Hospitals across the nation are adding electrophysiology services to their cardiovascular lines with increasing speed. Patients who had previously been treated by medications or pacemakers for their cardiac arrhythmias are now learning the word “electrophysiology” and are wondering what it can do for them. So what is electrophysiology and why is it important?
Electrophysiology, if broken down into root words, would mean electricity of the body. Typically this term refers to the study of the electrical impulses of the heart. The human heart has an internal pacemaker or time keeper. This pacemaker controls the contractions of the heart which pumps throughout the body. If these electrical impulses are inaccurate, either by coming too fast or too slow, the way the heart pumps oxygenated blood to the body will be affected. This condition will often manifest itself with a variety of symptoms including fatigue, dizziness or shortness of breath.
Many people suffer from cardiac arrhythmias, or irregular heartbeats, that interfere with their daily activities. Common arrhythmias include bradycardia, or slow heartbeat and tachycardia or fast heartbeat. The advancing field of electrophysiology offers patients alternatives to daily medication or implantable devices. Some patients can be effectively cured of their conditions through a single electrophysiology procedure.
An electrophysiologist, or heart rhythm doctor, can perform a number of procedures to correct these and other electrical problems within the heart. Diagnostic testing like 3D cardiac mapping can detect electrical abnormalities. The electrophysiologist will insert catheters (thin flexible wires) into the heart to detect the electrical activity from the inside. Sophisticated instrumentation will allow a wide array if information to be gathered regarding the heart. 3D images can be created, impulses can be viewed, mapped and timed. These procedures are very intricate and require the greatest precision, which is why they tend to be time consuming. Patients are usually kept awake with conscious sedation, but must remain completely still in order for the data gathered to be useful. In order to detect the abnormalities, they must be present during the procedures. If they are not, the electrophysiologist will induce them so that they can be captured and studied. Once detected, treatments include ablation, or scarring of the area and the implantation of devices such as defibrillators and pacemakers.
Ablation is a procedure is which areas causing stray electrical impulses are burned, creating new pathways for the impulses. Much like redirecting traffic via a roadblock on a roadway, radiofrequency energy is used to scar the area where a stray circuit has been created. By scarring this and other affected areas, a new pathway for the electrical impulses is created, thus curing the arrhythmia.
Electrophysiologists also implant devices to relieve patients of arrhythmias. Pacemakers and defibrillators are implantable devices that assist the heart in maintaining an appropriate rhythm. Pacemakers assist the heart by setting the rhythm for each heart beat. Defibrillators only intervene and reset the rhythm when an irregular pattern occurs and is detected by the device. When this happens the heart will fibrillate, or shake like jelly, not effectively squeezing and forcing blood throughout the body. A defibrillator shocks the heart to interrupt the abnormal activity of the heart and reset it to a normal rhythm.
Electrophysiology is a very high tech and useful service for patients with cardiac arrhythmias. It is an important field of medicine because of the great benefits it offers patients. In the past many patients were taught they had to live with these conditions or take numerous medications to control the symptoms. With the advancement of technology within the electrophysiology field, more and more patients are getting treatments that can alleviate their symptoms and allow them to lead normal lives again.
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