Electrophysiology is the study of heart rhythm disorders

Cardiac electrophysiology is the science of diagnosing and treating the electrical activities of the heart. In practice, it is all about abnormal arrythmic symptoms, their causes, and their treatments. The studies involved can be invasive and non-invasive.

As a first line of treatment, non-invasive studies are preferred. Common non-invasive treatments can be drug therapies,
Invasive treatment- electrophysiology studies such as implantation of pacemakers and automatic implantable cardioverter-defibrillators (AICD).

Who is an Electrophysiologist?

An electrophysiologist is a medical doctor that upon completing medical school and a general practice internship and residency, has also completed a cardiology internship and residency and additional 1-2 year electrophysiology fellowship.

Out of the 20,000 practicing cardiologists, there are only 2,000 board-certified electrophysiologists (American College of Cardiology, 2003).

When to see an electrophysiologist

Electrophysiologists determine whether an individual is in a group that is at high risk for SCD or other cardiovascular diseases.

A number of tests may be performed including:

Echocardiogram. In this painless, noninvasive test, a device called a transducer is placed on the chest and sound waves are bounced off the heart. This provides a moving picture of the heart.

Holter monitors are external devices that are worn by an individual who may be at risk for heart disease. The monitor automatically records a continuous electrocardiogram (ECG) of the heart’s electrical activity; it usually is worn for 24 to 48 hours.

An event recorder is a small, pager-sized device that also records the electrical activity of the heart. Unlike a Holter monitor, it does not operate continuously, but instead is activated by the individual whenever he or she feels the heart begin to beat too fast or chaotically. After the device is activated to record the heart rhythm, the patient can report the event and transmit the recording by phone to his doctor or other health care provider.

An electrophysiology study (EPS) is a test that can help predict if an individual is at high risk for sudden cardiac death. Signals are administered to the heart muscle in patterns to see if they will stimulate ventricular tachycardia (VT). The test is performed in a safe and controlled electrophysiology laboratory at a hospital or clinic and the patient is in no danger. In an EP study, local anesthetics are used to numb areas in the groin or near the neck, and small catheters are passed into the heart to record its electrical signals.

During the study, the physician studies the speed and flow of electrical signals through the heart, identifies rhythm problems and pinpoints areas in the heart’s muscle that give rise to abnormal electrical signals.

An electrophysiology study can:

Identify which patients have had a prior heart attack, or MI, and are at risk for serious ventricular arrhythmias and, perhaps, Sudden cardiac death.

Help determine which patients may require aggressive treatment to prevent sudden cardiac death.

identify individuals whose hearts cannot be induced into dangerous arrhythmias.

Identify factors in a patient developing spontaneous, sustained VT that can lead to ventricular fibrillation and sudden cardiac death.

Aortic Stenosis

Aortic stenosis (AS) is a condition in which the aortic valve has become narrowed or constricted and does not open-and-close properly. Many times, calcium deposits in the blood can build up on the aortic valve, causing a hardening (calcification) of the valve and, as a result, aortic stenosis.