What is cardiac electrophysiology?
All heart activity is regulated by cardiac electrophysiology stimuli. The area called the sinoatrial node produces electrical impulses that stimulate the rest of the heart muscle to contract rhythmically. Problems with the heart’s electrical system can contribute to arrhythmia (abnormal heart rhythms).
While some types of arrhythmia are not serious, others can lead to cardiac arrest, heart disease problems, and other life-threatening conditions. When the heart needs medical help, structural problems sometimes require a “mechanic” or a “plumber” to fix circulatory problems. In other cases, you may need an “electrician” or a cardiac electrophysiologist.
Syncope expert assessment and management of sudden loss of consciousness, which is sometimes associated with a heart rhythm disorder. Treatment of abnormally fast heart rhythms with pharmaceuticals, cardiac electro auto, or ablation therapy.
Management of atrial fibrillation, which is the most common cardiac arrhythmia in adults in the United States. This condition is associated with impaired physical function, thromboembolic stroke, and heart failure. Our cardiac electrophysiologists offer multiple treatment options (individual and in combination) including specialized medical management, catheter ablation, electro-nautical alignment, and left atrial appendage closure.
Dynamic electroanatomic mapping to guide catheter-based interventions to replace or remove defective tissue that causes abnormal heart rhythms. Setting up a pacemaker or coordinating electrical impulses in the heart to treat unacceptable slow or unreliable heart rates. Placement of defibrillators for the treatment of dangerous heart rhythms and the restoration of a healthy heart rhythm.
Understanding cardiac electrophysiology
It is important to understand how the heart’s electrical system works. The heart muscle contains specialized cells that can produce electrical impulses. In healthy hearts, these impulses propagate in a reversible pattern, causing the heart muscle to contract and pump blood. However, if you have a heart rhythm disorder or arrhythmia, the electrical signals do not travel throughout the heart muscle.
Electrophysiology studies (EPS) are done to evaluate the electrical activity of your heart. By using special catheter tubes that can transmit electrical impulses, doctors can see where electrical signals begin and travel in your heart. This will help them identify the exact area of your heart that is the source of the problem.
If your doctor decides where your arrhythmia starts, he or she can treat your condition in the same way. In many cases, doctors destroy a small area of tissue in the heart that causes arrhythmia in a low-risk procedure called catheter ablation. Depending on the type of rhythm disorder you have, your doctor may set up a pacemaker or implantable cardiovascular defibrillator (ICD) to monitor and correct your heart arrhythmia when it begins.
Techniques performed by specialists in cardiac electrophysiology
A cardiac electrophysiologist can perform a variety of tests to diagnose problems with the electrical activity of the heart, including:
Electrocardiogram: An electrocardiogram measures the electrical activity of the heart through electrodes placed on the skin.
Tilt table test: Designed to detect problems associated with dizziness or fainting, you must lie on the table while monitoring the EKG and blood pressure monitor for the bow table test. The table stands out from the lie, and the cardiologist describes the changes in heart activity and blood pressure.
Ambulatory monitors: Your heart specialist may ask you to wear a special heart monitor attached to your chest throughout the day, which will give you a better idea of potential problems with heart function.
Electrophysiology study: During an electrophysiology study, the cardiologist makes a small puncture in the blood vessel, which allows small catheters to be placed in the heart. Patients are awake during the procedure, although they receive local anesthesia to prevent pain at the catheter insertion site. The doctor sends information about the origin of the arrhythmia through electrical catheters through catheters.
Cardiac electrophysiology treatments
- Holter monitor
- Cardiac event monitor
- Tilt table test
- Electrophysiology study
Your treatment will depend on the type and severity of the arrhythmia (depending on where it occurs and how it affects your heart rhythm). These treatments can include:
Lifestyle changes: Reducing or eliminating triggers such as alcohol, certain medications, caffeine, and stress can ease the arrhythmia on its own (persistent arrhythmia).
Medications: Antiarrhythmic medications, such as calcium channel blockers, beta-blockers, and blood thinners (such as aspirin or warfarin), can help control abnormal heart rhythms. Actions need careful monitoring to prevent side effects, and you may need other tests to see if this treatment is working.
Catheter procedures: Long, flexible leads to enter the heart and stop the arrhythmia at its source, often to cure the arrhythmia. These minimally invasive procedures include cutting abnormal power lines using radiofrequency heat (catheter ablation) or coagulation therapy (known as cryotherapy or cryoablation).
Robotic catheterization and surgery: Specialized system for catheter-based mapping of the chambers of your heart. The system allows for more precise and consistent catheter movement during complex cardiac procedures.
Cryoablation: This procedure restores normal electrical conduction by clotting the heart tissue or pathways that block the normal movement of electrical impulses from the heart.
Cardioversion: If your heart is beating too fast, cardiac electrophysiology can apply an electrical shock to the chest wall to restore normal heart rhythm.
Equipment for the treatment of arrhythmias and atrial fibrillation (AFib) As part of your treatment plan, your doctor may recommend an implantable device:
Monitoring device: People with atrial fibrillation are at increased risk of stroke because clots form in the chambers above the heart. The Watchman device can reduce this risk and provide an alternative to blood-thinning medications such as warfarin (which prevents clotting).
Pacemakers: We use pacemakers to treat slow heartbeats. The device sends electrical impulses to the heart to maintain an optimal heart rate.
Implantable cardioverter-defibrillator (ICD): This device corrects malignant arrhythmia in the heart’s ventricles (the lower chambers that send blood to the rest of the body). The ICD monitors your heart rhythm and interrupts dangerous arrhythmias by giving an electric shock.
Life west: This temporary external body device detects and counteracts malignant heart rhythm abnormalities.
- Example of an x-ray showing a pacemaker
- Living with an adjustable device
After you have received the mountable device, you need to take more precautions to ensure that it works properly.