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Dr. Eric Rashba

Eric Rashba, MD, Director, Heart Rhythm Center; Puja Parikh, MD; Interventional Cardiologist; and Smadar Kort, MD, Director of Non-Invasive Cardiac Imaging, in Stony Brook’s Advanced Multifunctional Cath/EP Lab. Photo by Jim Lennon/ SB Medicine

Stony Brook University Heart Institute is now offering its patients the latest generation of the Watchman FLX™ device, which provides protection from strokes for people who have atrial fibrillation (AFib), a type of arrhythmia or irregular heartbeat, that is not caused by a heart valve problem.

Eric Rashba, MD, Director, Heart Rhythm Center holding the new Watchman FLX device. Photo by Jim Lennon/SB Medicine

Stony Brook is one of a select number of sites in New York State to offer the new Watchman FLX device. The procedure, which closes off the part of the heart where 90% of stroke-causing clots come from, will be done in Stony Brook University Hospital’s new Advanced Multifunctional Cath/EP Lab. The large, 845-square-foot multi-functional laboratory has been carefully designed and outfitted with state-of-the-art technology to allow the Heart Institute physicians to perform a full range of procedures.

People with AFib, the most common type of heart rhythm disorder, have an increased risk of stroke by 5 times on average. Blood thinners are often prescribed to help prevent strokes but “some experience bleeding problems or have other reasons why blood thinners aren’t the best option,” explains Eric Rashba, MD, Director, Heart Rhythm Center at Stony Brook Heart Institute.

The Watchman device, which is about the size of a quarter, provides an alternative to the lifelong use of blood thinners (anticoagulants) for people with AFib by blocking blood clots from leaving the heart and possibly causing a stroke.

The design of the newer, Watchman FLX device used by the Heart Institute offers significant advantages to the patient, including:

  • Advanced safety due to the new framing of the device that allows for more long-term stability and a more complete seal

  • Enhanced procedural performance that allows the physician to better maneuver and position the device during the procedure

  • A broader size range to permit treatment of a wider range of patient anatomies

“At the Stony Brook Heart Rhythm Center, in the hands of our expert team, we are excited to bring this latest innovation to effectively provide protection equivalent to anticoagulants for preventing strokes and avoiding the risk of serious bleeding,” said Dr. Rashba. “It has saved lives and improved my patients’ quality of life.”

The Philips Azurion 7 provides imaging capabilities at ultra-low radiation dose levels. Photo from Stony Brook Medicine

Stony Brook University Hospital has taken a step in offering cardiac diagnosis and treatment that is even more advanced than in the past.

SBUH’s Dr. Robert Pyo, Dr. Henry Tannous, Dr. Eric Rashba and Dr. Hal Skopicki stand in the new multifunctional lab. Photo from Stony Brook Medicine

Recently, the hospital announced the opening of its Cardiac Catheterization and Electrophysiology Advanced Multifunctional Laboratory in the Stony Brook University Heart Institute at SBUH. The lab consolidates comprehensive cardiac catheterization and electrophysiology services into one location.

The multifunctional laboratory measures 845 square feet to allow room for various medical teams to perform emergency procedures at the same time if needed. The room includes anesthesia equipment, state-of-the-art angiographic suite equipment and the latest electrophysiology technology. In the lab, physicians are able to continue treating a patient even if the scope of a procedure changes from minimally invasive to more invasive.

When it came time to design the multifunctional laboratory, administrative and medical professionals were able to provide input including Cath Lab Director, Dr. Robert Pyo and EP Lab Director Dr. Eric Rashba.

Pyo said it was important to get input not only from doctors but nurses and technicians, who play a crucial part in documenting procedures, information that will be used during a patient’s treatment.

Rashba said time was spent with the construction group to ensure everything was laid out correctly and that it would work for both specialties in the multifunctional lab. He added that work began April 12 to renovate five existing labs, three Cath and two EP, adjacent to the new Cath/EP lab on the main level of the Heart Institute. One lab at a time will be worked on, and while the additional renovations will take several months, Rashba said the number of patients that Stony Brook doctors can treat will increase, and patients will be able to get appointments quicker than in the past.

“What we’ve seen over time in electrophysiology is that you see more and more patients with arrhythmias that need treatment,” he said. “There’s been an incredible growth in ablation procedures, in particular atrial fibrillation. This will allow us to meet the community need with less waiting times for procedures. So, we’re looking forward to that.”

Since the lab opened March 30, both doctors said the imaging has been superior to what they had been using before. The lab includes an image-guided diagnostic and therapeutic imaging system called the Philips Azurion 7.

“We’re replacing systems that have been installed for over 10 years,” Rashba said. “First of all, we can see a lot better what the definition of the structures are we need to see, plus the radiation definition is a lot lower. So, we’re getting better imaging with less dose to the patient.”

Rashba added that some EP procedures can even be done without radiation.

Pyo said the new multifunctional lab also saves doctors precious time when treating heart patients with both catheterization and electrophysiology in the same room.

“The importance of timing, reducing the time to treatment, whether it’s minutes or seconds, is relative,” Pyo said. “I think that in any case, even in patients who come in electively, getting early diagnosis is crucial.”

Being able to respond quicker is especially crucial with treatment of heart attacks.

“Patients who are presenting with a heart attack, minutes, even seconds, count toward early diagnosis and treatment,” Pyo said, adding if patients don’t get treatment early enough they could suffer irreversible damage.

By Eric Rashba, M.D.

Dr. Eric Rashba

Atrial fibrillation, or AFib, is generally considered to be reaching epidemic numbers, especially among people over age 60. This condition, which is characterized by an erratic, irregular heartbeat, can cause problems ranging from unpleasant symptoms to serious problems like heart failure or stroke.

At the Stony Brook Heart Rhythm Center, our physicians and entire team of heart rhythm experts are constantly working to help people with AFib live better and longer. These are some of the important new state-of-the-art therapies:

Reducing stroke risk for people with atrial fibrillation

People with AFib have a 5 to 7 percent increased risk of having a stroke compared to people without AFib. To help prevent strokes, blood thinners such as warfarin or direct oral anticoagulants (DOACs) are prescribed. Most people do well with medication, but some experience bleeding problems or have other reasons why blood thinners aren’t the best option. 

At the Heart Rhythm Center, our specialists are treating appropriate patients with an implantable heart device, called Watchman™, to offer lifelong protection against stroke. For people who have AFib that’s not caused by a heart valve problem, the device provides an alternative to the lifelong use of blood thinners by blocking blood clots from leaving the heart and possibly causing a stroke. 

Miniaturized pacemaker for people with bradycardia

Bradycardia, also called slow heart rate, is when the heart beats at 60 times a minute or less. Not everyone with a slow heart rate needs a pacemaker — the presence of symptoms and the type of rhythm disorder are key. At our Heart Rhythm Center, for people whose slow heart rate can be treated with a pacemaker in just one of the four heart chambers, we use a pacemaker that is 93 percent smaller than traditional pacemakers, called Micra™. It is the world’s smallest pacemaker available and it offers some big benefits to the patient. 

Conventional, bulkier pacemakers are visible under the skin and have a lead wire that is threaded from the pacemaker into the heart. Our team implants the Micra pacemaker in the electrophysiology lab where the device is placed aboard a catheter (a thin, flexible tube) and moved up to the heart through the femoral vein in the leg. The device lasts for about a decade, and because it is so small, another one can be added to the same heart chamber years down the road when needed. The patient can also be safely scanned using certain types of full-body MRI.  

Zero-radiation ablation

Ablation is a procedure that uses cauterization to burn or scar the electric pathways that trigger the arrhythmia or abnormal heart rhythm. During a conventional ablation procedure, real-time X-ray, called fluoroscopy, is used and it delivers the equivalent radiation of up to 830 chest X-rays. At Stony Brook, my colleague, Dr. Roger Fan routinely performs complex ablations for AFib without any fluoroscopy at all. This important advance eliminates radiation exposure to the patient, with the same excellent results as conventional ablation. Zero-radiation ablation is such an important advance for the overall health of the patient, since excessive radiation can lead to medical problems over the long term. 

Questions about your heart’s rhythm? Call Dr. Rashba at 631-444-3575 or call 631-444-3278. Interested in learning more about your heart health? Take the free heart health online risk assessment at www.stonybrookmedicine.edu/hearthealth.

Dr. Eric Rashba is the director of the Heart Rhythm Center at the Stony Brook University Heart Institute.