What is Electrophysiology?
Electrophysiology refers to the diagnosis and treatment of abnormal heart rhythms (arrhythmias). Your heart rate is controlled by a natural electrical system that tells your heart when to beat. Electrical signals usually travel through the heart in a regular pattern. If that electrical system is not functioning properly, your heart rate can be too slow, too fast or simply uneven.
What are the Symptoms of Arrythmia?
Changes in heart rhythm may be a consistent problem or may occur occasionally. If your heart is beating at an improper or uneven rate, you may feel symptoms such as dizziness, lightheadedness, shortness of breath, fatigue, confusion or fainting spells. It is likely that these symptoms are more noticeable when you are physically active.
What Tests do Electrophysiologists Use to Diagnose Arrhythmia?
Electrophysiologists use many different types of diagnostic tests to detect, diagnose and monitory heart rhythm disorders. Among the most commonly used tests for arrhythmia are:
- Holter Monitor - A Holter monitor is a small, portable electrocardiogram that a patient wears in order to record 24 hours or more of heart activity. Patients may be asked to notate their activities and symptoms while wearing the monitor. Later, this data will be reviewed and interpreted by an EP.
- Transtelephonic Monitor - Trastelephonic monitors are “event monitors” that are worn over a period of 1 to 2 months to capture activity related to a suspected arrhythmia that tends to pass quickly or that occurs infrequently. These devices may be worn with a finger clip, a bracelet or patches on the skin located beneath the arms.
- Treadmill Testing - Commonly known as a “stress test,” a treadmill test is useful in monitoring and diagnosing suspected arrhythmias that occur during physical exertion such as exercise. During the study, patients will walk or run on a treadmill or use a stationary bike as their heart rhythm is actively monitored.
- Electrophysiology Studies - Electrophysiology studies test the electrical activity of your heart to find where an arrhythmia (abnormal heartbeat) is coming from. These results can help you and your doctor determine the best course of treatment. These studies take place in a special room called an electrophysiology (EP) lab or catheterization (cath) lab while you are mildly sedated.
- Echocardiogram - Echocardiogram measures the heart’s size and motion with the use of ultrasound waves. By using a handheld Doppler and monitor, technicians are able to capture real-time images of the heart pumping which can then be reviewed and interpreted by the physician.
What are the Different Types of Arrhythmias?
Arrhythmias are classified based on their location within the heart and how they affect the heart’s rhythm:
Arrhythmias Originating in the Atria (top chambers of the heart)
- Premature / Extra Beats – The most common form of arrhythmia, premature beats are often asymptomatic. When they occur in the atria, they are called premature atrial contractions (PACs).
- Supraventricular Arrhythmia – These arrhythmias are fast heart rates (tachycardias) that either begin within the atria or the atrioventricular node located between the atria and ventricles. Within this category are several recognizable forms of arrhythmia, including:
- Atrial Fibrillation (AFib)
- Atrial Flutter
- Paroxysmal Supraventricular Tachycardia (PSVT)
- Wolff-Parkinson-White (WPW) Syndrome
Arrhythmias Originating in the Ventricles (bottom chambers of the heart)
- Ventricular Tachycardia – These are fast, irregular heartbeats within the heart’s ventricles. Typically these episodes are very brief, but those that last longer (more than a few seconds) may pose a danger to the patient.
- Ventricular Fibrillation (VFib) – Disorganized electrical signals cause the ventricles of the heart to quiver erratically during VFib. Because the chambers are not pumping blood as they should, these episodes can become life threatening in a matter of minutes. Immediate treatment with defibrillation is necessary.
- Bradyarrhythmias – Not all arrythmias result in a heartrate that is too fast. Bradyarrhythmias cause the heart to beat too slowly which can impede oxygen flow to the brain. A heart rate of less than 60 bpm in an adult is considered bradyarrhythmia.
- Sinus Arrhythmia - Arrythmias that occur during breathing are known as sinus arrhythmias. This is a common condition in both children and adults.
- Sinus Tachycardia – Electrical signals from the sinus node influence heartrate. When these signals come to quickly, the heart beats too quickly. Common causes of sinus tachycardia include exercise, medication, fever, and overactive thyroid gland.
What Arrhythmia Treatments do Electrophysiologists Provide?
Depending on the type and severity of a patient’s arrhythmia, there are many potential treatment options that an electrophysiologist may provide, including:
– These can include antiarrhythmic drugs, beta-blockers, calcium channel blockers and anticoagulants.
Ablation – Catheter ablation is a low-risk procedure in which a catheter is used to apply radiofrequency energy, extreme heat or extreme cold to the tissue responsible for the erratic electrical impulses causing the arrhythmia.Devices – Devices used to help control arrhythmia monitor the heart’s activity continuously and provide correction when problematic heart rhythms occur. These devices include pacemakers and implantable cardioverter defibrillators.