Cardiac Electrophysiology and Arrhythmia Service
The Harvard-Thorndike Electrophysiology Institute and Arrhythmia Service at BIDMC is internationally recognized as a leader in the diagnosis and treatment of cardiac arrhythmias. Electrophysiology fellowship education is directed by Dr. William Maisel.
Each year five to seven advanced fellows receive training in cardiac electrophysiology and are actively involved in both clinical and basic research. All fellows rotate on the EP consultative inpatient service and outpatient arrhythmia clinic on a weekly basis, participating in a full range of mapping and ablation procedures for all forms of supraventricular tachycardia including atrial fibrillation as well as ventricular tachycardia. Fellows also take part in device implantation including biventricular pacemaker and ICD procedures and have the opportunity to assist in lead explantation procedures and epicardial device placement. Fellows are also required to perform arrhythmia research during their two years of advanced EP training.
Arrhythmia Monitoring and Nonlinear Dynamics Laboratories. The Cardiovascular Division is the site for a unique linkage between a busy, state-of-the-art Arrhythmia Monitoring Laboratory and a basic science laboratory devoted to utilizing contemporary techniques in signal processing, including nonlinear dynamics. The Clinical Director of the Arrhythmia Monitoring Laboratory is Dr. Ary L. Goldberger. The Clinical Laboratory currently performs about 2,000 studies (including Holter monitors and patient-activated event recordings) per year. In addition to being a major clinical resource, the laboratory is also a leading academic center for research in non-invasive monitoring of arrhythmias and provides an extensive database of recordings available for retrospective and prospective studies.
Pacemakers and Implantable Devices. Directed by Dr. William Maisel, the Electrophysiology and Pacing Service is actively involved in extensive research of implantable devices including pacemakers for the treatment of bradyarrhythmias and implantable cardioverter defibrillators (ICDs) for the treatment of ventricular tachyarrhythmias. The Arrhythmia Service also provides a daily outpatient clinic and provides an inpatient consult service.
The Service has pioneered the implantation of purely transvenous ICDs in the electrophysiology laboratory. Recent clinical trials are evaluating various therapeutic pacing and defibrillation modalities for ventricular tachycardia. The service is studying even smaller devices and dual chamber devices that help in the detection of supraventricular arrhythmias, provide physiologic bradycardia pacing capabilities, and cardioversion therapy for sustained life threatening ventricular arrhythmias. Ongoing studies are evaluating the effects of AV junctional ablation and biventricular pacing in patients with depressed left ventricular function.
Atrial Fibrillation Clinic. The Electrophysiology Section, under the initiative of Dr. Peter Zimetbaum, has created an atrial fibrillation clinic dedicated to clinical management and research. Drs. Zimetbaum and Josephson have developed a multicenter national registry of atrial fibrillation that is soon to become an international registry. This registry is collecting important data pertaining to the efficiency, cost and quality of life related to different management strategies for atrial fibrillation.
Electrocardiographic Core Laboratory. Drs. Zimetbaum and Josephson also direct an ECG and Arrhythmia core laboratory in collaboration with the Harvard Clinical Research Institute. This laboratory evaluates data from ongoing clinical trials and will serve as an important tool for fellow education.