Cardiac Electrophysiology

Cardiac electrophysiology is the science of identifying, diagnosing then treating the electrical activities of the heart. The study of cardiac electrophysiology measures responses of cardiomyopathic or injured myocardium to programmed electrical stimulation (PES) on particular pharmacological regimens to assess the likelihood that the regimen will successfully prevent potentially fatal sustained ventricular fibrillation (VF) or ventricular tachycardia (VT). Procedures in this field increasingly include therapeutic methods such as radiofrequency ablation as well as diagnostic or prognostic procedures. Being a relatively new sub-discipline of cardiology and internal medicine, only having been developed in the 1970s, cardiac electrophysiology was granted its own specialty category in the United States in 2011 as promoted by the Centers for Medicare and Medicaid Services.

Cardiac electrophysiology tests are performed to determine the cause, origin and best treatment for abnormal rhythm by recording the electrical pathways to the heart. During the study, your electrocardiologist will safely reproduce your abnormal heart rhythm and may start you on a different medication to determine which drug works best to control your arrhythmia.

Specialists who work in this field are referred to as cardiac electrophysiologists and usually require two or more years of fellowship training beyond that of the general cardiologist. Cardiac electrophysiologists are educated to perform surgical device implantations as well as studies of interventional cardiac electrophysiology. They can also use EPS to determine if your medications are effectively treating your arrhythmia, see if a pacemaker or ICD may help you or see if you are at risk for cardiac arrest.

During the procedure, a sedative is given to aid in relaxation and after being given a local anesthetic, the doctor will puncture the skin, enter a blood vessel then gently guide several specialized EP catheters into the vessel and advance them to the heart. The doctor then sends electric pulses to the heart via the catheters to make the heart beat at different speeds and you may feel your heart beat faster or stronger. The signals produced by the heart are then transmitted through the catheters and recorded, a process called cardiac mapping which allows doctors to locate the source of the arrhythmia.

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