Electrophysiology & Arrhythmia Program
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Safe Care for Kids of All Ages With Irregular Heartbeat
When your child’s heart beats too slow, too fast or in disorganized patterns, we can help. The pediatric electrophysiologists at award-winning Nemours Children’s heart centers in Delaware and Florida have specialized training in caring for kids with irregular heartbeat, called arrhythmia.
We detect and treat all types of arrhythmias, like heart palpitations (fluttering), supraventricular tachycardia (when the heart beats too fast) and long QT syndrome (when the heart takes longer than normal to recover between beats).
Our team uses innovative methods to diagnose and treat arrhythmias. We perform catheter-based studies using thin, flexible tubes threaded through blood vessels, and state-of-the-art 3D mapping of the heart’s electrical activity. We may also implant devices like pacemakers, defibrillators and loop recorders. Our team has a strong record of safety and success using these procedures.
We work closely with expert cardiac anesthesiologists, other specialists and highly skilled advanced practice providers and nurses with one common goal — getting your child back to doing what they love.
Two Leading Pediatric Heart Centers
Our heart centers offer highly advanced, integrated care just for kids and young adults with congenital heart disease. Learn about our focused programs, innovative research and exceptional outcomes.
“Nemours Cardiac Center was wonderful. Dr. Temple and the staff were very professional and focused on making sure we had a good experience. We highly recommend Nemours to everyone.”
“Knowing that I had good doctors and nurses to take care of me helped me not feel so alone during the entire process.”
Highly Effective Care With Exceptional Outcomes
Electrophysiologists at Nemours are highly skilled at performing safe, effective procedures for even the most complex arrhythmias and related conditions.
We use the latest technology to precisely locate the source of the arrhythmia and can treat it using fewer, smaller cuts for faster healing.
Our EP lab team has vast expertise. Our experience and cooperative team approach results in better patient outcomes.
We have special expertise in caring for kids with inheritable arrhythmias, or those passed along in families.
Nemours offers everything your child needs within the same system. You get expert arrhythmia care, surgery and long-term condition management in one place.
Highly Effective Care With Exceptional Outcomes
Electrophysiologists at Nemours are highly skilled at performing safe, effective procedures for even the most complex arrhythmias and related conditions.
Our ablation success rates and time under X-ray fluoroscopy radiation — an average of four minutes — are better than national averages, with zero complications.
We use the latest technology to precisely locate the source of the arrhythmia and can treat it using fewer, smaller cuts for faster healing.
Our EP lab team has been together for many years. Our experience and cooperative team approach results in better patient outcomes.
Nemours offers everything your child needs within the same system. You get expert arrhythmia care, surgery and long-term condition management in one place.
We have special expertise in caring for kids with inheritable arrhythmias, or those passed along in families.
Meet the Team
Nemours electrophysiology teams are experienced and focused on your child's healthiest future. Meet them now.
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Joel D. Temple, MD
Cardiology Director, Electrophysiology; Associate Chief, CardiologyPrimary Office
Wilmington, DE
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Bahram Kakavand, MD
Cardiology Director, Cardiopulmonary Exercise Lab-OrlandoPrimary Office
Orlando, FL
Programs & Services
An arrhythmia is a problem with the rate or rhythm of the heart. Sometimes this can happen spontaneously, or without reason. Other times arrhythmias are inherited from a parent due to genetic changes. Irregular heartbeat can also come from infections or a chemical imbalance.
We work to find the root cause of your child’s arrhythmia and, as a team, plan the best path forward. We can help kids of ages, from newborns to young adults, with services that include:
- Complete heart rhythm testing, like electrocardiogram (EKG), exercise stress testing, tilt table testing, outpatient Holter monitoring, or surgically implanted loop recorders
- Electrophysiology (EP) studies with 3D mapping to precisely measure the heart’s electrical activity using thin tubes, or catheters, inserted into blood vessels and guided by special X-ray imaging
- Minimally invasive heart ablation therapies using catheters and heat or cold to restore regular heartbeat, often during EP studies
- Pacemakers and implanted cardioverter defibrillators (ICDs), or devices inserted in the chest and belly to control abnormal heartbeat, including innovative left bundle branch pacing
- Implantable loop monitors or small devices inserted under the skin that continuously monitor heart rhythm for intermittent arrhythmias or abnormal heart rhythms
- Perinatal and fetal cardiology management for babies still in the womb with arrhythmias
- Ongoing arrhythmia care, from medicines and pacemaker monitoring to lead extractions, cardiothoracic surgery and more
- Onsite delivery and immediate care after birth through our Advanced Delivery Program in Delaware
- Mental health support from cardiac psychologists who specialize in helping children with heart conditions and their families
Conditions & Treatments
We see many conditions — far too many to list here. The conditions we treat vary depending on the location and providers selected. Don’t see a condition listed? Call us.
Related Specialties & Programs
Convenient Follow-Up Appointments by Video
We offer follow-up appointments through scheduled, live video visits. You can avoid waiting rooms and save travel time. Ask your doctor if this is an option for your family.
What to Expect
The heart usually beats in a regular, steady pattern, or rhythm, that’s coordinated by electrical signals. When the electrical signals don’t work like they should, it can lead to too slow, too fast or disorganized heart rhythm. This can sometimes affect the way the heart functions.
An electrophysiology (EP) study measures the heart’s electrical activity. An EP study can help us diagnose and even treat certain heart rhythm problems. EP studies are performed in a special lab that’s like an operating room. Learn more.
What Happens During an EP Procedure
In this procedure, a small, thin tube called a catheter is placed in a blood vessel, usually the groin, but sometimes through the arm or neck. The electrophysiologist guides the catheter to the heart using a special moving X-ray called fluoroscopy.
Electrodes at the end of the catheter send signals to different areas of the heart. Using 3D technology, we can map the heart’s electrical activity and pinpoint the areas causing the arrhythmia.
Sometimes an EP study is done only to gather information. At other times, we may find that an arrhythmia can — and should — be treated right away.
Treating an Arrhythmia Using Ablation
During the EP study, we may treat the arrhythmia using ablation. Heart ablation creates scar tissue to disrupt problematic electrical signals. With the catheter in place, we may use:
- Radiofrequency ablation to heat the targeted area
- Cryotherapy ablation to freeze the targeted area
We use X-rays as little as possible (under five minutes, in most cases) so your child isn’t exposed to unnecessary radiation.
These procedures are incredibly safe and quite fast. Some kids only need one procedure to fix the arrhythmia. Others may need more than one.
You can learn more about arrhythmias and treatment from the experts at Nemours KidsHealth®.
EP Procedures at Nemours
Before your child’s EP procedure, we take the time to answer all your questions.
We look to you for how we should explain it to your child. Some curious kids want all the details, while others do better with less information. No one knows your child better than you.
Generally, you can expect the following:
- Our care coordinator will tell you when to have your child stop eating and drinking, medicines they can take, and where and what time to check in on the day of the procedure.
- You’ll arrive two hours before the procedure so you can meet with our team of advanced practitioners, nurses and Child Life specialists.
- The cardiac anesthesiologist will visit and talk about anesthesia in a way your child can understand. Your child can choose what “flavor” of anesthesia they’d like if they’re receiving it through a mask.
- When it’s time to go to the EP lab, you can come and stay with your child until it begins.
- Procedure times vary. We’ll update you on progress every hour or so.
- Once finished, we’ll give you all the details. Your child will be closely monitored as they wake from anesthesia.
- Most kids stay with us for one night. We’ll discuss everything you need to know before discharge, like any new medicines, recovery instructions and follow-up care.