Cardiac Arrhythmias

CVPH Electrophysiology treats irregularities in heart rhythm, or cardiac arrhythmias, with the latest - and minimally invasive - techniques.


Exterior of 214 Cornelia Street building

CVPH Electrophysiology

214 Cornelia Street
Suite 203
Plattsburgh,  NY  12901

Phone:  (518) 314-3420
Fax:  (518) 562-7064

Hours of Operation
Monday - Friday
8:00am - 4:30pm

Your heart has a very complex electrical system that generates and regulates your heart beat.  Irregularities in heart rhythm, also known as cardiac arrhythmias, can occur.  When this happens, you may need a treatment called electrophysiology (EP). Our Heart Center has developed a comprehensive cardiac electrophysiology program led by experienced, board certified Doctors Pierre Znojkiewicz, Robert Lobel and Joseph Winget who are supported by a team of highly trained nurses and technicians, working in our state-of-the-art electrophysiology laboratory.

We provide superior care close to home, while striving for excellence in outcomes and patient satisfaction.

Common Cardiac Arrhythmias
Signs and Symptoms
Causes, Risk Factor and Prevention
Treatment Options


Common Cardiac Arrhythmias

  • Premature Beats - Also know as skipped beats, they are usually harmless but can be quite bothersome.
  • Atrial Fibrillation - This is a common arrhythmia resulting from a fast, chaotic beating of the upper chambers of the heart (the atria).
  • Aupraventricular Tachycardia - A rapid but organized heartbeat, also originating in the atria.
  • Ventricular Tachycardia - A rapid heartbeat originating in the lower chambers of the heart (the ventricles).
  • Ventricular Fibrillation - A rapid chaotic rhythm originating in the lower chambers of the heart. It can lead to inefficient pumping of blood, causing poor blood circulation and sudden death.
  • Bradycardia - Refers to a very slow heartbeat. This can result from damage to the electrical system of the heart.

Signs and Symptoms of Cardiac Arrhythmias

Arrhythmias may produce no symptoms and may be detected during routine examination. Often, however, arrhythmias can result in symptoms such as:

  • Chest pain, pressure or discomfort
  • Dizziness
  • Fainting or blacking out
  • Palpitations or fluttering in the chest
  • Shortness of breath
  • Weakness


Causes, Risk Factor and Prevention
Arrhythmias may occur in people who are otherwise healthy and free of heart disease. However most arrhythmias occur in patients with a previously established heart condition. Measures that are known to reduce the risk of heart disease such as smoking cessation, exercise, healthy eating habits and controlling diabetes and high blood pressure can significantly reduce the risk of cardiac arrhythmias.

The diagnosis of cardiac arrhythmias begins with the patient’s history, physical examination and electrocardiogram (EKG). Many patients, however, will require further work that may include:

  • Echocardiography or Utrasound Examination of the Heart
  • Stress Testing - During stress testing, you exercise to make your heart work harder and beat faster while various tests are performed.
  • Prolonger Monitoring - Your heart's rhythm is monitored for a prolonged period of time with a portable recorder (Holter monitor, event monitor, outpatient telemetry, etc.).
  • Tile Table Testing - This test investigates fainting or near-fainting spells. The test involves continuous monitoring of blood pressure and heart rhythm while the patient rests on a specialized table tilted to 70-80 degrees.
  • Electrophysiology Study - A procedure involving the introduction of specialized wires (catheters) into the heart through blood vessels in the groins or neck.  These catheters record electrical signals originating from the heart. They can also deliver electrical impulses to reproduce and diagnose the patient’s arrhythmia.


Treatment Options
Some arrhythmias require no treatment. Sometimes avoidance of certain behaviors such as using caffeine, tobacco, excessive alcohol, stress, etc. is sufficient. When treatment is required, it may involve one or more of the following methods:

  • Medications -  Medications can be helpful in the treatment of cardiac electrical problems, especially a class of drugs known as antiarrythmics.
  • Pacemakers - Pacemakers pace the heart when it beats too slowly.
  • Biventricular Pacers - Biventricular pacers pace the right and left sides of the heart simultaneously, which may improve the pumping efficiency of weakened hearts.
  • Implantable Cardioverter/Defibrillators (ICDs) -  ICD’s are implantable, fully automated devices that constantly monitor your heart rhythm. They can terminate rapid, potentially lethal arrhythmias either by pacing the heart or delivering an electrical shock.
  • Catheter Ablation -  A catheter is introduced via a blood vessel into the heart to destroy tissue causing an arrhythmia. A very small area of tissue is destroyed either by heating (radiofrequency ablation) or cooling (cryoablation) methods

Scheduling Appointments
Ways to Receive Care
Visitor Restrictions

While the COVID-19 pandemic is changing the way some things look and feel at CVPH, providing you and your loved ones with the care you need is always our top priority. We are taking extra precautions by adjusting some of the ways we provide care, both in-person and remotely at CVPH Electrophysiology. It is important to know what to expect when you are in our care. Below is a glimpse of the experience you can expect before, during and after your provider visit.

Scheduling Appointments

If you have a pressing issue, do not hesitate to call (518) 314-3420 from 8:00 a.m. - 4:30 p.m. Monday - Friday.


To streamline your visit and limit time spent in the waiting room,you may go through pre-registration before the appointment if you haven’t been seen in the last 4 months. That involves a phone call a few days ahead of the visit to verify some basic information about you and your insurance.This is similar to what you used to do in the waiting room before seeing your provider. The entire call will only last a few minutes.

The process is similar for same day appointments. Once the appointment is scheduled, you will be transferred to a representative for pre-registration.

Care That’s Right For You

Whether it’s in person, on the phone or via video, we are offering expanded access to ensure you get the care you need, when you need it. CVPH Electrophysiology offers these options:

Please call our office to speak with a staff member about the different ways you can get care, or click here to learn more about each option.

In-person Visits

When you arrive for your appointment, you’ll notice more precautions in place to support your health and comfort.

What you can expect:

  • Check-in: To ensure a smooth process and avoid significant waiting times, we ask that you arrive promptly for your appointment. If you arrive early, you may be asked to wait in the car until an exam room opens up. A staff member may then call you (if you have a cell phone) when a room is free or come out to get you. You will go inside the FitzPatrick Cancer Center entrance. If you have a mask, be sure to put it on before going into the building.  
  • Screening: Once you enter the building, a representative at the desk immediately in front of the doors will ask you a few screening questions to determine if you’ve been exposed to COVID-19 or have any symptoms and get your temperature checked. If you do not have a mask, we are happy to provide one for you and help put it on.
    • If you do not pass the screening: Don’t worry! We are taking every precaution to ensure you receive the care you need and minimize exposure to others. If necessary, your provider will be notified and will work directly with you to ensure your appointment is kept.
    • If you pass: Head to the office. If an exam room is not immediately available, you may be taken to the waiting room for no more than a few minutes. If the wait is longer, you may be asked to go back to your car. A staff member will be sent out to get you when a room is available. 
  • Exam Room: Once in the room, the nurse will go over basic information as usual, including medications and the reason for the visit. You will be asked to wash your hands before the provider sees you. Your provider will then visit with you.
  • Check Out: Once the visit is complete and your provider leaves the room, you may head to the check out desk where a member will get you checked out, schedule any follow-up visits and escort you to the exit. Any co-pays or other payments owed will be handled over the phone or through the mail. 

What we will be doing:

  • Masking: For everyone’s protection, we’re asking you to wear your mask while in our care, and we’ll be wearing masks, too.
  • Cleaning & Sanitizing: Following CDC and New York State Department of Health Guidelines, we are cleaning and disinfecting exam rooms, front desk counters, check-out counters, waiting room furniture and patient bathrooms in between each patient visit. You may also notice we are cleaning common areas and wiping down surfaces more frequently throughout the day.
  • Social Distancing: We are limiting the use of the waiting room as much as possible. We have also made changes to support safe social distancing of at least 6 feet. That includes fewer chairs and new floor markings to create a “circle of health” to help with appropriate distancing.  

Visitor Restrictions

You may be accustomed to bringing a friend or loved one to your appointments. For the most up-to-date visitation policy at the hospital and our clinics, click here.

If you need a support person or driver to accompany you to the office, we ask that they wait in their vehicle or return at a specific time. We also ask that they be no more than 15 minutes away while you are with us. After your appointment, a staff member will bring you to the designated entryway to meet up with your support person outside the office. 

If a support person needs to come inside the building with you for the appointment, that individual will also be screened before entering the building and must wear a mask for the duration of the visit. Please call us at (518) 314-3491 to determine if a support person during the visit is appropriate.