Electrophysiology
In the Cardiac Electrophysiology Lab at ACH, Dr. Srikant Das provides full-spectrum pediatric and adult congenital cardiac electrophysiology services, with an average of ~170 procedures annually. This includes:
- Performing and interpreting electrophysiology studies
- Radiofrequency ablations
- Cryoablations (only program with this capability in the state of Arkansas)
- Pacemaker, defibrillator, and other cardiac device implantation
- Drug challenge studies
Despite a large proportion of complex adult congenital EP procedures and combination (cath and EP/device) procedures, our performance and outcome measures meet or exceed the standards reported in the IMPACT Registry (Improving Pediatric and Adult Congenital Treatments). For example, the snapshot below shows the mean fluoroscopy time is consistently less than half of the national average, as Dr. Das maximizes fluoroless techniques.
Technologies/Products utilized in our Electrophysiology Program:
- Insertion of smallest loop recorder (LINQ)
- Subcutaneous-ICDs (among national leaders in adopting this technology)
- Leadless cardiac pacemaker implant (MICRA Transcatheter Pacing System, the world’s smallest pacemaker)
- MRI-compatible cardiac pacemakers and devices
- Intracardiac echocardiography for EP procedures
- Irrigation catheter ablations
- Ablations with IMPELLA pump support
- Novel Safesept wire technique for transseptal punctures
The ACH EP lab has demonstrated an excellent track record in treating adult congenital and pediatric patients with complex dysrhythmias. For example, our team performed successful ablation on an infant with preexcitation-induced cardiomyopathy. The patient had been dependent on an implanted Berlin BiVAD heart pump, but after ablation, cardiac function normalized and a transplant was avoided. The Berlin BiVAD was explanted (the world’s first report of such).
Outpatient /Non-invasive electrophysiology services:
- Electrophysiology and cardiac devices clinic (weekly)
- Adult congenital arrhythmia and device clinic (monthly)
- Outreach/regional arrhythmia clinics
- Management of ~ 300 cardiac device patients
- Review, interpretation, and recommendation for all Holters and event monitors
Adult Congenital Heart Disease Program
Arkansas Children’s Hospital established its Adults with Congenital Heart Disease (ACHD) Program in 2010. The program has grown substantially each year and is now following more than 2250 patients from throughout the state and region.
Arkansas has a large population of adults with congenital heart disease, many of whom underwent surgical interventions many years ago and are only now able to reestablish care with a congenital cardiology specialist. Our ACHD cardiologists work closely with community cardiologists from around the state to optimize medical management and thoughtfully consider the role of further intervention. We offer patients a comprehensive array of ACHD Program Services.
In addition to excellent patient care, our goal is to train pediatric cardiology fellows in the management of adults with congenital heart disease in both the outpatient and inpatient settings. Our fellows prepare and present complex ACHD patients in the weekly surgical conference. They get an opportunity to analyze the data, understand the nuances of adult cardiology, and help in formulating a management plan.