Nationally ranked cardiology services in Ventura and Los Angeles counties
For more than 50 years, Los Robles Regional Medical Center has led the way in providing a full range of diagnostic and treatment options for all areas of cardiac and cardiovascular care, leading to the best outcomes for our patients. We are focused on heart health, from diagnosis of heart disease to management of heart failure and everything in between.
To find a Los Robles Regional Medical Center physician specializing in cardiac care, please call our Consult-A-Nurse® line at (877) 888-5746.
Services we offer
Our dedicated team of cardiologists and in-house cardiac surgeons offer the highest levels in heart care through interventional cardiology,electrophysiology and cardiac surgery. Our outcomes for heart care are consistently in the nation’s top 10 percent. Your cardiovascular physician or surgeon will choose the best approach to the treatment that is unique to you. From cardiac surgery to non-invasive testing and cardiac rehabilitation to management of atrial fibrillation and heart failure. We have opportunities to participate in various cutting edge clinical trials. We focus on your outcomes as a team and create the best treatment plan for your needs.
Conditions diagnosed and treated at Los Robles include:
- Structural heart and valve diseases
- Chest pain (angina)
- Management of Heart attack and Cardiac Arrest including Targeted Temperature Management
- Acute coronary syndrome through medical and percutaneous interventional and surgical care
- Management of Arrhythmias
- Heart failure Management
- Cardiovascular Risk Factor Identification and Disease Prevention
- Cardiac and Pulmonary Rehabilitation
- Congenital heart defects
Interventional cardiology is typically a non-surgical procedure that uses a catheter to repair parts of the heart like damaged vessels or narrowed arteries; however, there are some invasive procedures. Our technologies range from catheterization (or angiogram), angioplasty, intravascular ultrasound (IVUS), fractional flow reserve (FFR) and stent placement as well as balloon pump and the Impella® device to enhance the support of the heart.
Common conditions treated by interventional cardiology include coronary artery disease, heart valve disease, peripheral vascular disease (legs and kidneys), and carotid artery disease
Structural heart disease treatment
Advances in technology have spawned new minimally invasive procedures for treatment of structural heart diseases which occur when the structure of your heart becomes damaged or diseased. Think of the structure as the walls and beams that hold the heart together. When these structures become damaged, also known as aortic valve diseases, the heart has to work harder to pump blood and oxygen through the rest of the body.
Aortic valve disease
There are two main types of aortic valve disease – aortic stenosis (AS) and aortic regurgitation
Aortic stenosis: Aortic stenosis is a narrowing of the aortic valve opening that does not allow normal blood flow. In elderly patients, severe aortic stenosis is sometimes caused by the build-up of calcium on the aortic valve’s leaflets. Over time, the leaflets become stiff, reducing their ability to fully open and close. When the leaflets do not fully open, the heart must work harder to push blood through the aortic valve to the body. If the heart worked too hard, it can lead to heart failure.
Aortic regurgitation: In aortic regurgitation, the valve does not close tightly, leading to leaky valves and reversed blood flow from the aorta to the left ventricle causing the heart to work harder than it should. When severe, surgery may be needed to replace the valve.
Aortic valve disease treatment
Transcatheter Aortic Valve Replacement (TAVR)
If a cardiac surgeon determines you are at high-risk or too sick for open-heart surgery, and if medicine is not helping you feel better, TAVR allows a new valve to be inserted within your diseased aortic valve while your heart is still beating. This minimally invasive surgical procedure repairs the valve without removing the old, damaged valve. Instead, it wedges a replacement valve into the aortic valve’s place.
The TAVR approach delivers a fully collapsible replacement valve to the valve site through a catheter. Once the aortic valve replacement expands, it pushes the old valve leaflets out of the way and the tissue in the replacement valve takes over the job of regulating blood flow.
Usually valve replacement requires an open-heart procedure with a “sternotomy,” in which the chest is surgically open for the procedure. The TAVR procedure can be done through very small openings that leave all the chest bones in place.
The TAVR procedure is performed using one of two different approaches, allowing the cardiologist or surgeon to choose which one provides the best and safest way to access the valve:
- TAVR procedure can be performed by entering through the femoral artery (large artery in the groin), called the transfemoral approach, which does not require a surgical incision in the chest.
- TAVR surgery can be performed by using a minimally invasive surgical approach with a small incision in the chest and entering through a large artery in the chest or through the tip of the left ventricle (the apex), which is known as the transapical approach.
Mitral valve disease
There are two types of mitral valve disease – mitral regurgitation and mitral stenosis. Mitral valve disease prevents proper flow of the blood through the heart.
Mitral regurgitation: The most common heart valve disorder is mitral regurgitation, where the mitral valve does not close properly causing blood to flow backwards to the upper heart chamber to the lungs reducing the amount of blood flowing to the rest of the body. This places undue pressure on the lungs. When the heart works harder to pump blood, the lungs are strained which can lead to shortness of breath, irregular heartbeat, high blood pressure, stroke and congestive heart failure. When sever, surgery or a catheter-based treatment may be required to replace the valve.
MitraClip - MitraClip is a newer treatment performed through a small whole in groin. In the procedure a heart valve clip is inserted through the catheter and clips together the leaflets (or flaps) of the valve that are not coming together properly. In some cases the Mitra Clip may also be considered in patients with Tricuspid Disease as well.
Mitral balloon valvuloplasty – this procedure is prescribed when the heart valves opening is narrowed. In this case, the leaflets may have become stiff or thick and fused together (also known as stenosis). In this procedure, a balloon is inserted through a catheter and inflated. This alleviates the narrowing and allows blood to flow across the valve more freely.
Non-valvular atrial fibrillation (AF) is an irregular heartbeat that can lead to blood clots, stroke, heart failure and other heart-related complications. AF is the most common cardiac arrhythmia, currently affecting more than five million Americans.
Left Atrial Appendage occlusion
Los Robles was among the first hospitals in the region to offer patients with non-valvular atrial fibrillation (AF), an alternative to long-term warfarin medication with a new left atrial appendage occlusion (LAAO) device. Research has proven that the LAAO device is an alternative for stroke-risk reduction in patients with non-valvular atrial fibrillation (AF).
The LAAO device is intended for transcatheter left atrial appendage (LAA) closure through the skin. Patients with non-valvular atrial fibrillation who are at increased risk for stroke and systemic embolism, are suitable for warfarin and seek a non-pharmacologic alternative to warfarin may be eligible for a left atrial appendage ligation. By closing off the LAA, a thin, sack-like appendix arising from the left side of the heart that is believed to be the source of a majority of stroke-causing blood clots in people with non-valvular AF, the risk of stroke may be reduced and, over time, patients may be able to stop taking warfarin.
Learn more about stroke and our comprehensive stroke center.
Electrophysiology (EPS) is a diagnostic procedure that examines the electrical function of your heart. Our electrophysiologist physicians use this procedure to examine your heart rate, which assist in the treatment of abnormal heart rhythms.
The majority of procedures, including pacemakers, implantable cardioverter defibrillators (ICD) and catheter and epicardial ablations are done with minimally invasive techniques on an outpatient basis. We are also happy to provide implantable loop recorders, cardiac resynchronization therapy (CRT), 3D mapping and laser lead extraction.
Implantable/Injectable Loop Recorders
- A loop recorder is a small device that is implanted or injected below the skin of the patient's chest.
- Measuring no larger than a pack of gum, this powerful device can record any arrhythmias for up to 3 years.
- A pacemaker is a device that regulates the beating of the heart by delivering an electrical impulse through electrodes connected to the heart muscle.
- This device will "pace" the heart rate when it senses your heart is too slow (Bradycardia) and / or it will take over from the heart's natural pacemaker when it is functioning improperly.
- Patients implanted with a pacemaker can expect a quick recovery and return to their previous activity level.
Implantable Cardioverter Defibrillators (ICD)
- The ICD device is slightly larger than a pacemaker and monitors the heart for abnormal heart beats which are considered "lethal".
- This device is implanted in patients at risk for sudden cardiac death. The ICD is capable of delivering an internal shock, directly into the heart muscle, when it senses that the heart is in either a rhythm called ventricular tachycardia or ventricular fibrillation.
- This device will help to convert the heart rhythm back to normal. The ICD can also function as a pacemaker if necessary.
Cardiac Resynchronization Therapy (CRT)
- CRT devices are either pacemakers or defibrillators with an extra lead attached which can pace both ventricles of the heart.
- This device can be programmed to help the ventricles of the heart to synchronize and improve cardiac function.
- This device has been shown to reduce mortality and improve the quality of life in patients with Congestive Heart Failure and a low ejection fraction.
- An arrhythmia is often caused by cells in the heart that "misfire" or change the normal electrical conduction to an abnormal electrical conduction. This misfiring can cause dizziness, shortness of breath, and chest pain. Your physician may prescribe medications to control the abnormal conduction. Common arrhythmias include atrial fibrillation, supraventricular tachycardia and ventricular arrhythmias
- An ablation may be recommended to you when medication fails to control the abnormal rhythm.
- Catheter ablation uses a series of thin, flexible wires (catheters) that are inserted through an artery or vein and guided to the heart.
- Once the Electrophysiologist has made sure you are in the abnormal rhythm, a 3-D map is created showing us the abnormal rhythm's type and location.
- Using the map as a guide, the Electrophysiologist places the catheter in the correct area and destroys the problem cells with a very small and focused radiofrequency wave.
- The Electrophysiologist will then try to induce the abnormal rhythm to make sure that the problem cells are no longer causing a problem. Once we find that there is no longer a problem we consider the procedure successful.
- Cryoballoon catheter ablation represents an alternative to traditional RF energy ablation associated with similar outcomes for paroxysmal AF patients but with shorter procedure times and less radiation exposure.
3-Dimensional Mapping of the heart
- 3-D maps of the heart and its chambers are created in "real time" to help visualize the source and path of the arrhythmia. At our facility we have both the Velocity and Carto 3 mapping systems. Equipped with the latest software, they aid our team in seeing the structures of the heart so we can position the catheters within 1mm accuracy of the problem cells.
- Improved visualization helps reduce x-ray exposure as well as significantly decreasing the length of the procedure.
3 Dimensional Intra Cardiac and Transesophageal Echocardiography (TEE and ICE)
- An ICE catheter is a small ultrasound device placed within the heart. ICE provides clear information about the structure of the heart as well as the position of the catheter.
- With our high resolution pictures that we get with ICE, the Electrophysiologist is able to cross between atrial chambers safely and efficiently. By minimizing the potential for complications, the Electrophysiologist can focus on the task of ridding the heart of the problem cells.
Los Robles Regional Medical Center is proud to offer full cardiovascular surgical services in Ventura County, California. Our team of cardiovascular surgeons has substantial expertise to care for our patients and our community. Skilled in both on-pump and off-pump procedures, we are proud to have some of the best outcomes in cardiovascular surgery.
Coronary artery bypass surgery (CABG)
CABG is an invasive surgical procedure, which will allow your cardiovascular surgeon to bypass, or graft, a blockage you have in one of your coronary arteries with a blood vessel from another part of your body. The vessels chosen by the surgeon to use as the bypass graft will depend on what you have available and could come from your leg, your arm or an artery called the internal mammary, which comes from your chest wall.
Valve surgery is an invasive surgical procedure, which will allow your cardiovascular surgeon to repair any of your four heart valves. These valves—the tricuspid valve, pulmonary valve, aortic valve and mitral valve—keep blood flowing in the correct direction.
Other Cardiovascular surgeries
- Combination bypass and valve surgeries
- Aortic aneurysm repair
- MAZE procedures for atrial fibrillation.
Carotid Artery Stenosis is a narrowing in the carotid artery usually caused by a buildup of plaque.
Much like coronary artery stents, carotid stents are made of metal and are permanently placed in the carotid artery at the point of the narrowing. Stents are inserted on a balloon catheter, and expanded in place to open the blockage in the carotid artery. Additionally, we provide procedures such as angiography and angioplasty.
Non-invasive cardiovascular testing
Our non-invasive cardiovascular testing departments are designed to assist the physician in gathering information about the patient to assess cardiac or vascular functioning. These departments include electrocardiogram (EKG or ECG), echocardiography and vascular ultrasound.
In our EKG department, you can receive one of the following cardiac tests:
- 12-lead EKG: A 12-lead EKG is a recording of your heart's electrical signals as recorded on paper. This recording will give your physician information to show any potential problems with the electrical system of your heart. Sometimes a physician may want to see more than what a 12-lead EKG test can show and will order a holter monitor or an event monitor for you to wear for a longer period of time.
- Tilt table test: A tilt table test is done to give your physician more information if you are experiencing fainting, also known as syncope. During the exam, the physician may try to recreate the symptoms you have when you faint in order to provide proper diagnosis and treatment.
- Stress test: Stress tests allow your physician to see how your heart is responding to exercise. This test uses a treadmill or medication to speed up your heart rate. At times, an echocardiogram will be performed to give the physician ultrasound images to see how your heart is working when exercising.
In our echocardiography department, you can receive heart tests that will give your physician information about how well you heart is working. These ultrasound images give clear pictures of the walls, chambers and size of your heart. Our clinical staff is certified to provide the best imaging possible. These ultrasound tests include:
- TEE exam: The TEE exam is completed when your physician wants to have a closer look at your heart from inside your esophagus (or throat). These ultrasound images can give your physician information about diagnosing and treating diseases, infections or problems with the walls or chambers of your heart.
Vascular ultrasound department
In our vascular ultrasound department, you can receive testing which will give your physician information about the vessels of your body, including your brain vessels and the carotids in your neck all the way down to your lower legs. These ultrasound images help to show how fast your blood is moving through your vessels. Additionally, our clinical staff also performs an exam looking for peripheral arterial disease (PAD) called an ankle-brachial index test (ABI). Our clinical staff is specialty certified to provide the best imaging possible. Vascular imaging will give your physician information about diagnosis and treatment options for possible blockages, aneurysms, tears, blood clots and varicose veins.
Our cardiologists and registered nurses are here to reduce the impact of cardiovascular disease within Ventura County. Our cardiac rehabilitation program is designed to aid our patients back into a productive, active lifestyle after a heart attack or heart surgery. Visit our cardiac rehabilitation page for a more information about our cardiac rehab program.
Our cardiovascular research team and physician leaders are integral to the process of improving the lives of those in our community using leading edge techniques, medicines and processes. Our team members are also trained and certified by the National Institute of Health.
We conduct several studies and clinical trials, many of which have been affiliated with major research institutions such as Yale and Duke, on topics including:
- Young women and heart disease
- Anti-platelet therapy after stent placement
- New options for stroke treatment
- New options for heart failure treatment
- Non-surgical options for carotid artery stenosis