Kenny Nguyen/Dr. Jonathan Weinsaft - Week 2

 Week 2: 06/12/23 - 06/16/23

I continued my second week of the Summer Immersion term by learning more about reading cardiac magnetic resonance images and observing different procedures in the electrophysiology (EP) labs. From the radiologist’s perspective, I am becoming familiar with the different views such as the 4-chamber-view that shows all of the heart chambers (right atrium, right ventricle, left atrium, and left ventricle) and the expected morphology for each chamber. From the electrophysiologist’s perspective, I learned about the role imaging modalities play in the EP labs and the unique equipment used by physicians when treating patients.

The EP labs are specialized units within Weill Cornell Medicine’s Greenberg Division of Cardiology where diagnostic and therapeutic procedures related to the heart’s electrical systems are performed. I had the privilege of witnessing the physicians use cutting-edge technology during ablation procedures to treat heart arrhythmias in patients. Ablation procedures are commonly used to block irregular electrical signals in the heart by scarring small areas in your heart. Other interventional methods such as medications are the first lines of treatment for arrythmias before a patient is scheduled for a cardiac ablation procedure. The room was filled with state-of-the-art monitors, imaging equipment, and a variety of specialized catheters. During electrophysiological studies, electrodes and catheters are placed in various locations inside the heart to record electrical signals. These signals provide important information to map out the propagation of arrythmias and guide physicians during ablation procedures. The 3-D model is based on computed tomography (CT) images of the patient’s heart that allows for accurate visualization for each case. Other tools such as x-ray fluoroscopy give additional visualization cues to the physicians on the position of the catheters within the heart.

A notable procedure that I observed was an ablation procedure for a patient with atrial fibrillation. Atrial defibrillation (Afib) is a condition characterized by irregular and rapid electrical activity in the upper chambers of the heart. The standard procedure to treat Afib uses ablation to scar regions of the heart around the four pulmonary veins connecting to the left atrium to prevent electrical signals from reaching the atrium (i.e., preventing the short-circuit). Most of the procedure was spent mapping out the different regions of the heart using catheters with special electrode attachments that provide spatial cues of underlying electrical abnormalities. The mapping information helps guide the precise placement of ablation catheters during the procedure. It is critical that the 3-D model is accurate as the physician is working in millimeters when targeting specific areas within the heart. In the end, the procedure was a success, and the medical team was able to restore the patient’s heart rhythm and resolve the atrial fibrillation.

It was inspiring to see the medical team be composed of different professions such as electrophysiologist, nurse, cardiovascular technologist, and biomedical engineer, and yet, were able to harmoniously work together to make the procedure a success. After talking with members of the medical team, they emphasized how the 3-D mapping technology has drastically reduced the number of x-rays needed for ablation procedures. This makes the minimally invasive procedure safer for patients as they are subjected to less amounts of harmful ionizing radiation from x-rays. Overall, my experience this week reminded me of the vast applications that can come from imaging technology from aiding cardiovascular radiologists in diagnosing diseases to guiding electrophysiologists in treating heart arrythmias.  


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