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Electrician of the heart

Tracey Porpora A- A A+

A Pioneer in Cardiac Care brings lifesaving techniques to SIUH

Although Marcin Kowalski, a cardiologist specializing in electrophysiology at Staten Island University Hospital (SIUH) is a doctor, he often refers to himself as an “electrician for the heart.” “Electrophysiology is a brand new field; only 20 to 30 years old. With the advent of technology, its practitioners have been able to understand arrhythmia or the ‘electrophysiology of the heart’ in just the last 15 years,” said Kowalski. “Think of an arrhythmia as a short circuit in the heart that makes the heart beat very fast, very slow, or have an abnormal rhythm.”

SIUH is on the forefront of being equipped with the latest technology to treat different arrhythmias of the heart, which can be life-threatening cardiac conditions. “We are now able at SIUH to treat all types of arrhythmias,” the doctor added. “This includes complex arrhythmia, which was previously not able to be treated here. In the past two years, we’ve built a brand new, $2.5 million lab to facilitate the treatment of these conditions—for which you need very specific, complex equipment. We have come a long way in technology over just the last two years.”

Kowalski has helped bring new procedures to the hospital, too. He is a pioneer in cryo-balloon ablation, a technique that controls dangerous heart rhythms caused by abnormal electrical signals traveling from the pulmonary veins to the atria. During the procedure, catheters are used to terminate (ablate) these abnormal electrical signals and stop them from spreading and continuing to cause difficulty. The catheters used in the treatment feature electrodes able to sense intracardiac electrical signals when connected to the electrophysiology lab system. “We can put the balloon right at the entrance of the pulmonary vein and inject nitrate oxide [a refrigerant] into the balloon, which goes down to minus-50° Celsius,” he explained. “Basically, it freezes the entrance of the pulmonary vein and creates a uniform scar at the entrance of the vein at the same time.” Kowalski was the first doctor on the East Coast to perform cryo-balloon ablation, a faster technique compared to traditional remedies, and one that poses fewer complications. “Short term, our success rate has already been 80% in curing atrial fibrillation. The national average is 65 to 70%. With cryo balloon ablasion, we are above average, and it’s is done quicker and more safely.”

A graduate of New York Medical College, Kowalski completed his residency at St. Luke’s/Roosevelt Hospital Center (an affiliate of the Columbia University College of Physicians & Surgeons). He completed a fellowship in cardiology at Henry Ford Hospital in Detroit, MI, and another in Electrophysiology at the Medical College of Virginia in Richmond, VA. He is quick to point out that ablation is one key procedure being used to treat another cardiac problem:

atrial fibrillation. “This is the most common form of arrhythmia. Over two million people suffer from atrial fibrillation every day in the U.S.,” Kowalski said. “It makes your heart go very fast. Some people feel tired, weak, and have shortness of breath, but others can have it and not feel it at all. Atrial fibrillation can predispose people to forming clots in the heart. Once they form, clots can take off from the heart, go up to the brain, and give you a stroke. People with atrial fibrillation are at a five-times higher risk of getting a stoke.”

The Forefront of Electrophysiology

“There is a huge problem in the United States: sudden cardiac death. These are people walking on the street and all of a sudden they die,” Kowalski explained. Electrophysiology can be used to stop sudden cardiac death with the use of a defibrillator. “To prevent this, we implant a defibrillator, which is a machine planted under the skin with wires down through the heart that monitors people’s heart rhythms. We find a lethal and abnormal arrhythmia, called ventricular tachycardia that’s originating in the lower chamber of the heart that causes people to die suddenly. The only way to stop that arrhythmia is to shock someone. Imagine how long it can take for someone to find a patient and then call EMS to come to shock someone. Every second counts for that patient. We implant a device that monitors every beat of the heart and is designed to find that abnormal rhythm…the ventricular tachycardia. It then shocks the patient back to normal in five to ten seconds and saves their life. This is the standard of care now for a certain population of patients who require the defibrillator, and it has shown that it works. Helping to advance the kind of care that has the potential to save lives; it’s just a remarkable career…a remarkable opportunity.”

Photos: By Vinnie Amessé  ©  www.amessephoto.com

 

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