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Electrophysiology

The heart has an electrical system that produces tiny electrical impulses. These impulses travel from the upper to the lower chambers of the heart and tell the chambers to contract and pump blood. However, sometimes this electrical system may not be functioning properly.

When this happens it is necessary to study the electrical system with an intracardiac (within the heart) electrophysiologic procedure. In this procedure, one or more catheters (long, thin, flexible tubes) are placed into a blood vessel in the legs, arms or both. The tips of the catheters are strategically placed into the heart where they record the electrical signals. The precision of this procedure far exceeds that of an ordinary electrocardiogram (commonly referred to as an ECG or EKG).

Procedures

Tilt Table Test

This can help determine how your body responds to changes in position, in the event that you have had recurrent syncope (fainting spells).  During the test, you lie on a table that can be moved to a nearly upright position while your symptoms, heart rate, and blood pressure are continuously monitored.

Arrythmia Evaluation

This test is preformed when the heart’s electrical system appears to not be working properly. This can cause abnormal abnormal heart rhythms, called arrhythmias. During an arrhythmia, the heart may beat too fast, too slowly, or irregularly. This is a fairly frequent occurence affecting as many as 2.2 million Americans are living with atrial fibrillation (one specific type of rhythm  problem). Arrythmias can occur in a healthy heart and be of minimal consequence while some may indicate a very serious problem. These problems can lead to heart disease, stroke, or even sudden cardiac death.

Types of Arrhythmia

The four main types of arrhythmia are:

  • Premature (extra) beats: Too-early heartbeats that disrupt your heart’s rhythm; may occur in the upper chambers (premature atrial contractions) or the lower chambers (premature ventricular contractions) and usually need no treatment.
  • Supraventricular arrhythmias: Fast heart rates  that start in your heart’s upper chambers, including atrial fibrillation (AF or a-fib), atrial flutter, paroxysmal supraventricular tachycardia (PSVT), and Wolff-Parkinson-White (WPW) syndrome.
  • Ventricular arrhythmias: Arrhythmias that start in the heart’s lower chambers (ventricles), including ventricular tachycardia and ventricular fibrillation (VF or v-fib).
  • Bradyarrhythmias: A heart rate that’s slower than normal, resulting in not enough blood flow to the brain.

Catheter Ablation

Catheter ablation is used to treat some types of arrhythmia (irregular heart rate or rhythm.) During catheter ablation, a series of catheters (thin, flexible wires) are inserted into your heart through a blood vessel in your groin or wrist. A special machine sends radiofrequency energy through the catheter to tiny areas of the heart muscle that cause the abnormal heart rhythm. The energy destroys and “disconnects” the pathway of the arrhythmia.

Pacemaker

A pacemaker is a small devise placed in the chest to help control arrhythmia (abnormal heart rate or rhythms). It sends electrical impulses to the muscle to prompt the heart to beat at a normal rate. A pacemaker may also be used to relieve some arrhythmia symptoms, such as fatigue and fainting spells.