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Advances in Electrophysiology by robert Janek bruce D. Lindsay, mD, is Section head of Cardiac electrophysiology & pacing at Cleveland Clinic. E the fastest growing cardiovascular discipline, according to the Heart Rhythm Foundation. Cleveland Clinic���s statistics bear this out. In 2012, procedures performed in the Cleveland Clinic���s main campus EP laboratories totaled 6,517. This includes 1,502 implantations of pacemakers and defibrillators, 808 pulmonary vein antrum isolations (PVAIs), 1,486 ablations and 290 lead extractions. C l e v e l a n d C l i n i c ���s C a r d i a c Electrophysiology & Pacing Section has eight state-of-the-art laboratories on the main campus, including one at Hillcrest Hospital and two at Fairview Hospital, staffed by 24 adult and two pediatric electrophysiologists. Together, they offer a wide range of procedures to patients with suspected arrhythmias. Other services include a Center for Atrial Fibrillation, genetic testing, advanced mapping and ablation therapy, Syncope Clinic and Device Clinic. ���We���re an international referral center for patients with heart rhythm disorders,��� says Bruce D. Lindsay, MD, Section Head of Cardiac Electrophysiology & Pacing 12 lectropHYSiologY (ep) iS | Cleveland/Akron/Canton MD News at Cleveland Clinic. A past president of the Heart Rhythm Society (HRS), Dr. Lindsay chaired the HRS Annual Scientific Program in Boston in 2006, which attracted more than 13,000 attendees from around the world. He also chaired the American College of Cardiology���s (ACC) Board of Governors and recently completed a term as an ACC Board of Trustees member. Currently, he is a contributing author for the HRS state-ofthe-art consensus document for ablation of atrial fibrillation (AFib), which is one focus of his clinical research. ���To make it easy for NE Ohio patients to see us, we have offices at our community hospitals and family health centers in Avon, Beachwood, Cleveland, Mayfield Heights, Strongsville, Twinsburg and Willoughby. For patients from across the state or across the country or even from abroad, if it���s clear that they need a procedure, we���ll often discuss this with them and their referring physician over the phone. Then when the patient comes to one of our hospital sites ��� sometimes on the same day, since we do offer same-day appointments ��� we���ll do an examination ��� MDneWS.coM ��� MarcH -april 2013 the first day and schedule any needed procedures for the next day, so two trips won���t be necessary.��� AFib is the most common arrhythmia. According to HRS, it affects more than 2.5 million American adults and accounts for approximately one-third of hospitalizations for abnormal heart rhythms. Although not life threatening in itself, if left untreated, the side effects of AFib can lead to stroke or heart failure, which is why identifying and treating AFib is so important. ���It���s difficult to manage with medication, so ablation is often the treatment,��� says Dr. Lindsay. ���Techniques for ablation have evolved since 1999, and Cleveland Clinic has been a leader in this area. Last year, we did almost 800 ablations for AFib alone.��� For more complex cases of AFib, an ablation procedure called PVAI is performed. PVAI is an anatomically based procedure that essentially disconnects the pathway of the abnormal heart rhythm. It involves directing a catheter through the veins in the leg to the right atrium and then through a thin membrane called the interatrial septum to gain access to the left atrium and