arrhythmias live productive and full lives. An irregular heart rhythm definitely impacts blood flow that may lead to stroke and heart failure. Don’t limit yourself by medication therapies that have too many side effects or older model pacemakers. Our physicians and dedicated staff are here to help.

Arrhythmia Treatments

Arrhythmia symptoms range from fatigue and lightheadedness to more dangerous symptoms of cardiac arrest and stroke. For the millions of people in the U.S. with irregular heartbeats St.Vincent Heart Center is a leading provider of safer, minimally invasive procedures called radiofrequency catheter ablation.

St.Vincent Heart Center Electrophysiologists are using Stereotaxis Robotic Ablation (SRA) technology (a computer-aided magnetic navigation system) to manuever softer, more flexible catheters that are gentler on the heart. This lower risk method enables faster and easier access to complex areas of the heart and less x-ray exposure. In clinical research, the St.Vincent Heart Center specialists are investigating new ways to treat a variety of arrhythmias.

Traditional Therapies and Treatments

Not every patient is a candidate for ablation, and for some, more traditional treatments may be advised. St.Vincent Heart Center has a full spectrum of therapies for all categories for AFib and arrhythmia conditions.

Medication therapy ranges from anti-arrhythmic drugs to calcium channel blocks and beta-blocker medications. This is often a first line of treatment.

Pacemaker or implantable cardioverter defibrillator (ICD) devices are implanted in the chest to correct irregular heartbeats,  regulate the heart rhythm or prevent cardiac arrest.

  • For some patients with damaged pacemaker or debifrillator leads, laser lead extraction is needed to repair them. Cardiac Electrophysiologists work closely with the Heart and Vascular Surgeons to revise these systems.
  • A unique, very small implantable wireless recorder is available to monitor a patients’ heart rhythm 24/7.
  • Newer model pacemakers and ICD devices have wireless monitoring so that the electrophysiologists can remotely see the data and monitor progress.

Cardiac Resynchronization Therapy (CRT) is available to improve symptoms of heart failure.

Cardioversion can be done with medication or as a procedure. This treatment plan “shocks” the heart to restore a normal heart rhythm.

Subcutaneous defibrillator is implanted under skin in chest. This procedure is done in selected patients with life threatening arrhythmia.

AFib can be worsened with sleep apnea. Sleep Studies evaluate if sleep apnea is present and causing atrial fibrillation. Electrophysiologists work closely with the Sleep Center Pulmonary Specialist to evaluate and create a care plan. The Sleep Center is onsite at the 106th Street Heart Center location.

Next Steps