And while there is no cure for matters involving the latter, Danbury Hospital is increasingly able to treat the former, which is a form of cardiac arrhythmia, or abnormal, uneven heart rhythms.

With two new electrophysiology specialists -- Drs. David Rubin and Robert Winslow -- added to the staff of the hospital's Praxair Regional Heart and Vascular Center, the hospital can now do radiofrequency ablation to treat certain types of arrhythmias.

With Rubin and Winslow, the Praxair Center now can do every type of cardiac procedure -- open heart surgery, valve replacements, angioplasty, and the installation of pacemakers and defibrillators -- short of heart transplants. It is a full cardiac center.

"For the last year, we've worked to complete this," said Dr. Andrew Keller, chief of cardiology at the hospital. "This is the last piece we needed to create an advanced cardiac program here."

After opening in 2005 -- after a long battle to win state approval for a cardiac center in western Connecticut -- the Praxair Center has won national recognition for excellence. HealthGrades -- the leading independent health care rating organization in the United States -- has given it a five-star rating. Only five hospitals in the tri-state area received this rating, out of 63 that offer advanced cardiac care.

"We have had zero mortality for the patients treated here," Keller said. "You can't do better than zero."

Keller said there is no advanced cardiac care center within a 19-mile radius around the hospital, a circle that includes parts of New York State, parts of New Haven county and most of Fairfield County.

"Only three hospitals got a five-star rating from HealthGrades for open heart surgery in the New York metropolitan area," Keller said. "The other two are in New Jersey."

To ensure the highest quality for its cardiac program, the hospital worked extensively with the Cleveland Clinic to train its staff. After deciding to offer cardiac ablation procedures, the hospital did the same thing using Columbia University Medical Center. Dr. David Rubin, who teaches at Columbia, will begin working at Danbury Hospital two days a week as part of this program; Winslow will be at the hospital full time.

Rubin, 57, said the university has asked him to set up similar programs at other hospitals.

"My favorite has been Danbury, because there's a lot of guys from Columbia there," Rubin said.

Winslow, 34, hails from Harvard University by way of Brigham and Women's Hospital in Boston, where he trained in radiofrequency ablation.

Both men said they liked the idea of setting up a new program at a hospital. They also like the location -- Rubin lives in Westchester County, while Winslow's mother lived there.

"This was a family decision," Winslow said. "My wife and I know the area and we like it."

"It's very nice driving north on 684 in the morning to Danbury and seeing all the traffic heading south to New York City," Rubin said.

"Everyone there works together, everyone wants to make things better," Rubin said. "That's why the hospital is doing so well."

"There's nothing other cardiac centers offer that we can't offer now," Keller said. "Except with us, you don't have to drive as far."

The term arrhythmia is a general one, covering any skipped heartbeats or heart rhythms that slow down or speed up. About one in four adults in the United States experience such arrhythmias as they get older.

"You can feel palpitations, or lightheadedness," Winslow said. "You can feel faint, or even pass out."

Some of the medical conditions that cause arrhythmias are congenital -- people are born with them. Others develop over time, Winslow said.

"We don't know why," he said.

Most arrhythmias don't need to be treated. But if symptoms persist and prevent people from leading normal lives, doctors can step in to help.

There are several things doctors can do to treat chronic arrhythmias, including the use of medication and implanting devices like pacemakers or small defibrillators that send an electrical charge to the heart to keep its beat steady. Sometimes they use cardioversion -- a stronger electric shock -- to get all four chambers of the heart beating in synch again.

But for certain types of arrhythmias, ablation can be the best choice of treatment, with a success rate of 90 to 95 percent.

"There are enough of these cases to make me always late for dinner on Mondays and Thursdays," Rubin said.

Ablation starts with an electrophysiology study. To do this, Rubin said, doctors first thread three electric probes to the heart via a blood vessel in the groin. Using them, doctors can find the spot in the heart that's not receiving and sending electric impulses properly and causing the rest of the heart to go offbeat.

"These spots can't be seen with the naked eye," Rubin said. "They're microscopic."

Once doctors locate the spots, they remove the electric probes and insert a second catheter to the heart. Using laser-like radiofrequency energy, they burn the faulty spots away and the heart begins beating normally again.

Winslow said using radiofrequency ablation means that the patient will be cured of the arrhythmias. That means they don't have to be on a lifelong regimen of medication. They also don't have to go to a cardiologist as frequently or rush off to the emergency room because their heart is out of synch.

"You find that area and get rid of it and 90 percent of the time, the arrhythmia is gone," Winslow said.

He said it's a procedure hospitals will be using more often -- in part because the technology and training for it has improved and in part because, as people age, they develop arrhythmias more often.

Contact Robert Miller


or at (203) 731-3345.