Electrophysiology

Under the leadership of Academic Director Dr. Joseph Akar, Associate Professor of Medicine and Clinical Director, Dr. Mark Marieb, Associate Professor of Medicine, the electrophysiology program provides a full spectrum of rhythm management services.

These include a Complex Ablation Program (Dr. Akar, Director) focused on atrial fibrillation and ventricular tachycardia that offers epicardial ablation approaches, and a high volume Lead Management Program (Dr. Jude Clancy, Director) that provides laser-based device lead extraction, as well as a comprehensive menu of other EP services.

The EP lab also provides national physician education courses on the use of intracardiac echocardiography (ICE). Current clinical trials in the EP laboratories include first-in-man clinical evaluation of 3D ICE, a registry for MRI safety with ICD patients, an NIH-sponsored study examining the effects of mental stress on arrhythmogenesis, the MADIT-CRT post-approval study, and studies examining the use of remote monitoring of ICD's, among others.

Inpatient Services

The electrophysiology laboratories are directed by Dr. Joseph Akar and consist of three dedicated EP labs including two biplane hybrid operating room suites. A fourth swing cath lab is used for overflow devices as needed. The EP labs are equipped with three-dimensional mapping systems, intracardiac ultrasound, robotics and all aspects of cutting edge technology. Procedures commonly performed include: radiofrequency ablation of all supraventricular tachycardias including atrial flutter and focal atrial tachycardia. Radiofrequency ablation of more complex arrhythmias such as atrial fibrillation (AF) is commonly performed and includes patients with long-standing persistent AF and those with structural heart disease. Yale-New Haven hospital offers the largest and most comprehensive ventricular tachycardia ablation program in the state of Connecticut (1-888-NOVTACH) with experienced operators performing catheter ablation for ischemic and non-ischemic ventricular tachycardia using both endocardial and epicardial approaches.

The Electrophysiology Service offers the full-range of device therapies including pacemakers, defibrillators (ICD) and cardiac resynchronization therapy (CRT). Implantable devices are routinely followed using remote monitoring technology which improves patient safety and convenience. Dr. Jude Clancy directs the largest and most comprehensive lead management program in the state of Connecticut using novel laser lead extraction technology. 

Inpatient consultation is available on a full-time basis for assistance in management of patients with arrhythmias. A full-time advanced nurse practitioner is dedicated to the in-patient EP service and works closely with the physicians to ensure a seamless in-patient to out-patient transition.

Faculty

Akar, Joseph G.

Associate Professor of Medicine (Cardiology)
Academic Director of Electrophysiology
Director, Cardiac Electrophysiology Laboratory

Clancy, Jude F

Assistant Professor of Medicine (Cardiology)
Director, Lead Management Program

Lampert, Rachel J.

Associate Professor of Medicine (Cardiology)

Marieb, Mark Alexander

Associate Professor of Medicine (Cardiology) and Associate Clinical Professor of Nursing
Clinical Director of Electrophysiology

Rosenfeld, Lynda Ellen

Associate Professor of Medicine (Cardiology) and of Pediatrics

     

Outpatient Services

New patient consultations are available from all EP faculty members with either physician or patient self referral. Dedicated outpatient EP nurses and APRNs work closely with the faculty physicians. Pacemaker and ICD clinics meet 3 half days each week and are primarily staffed by Nurse Coordinators with faculty back-up. Patients are seen at Yale Physicians Building, Griffin Hospital, and the Branford/Guilford cardiology satellite office. An ICD follow-up clinic meets periodically at Lawrence and Memorial Hospital for patients living in the New London area. The Electrophysiology Service also directs the ambulatory monitoring and tilt-table laboratories at Yale-New Haven Hospital.

Subspecialty clinics and programs offer individualized care for patients. The cardiovascular genetics program under the leadership of Dr. Arya Mani routinely evaluates patients and family members with suspected channelopathies and performs whole-exome genetic testing. Another unique subspecialty service is the Syncope/Falls clinic in which faculty members from Electrophysiology and the Department of Geriatrics work closely to evaluate and manage patients with recurrent falls or syncope. Finally, Yale-New Haven Hospital has established the first and only Atrial Fibrillation Support Group in the state of Connecticut. This support group which is all AF patients and their families helps individuals and loved ones cope with the psychological and emotional burden that AF imposes.

Faculty

Akar, Joseph G.

Associate Professor of Medicine (Cardiology)
Academic Director of Electrophysiology
Director, Cardiac Electrophysiology Laboratory

Clancy, Jude F

Assistant Professor of Medicine (Cardiology)
Director, Lead Management Program

Lampert, Rachel J.

Associate Professor of Medicine (Cardiology)

Marieb, Mark Alexander

Associate Professor of Medicine (Cardiology) and Associate Clinical Professor of Nursing
Clinical Director of Electrophysiology

Rosenfeld, Lynda Ellen

Associate Professor of Medicine (Cardiology) and of Pediatrics