COVID-19 ALERT: For the latest COVID-19 updates from CVPH, click here.

Cardiac Arrhythmias

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

COVID-19 ALERT: Get the care you need, when you need it. Video visits are available and safety measures are in place for in-person visits to Primary Care and Specialty practices. Click here to learn more about the many care options available to you.


CVPH Electrophysiology

214 Cornelia Street
Suite 204
Plattsburgh,  NY  12901

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 Arrhythimias
Signs and Symptoms
Causes, Risk Factor and Prevention
Treatment Options


Common Cardiac Arrhythimias

  • Preamature 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