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Cardiac Electrophysiology – fort worth
Electrophysiology is an important component of the
comprehensive cardiovascular services offered in Fort Worth.
Physicians from Tarrant County and the surrounding
area have long been referring patients with heart rhythm
disorders to the electrophysiologists on the medical staff
because of their expertise offering therapies for all types of
arrhythmia from atrial fibrillation to ventricular tachycardia. • Are at increased risk for stroke and systemic embolism
based on CHADS 2 or CHADS 2 -VASc scores and are
recommended for anticoagulation therapy
According to Electrophysiology Medical Director, Craig
Delaughter, MD, PhD, FACC, FHRS, the program
for Baylor Heart and Vascular Services at Fort Worth
excelled in fiscal year 2017 through the engagement of the
electrophysiologists collaborating to better streamline patient
care and assess protocols to continually improve outcomes.
“We were also pleased to enhance our capabilities in fiscal
year 2017 with the use of the WATCHMAN™ device.
Designed to prevent blood clots that can form in the left
atrial appendage (LAA) and travel to the brain causing a
stroke, the device can be implanted in atrial fibrillation
patients using a minimally invasive technique,” says Dr.
Delaughter. “Patients are generally released after 24 hours
and over time with medical supervision and close follow-
up, patients decrease their blood thinner medication.” Dr. Delaughter also offers a cautionary note that there are
other causes of stroke other than a clot traveling to the
brain from the left atrial appendage including high blood
pressure and narrowing of the blood vessels in the brain.
According to data available at the time of printing,
Baylor Heart and Vascular Services at Fort Worth had
the top volume of LAA procedures and the use of the
WATCHMAN device. The WATCHMAN device is
suitable for patients with non-valvular atrial fibrillation who:
ABLATIONS BY TYPE
OF ARRHYTHMIA
11%
AVN
9%
VT
41%
AFIB
39%
SVT
SVT: Supraventricular Tachycardia
AFIB: Atrial Fibrillation
VT: Ventricular Tachycardia
AVN: Atrioventricular node
More than
500
Pacemakers/ICDs
implanted in
Fort Worth (FY17)
• Have an appropriate rationale to seek a non-
pharmacologic alternative to oral anticoagulation,
taking into account the safety and effectiveness of the
device compared to warfarin
Nearly 400 ablations were performed in the heart
catheterization/electrophysiology labs at Baylor Heart
and Vascular Services at Fort Worth during fiscal year
2017. Ablation therapy for patients who experience
abnormal heart rhythms requires the use of advanced
mapping systems for signal analysis. Electrophysiologists
on the medical staff are known for their skill at correctly
identifying the abnormal rhythm circuit and eliminating
it both safely and effectively.
Electrophysiologists on the medical staff continued to
see an increase in the number of patients referred for
implantable cardioverter defibrillators (ICDs) and cardiac
resynchronization therapy (CRT). MRI compatible
ICDs are now routinely used, allowing patients and their
physicians to use this modality for diagnostic imaging
even after ICD implantation. Baylor Heart and Vascular
Services at Fort Worth also has CRT devices that can
provide Multi Point Pacing, a “next generation” form of
CRT that can pace the ventricles from three sites instead
of two. This form of pacing has been shown to increase
the clinical response rate of heart failure patients in
early clinical trials. Dr. Delaughter says, “Pacing made a
significant technological leap this year, as the Fort Worth
campus now has the ability to implant a completely
leadless pacemaker. This device is delivered by femoral
access and is entirely contained within the heart itself.”
The Electrophysiology area of Baylor Heart and Vascular Services at Fort Worth participates in the ICD Registry.
A sample of the indicators are:
Goal Baylor HHVH
Fort Worth*
100% 100%
Percent of ICD patients with post-
procedure hematoma 0% 0%
Percent of ICD lead placement issues 0% 0%
ICD
Prophylactic antibiotic administration
(NCDR through Q4 2016)
TOTAL LENGTH OF STAY
Primary Prevention ICD 0.8 day
average
Secondary Prevention ICD 0.6 day
average
*Baylor Jack and Jane Hamilton Heart and Vascular Hospital – services provided in Fort Worth