Science Makes The Heart Go Longer

Treating the heart’s electrical system is a bit like jump-starting a car: attach leads and provide a jolt. But the science being applied to electrophysiology (EP) puts the technique closer to a racecar than the family wagon. An EP specialist who treats arrhythmias –– abnormal heart rhythms that can lead to low blood pressure or death –– is using great recent advances in the battle against America’s greatest health risk.

“People who have heart disease tend to develop arrhythmias,” explains Dr Adam Lottick, the first full-time electrophysiologist at St Vincent’s Health Services and only the second one in Bridgeport. “The patients here are getting much better served because I’m bringing the latest technology and expertise to the care of cardiac problems.” The EP lab at St Vincent’s holds a national certification as a result of meeting stringent quality standards.

New treatments developed within the last 20 years include minimally invasive in-heart tests of electrical impulses and the ability to implant defibrillators to fix irregularities, he says. “My career has covered the creation of these devices and much more wide utilization of them.”

The most serious problem arising from an irregular heartbeat is sudden death. Before the maturity of EP, doctors could only react to such an event, trying to revive the patient and then address what caused the heart to stop.

“What I do is prevent emergencies,” said Dr Lottick. “We now have tests to determine if somebody is sufficiently likely to have sudden death, and if so, we can implant a defibrillator to prevent it.”

An implantable defibrillator –– a recently developed device about the size of a man’s wallet –– detects irregular heartbeats and shocks the heart out of its lethal arrhythmia. Unlike the pacemaker, a smaller, more common device implanted to keep a patient’s heart beating at a minimum rate, a shock from a defibrillator is used to slow down a racing heart to restore a safe rate.

To determine the need for a defibrillator, the doctor can monitor a person’s heart or perform an EP study in a lab. By running X-ray guided leads up into a patient’s heart through a vein in the leg, Dr Lottick can pinpoint an area of a few cells in the heart causing the problem, then use radio wave energy to ablate (burn away) tissue to the point that it can no longer conduct electricity, which can solve the problem. He says the two- to four-hour treatment, called radio frequency ablation, “is one of the most satisfying parts of EP, because it’s curative.”

Because EP is so new and the specialists so few, most community hospitals do not have electrophysiologists on staff. Nationwide, only about 50 cardiac doctors each year graduate with a specialty in EP, and half of them go to work in research or academia, he says. “The need for electrophysiologists has expanded dramatically.”

Dr Lottick is energized about the possibilities at St Vincent’s new Regional Heart and Vascular Center, where world-class heart care is the goal. “I think we’ll really be able to build something here.” He says the atmosphere of care at St Vincent’s sets it apart. “The staff at S. Vincent’s is exceptional,” Dr Lottick said. “Patients really do have a closer relationship with their physicians here.”

Dr Lottick, 39, came to St Vincent’s from the Minnesota Heart Center in Edina. A native of Kingston, Penn., he completed medical school at Washington University in St Louis and served his residency at Johns Hopkins in Baltimore, where great advances in his specialty were first introduced. He followed this with fellowships in cardiology and electrophysiology at the University of Colorado. Dr Lottick and his wife, Dr Nina Kadan-Lottick, a researcher on children’s cancers, have three children and reside in Woodbridge.

St Vincent’s Health Services in Bridgeport recently expanded its cardiovascular services and grouped them under the umbrella of the Regional Heart and Vascular Center. The center is committed to providing the best health services in Connecticut for heart-related diagnosis, education, and treatment.

Services include 24-hour emergency angioplasty, a state-of-the-art electrophysiology lab, the area’s first cardiac diagnostic and observation center, a comprehensive congestive heart failure program and a nationally certified cardiac rehabilitation program. For more information, visit www.stvincents.org or call 877-255-SVHS.