Electrophysiology is a sub-specialty within cardiology, specifically for the study and treatment of arrhythmias (abnormal heart rhythms). An electrophysiology study (EPS) is performed to check the health of the internal electrical system that causes your heart to beat.
EP Non-Invasive Diagnostic Testing
An electrocardiogram records the electrical activity of your heart. The ECG provides information about your heart rhythm. An ECG (also known as an EKG) can tell if the heart is beating normally, detect heart disease, or identify problems with the electrical conduction system of the heart. It records the rate and regularity of heartbeats, and can tell the size and position of the chambers of the heart.
Echocardiography uses sound waves to create two-dimensional moving images of your heart. During an echocardiogram a small, micro-phone like device called a transducer is used to generate sound waves that echo off your heart structures. The echoes are converted into a moving image of your heart, allowing the doctor to evaluate the size of your heart chambers, the function of your heart valves, and the pumping action and blood flow through your heart.
Non-Invasive Program Stimulation (NIPS)
When a patient has an implantable cardioverter-defibrillator (ICD), they may have a change in their health or medications that can potentially interfere with how the device works. If your physician needs to evaluate to make sure that your ICD is functioning properly to stop a life-threatening arrhythmia, he or she will schedule you for a NIPS. Similar to a cardioversion, a NIPS is a brief procedure where your heart is stimulated into a rapid heart rate and your ICD delivers a shock or rapid pacing sequence to restore a normal rhythm. Your physician can then adjust the ICD's programming, if needed. You will be under anesthesia for the testing and able to go home a few hours later.
Head Up Tilt Table Test
A tilt-table test may be ordered if you are experiencing syncope (dizzy spells or fainting) and no other cause has been found to explain your symptoms. Syncope may be the result of a neurological or cardiovascular problem. The tilt table test is designed to induce or bring on your syncope under controlled conditions. 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 monitored continuously. Expect to be at the hospital for two to three hours for a tilt table test. After the test, your doctor will recommend a treatment plan for you.
EP Invasive Diagnostic Testing and Procedures
Cardioversion is the delivery of a timed electrical shock to the heart of a sedated patient, in an attempt to convert an abnormal heart rhythm to a normal rhythm. Atrial fibrillation (AF) is the most common arrhythmia requiring cardioversion. Cardioversions are scheduled procedures at The CardioVascular Center. Specific details about preparation for the procedure will be explained during the scheduling process.
Catheter ablation is used to treat or eliminate abnormal heart rhythms (arrhythmias). This minimally invasive procedure requires the insertion of one or more catheters into the heart from veins in the groin or neck area. You will receive local anesthesia and mild sedation for the procedure. Catheter ablations can take several hours to complete. Ablations can be scheduled at the hospital's Center for Atrial Fibrillation.
A pacemaker is a small device that sends electrical impulses to the heart muscle to maintain a suitable heart rate and rhythm. The device is implanted just under the skin of the chest during a minor surgical procedure. Your doctor may recommend a pacemaker if you have persistent abnormal heart rhythm. There are different types of pacemakers. Your physician will discuss the best option for you.
Implantable Cardioverter-Defibrillator (ICD)
An implantable cardioverter defibrillator (ICD) is a device that monitors heart rhythms, and delivers shocks if dangerous heart arrhythmias are detected. Some rapid heart arrhythmias, such as ventricular tachycardia or ventricular fibrillation, are associated with sudden cardiac death. If you have had or if you are at risk for one of these arrhythmias, your doctor may recommend an ICD. The type of ICD will depend on your arrhythmia and heart health history. All ICDs have the ability to co-function as a pacemaker to help regulate your heartbeat as needed.
Cardiac Resynchronization Therapy (CRT)
Cardiac Resynchronization Therapy involves the implantation of a device that can re-coordinate the action of both the left and the right ventricles (pumping chambers) in patients with heart failure. Synchronized contractions result in more effective pumping of the heart. Patients with heart failure often feel better and have more energy as a result of improved coordination of the pumping function of the heart. This treatment for heart failure may be offered in a pacemaker or an ICD. You and your physician will determine if you are a candidate for CRT and which device would best meet your needs.
Loop Recorder Implant
A Loop Recorder is a small implanted device that can continuously monitor the heart's activity for as long as a year or more. It is used for patients who have fainting episodes or suspected heart arrhythmias (abnormal heart rhythms) that occur relatively infrequently and without warning. These arrhythmias may be difficult to detect by other means.
A lead is a flexible wire that connects the pacemaker or ICD to the heart muscle. Pacemakers or ICD leads are designed to last for many years, however the lead or the lead and the device may need to be removed or replaced. A lead extraction is the removal of one or more leads from inside the heart.
The most common reasons are:
- The lead may be damaged or malfunction.
- Infection that involves the device and the lead(s).