An electrophysiology (EP) study is done by a specially trained cardiologist, known as an electrophysiologist. During this procedure, the heart’s electrical system is “mapped�? to determine if there is any abnormal electrical pathway that is causing an arrhythmia. The electrophysiologist uses special “electrode catheters�? to record the heart’s electrical activity and to “induce�? (make happen) certain arrhythmias in order to determine its exact location of origin. The following electrophysiology procedures may then be performed to prevent the arrhythmia from reoccurring. In some cases, the arrhythmia comes back and the patient may require second, or possibly more attempts to “cure�? the arrhythmia.
Catheter Ablation
This procedure is performed by placing a catheter at the site of the abnormal pathway. Then, radiofrequency energy (heat) is passed through the catheter. The tip of the catheter heats up and “ablates�? or destroys, the small area of tissue causing the abnormal pathway.
Electrocardioversion
During this procedure, the person’s heart is given a brief shock to convert the abnormal rhythm back to a normal rhythm.
Pacemakers
A pacemaker is a small electronic device for people whose heart beats too slow or pauses too long in between heartbeats. It is implanted in a patient’s upper chest, just below the skin. It has one or two leads (thin wires) that carry electrical pulses to the heart to maintain a healthy rhythm. The leads also track a patient's own heart rhythm and stores this information in the pacemaker. Pacemakers are used to correct dangerously slow heart rhythms. Doctors implant the pacemaker typically while the patient is under local anesthetic. The “pulse generator�? (pacemaker battery) lasts anywhere from 2 to 10 years and may need to be replaced from time to time. A patient's doctor monitors pacemaker function during routine check-ups to ensure that everything is working well.
Defibrillators
Defibrillators, also known as ICD’s (implantable cardioverter defibrillator), are used to correct abnormally fast heart rhythms called tachycardias. The defibrillator works much like a pacemaker. It is implanted into the patient's chest or abdomen under local anesthesia. Then one or more leads (thin wires) are inserted into a vein and ultimately placed inside the heart. Once in place, if the defibrillator senses a very rapid heart rhythm, it sends an electrical current to restore the heart's normal rhythm. A patient's doctor monitors defibrillator function during routine check-ups to ensure that everything is working well.
Cardiac Resynchronization Therapy (CRT)
If a person’s heart is not beating “in synch,�? commonly associated with conduction abnormalities and congestive heart failure, a CRT device may be prescribed to help the heart beat in a coordinated fashion, which, in turn, will make the heart beat more efficiently. The CRT device is actually a type of pacemaker, but instead of just one lead in the patient’s left ventricle, a CRT has leads in both the right and left ventricle, as well as one lead in the atrium. Some CRTs also have a defibrillator function. These are known as bi-ventricular ICD’s.
California Cardiac Institute
