The Arrhythmia and Pacing Service at the Heart Center at Texas Children’s Hospital is part of an integrated team committed to caring for infants, children and adolescents with heart rhythm and related disorders. In addition, we care for those adults who have undergone palliative surgery of their congenital heart defects with resultant arrhythmias.
We annually perform over 150 electrophysiology studies and ablations of arrhythmic substrates using the newest mapping techniques including 3-D reconstruction and magnetic navigation. Ablative lesions for cure of arrhythmia substrates includes the use of radiofrequency current and cryoablative techniques (freezing) where appropriate.
Implantation of permanent pacemakers and defibrillators is also performed by our faculty in the cardiac catheterization laboratory under general anesthesia with the assistance of our cardiovascular anesthesia colleagues. We also implant “loop recorders” for patients with atypical syncope (passing out) where previously applied non-invasive techniques have failed to demonstrate the cause of syncope. In those patients whose pacemaker lead systems have failed and/or become infected, we perform extraction of the leads using “powered sheaths” applying radiofrequency current or laser energy to vaporized scar tissue that holds those leads in place. In order to provide the highest degree of safety, our cardiovascular surgical colleagues are consulted and on “standby” for all such cases.
We have 3-4 clinical electrophysiologist physicians in the clinic each week to see those patients who have been referred for evaluation of rhythm disturbances and in addition have a Syncope Clinic twice monthly which specializes in investigation and treatment of “passing out episodes” in children and adolescents. Some of the patients referred for syncope may be referred to our catheterization laboratory for a “Head-up Tilt Test” if further investigation of their symptoms is required. We also have a genetic arrhythmia clinic once monthly which specializes in the evaluation of inherited causes of arrhythmias & sudden death.
The faculty is active in clinical research and has published extensively in the leading medical journals. Among the many areas of interest in which we have published include:
- Causes of and prevention of sudden cardiac death in children and adolescents
- Use of antiarrhythmics agents in the young
- Novel mapping & naviation techniques for ablation of cardiac arrhythmias in children.
- Novel techniques for implantation of permanent pacemakers and defibrillators
- Surgical approaches to complex arrhythmias in single ventricle patients
- Device therapy in hypertrophic and dilated cardiomyopathies
- Treatment of Prolonged QT Syndrome
- Michele Krenek, RN, FNP-C
- Melissa Domino, RN
- Melissa Lewellen, RN
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