The Electricity of the Heart
Electrophysiology is the study of electrical activity in the heart. An arrhythmia is an abnormality in the timing or pattern of the heart beat. These abnormal heart rhythms may originate in the atria (the upper chambers of the heart) or the ventricles (the bottom chambers of the heart which provide the main pumping of blood through the body). Saint Thomas Heart physicians are extensively trained in treating a wide range of heart rhythm conditions including:
- Atrial fibrillation
- Atrial flutter
- Supraventricular tachycardia
- Ventricular tachycardia
- Ventricular fibrillation
- Sick sinus syndrome
- Heart block
Cardiac electrophysiologists (arrhythmia specialists) rely on a patient's medical history and the results of a variety of procedures to diagnose heart rhythm abnormalities. Some of these tests may include:
- Electrocardiogram (ECG/EKG) - recording of your heart's electrical activity for several seconds
- Holter monitor - recording of your heart's electrical activity during 24 or 48 hour period of time.
- Event recorder - longer term recording of your heart rhythm, usually worn for about a month
- Echocardiogram - ultrasound that provides pictures of the heart's valves, chambers, and pumping function via a wand placed on the outside of the chest
- Exercise test (stress test or treadmill stress test) - helps to determine abnormal heart rhythms during exercise.
- Tilt table test - a procedure performed to evaluate causes of lightheadedness or fainting. A table starts in a horizontal position and then is tilted upwards at different angles while heart rate and blood pressure are monitored.
- Advanced cardiac CT scanner - Advanced CT technology that uses intravenous dye to obtain high-resolution, three dimensional (3D) pictures of the moving heart and great vessels.
- Cardiac MRI - Magnetic resonance imaging of heart to evaluate the heart's structure and function, no radiation is involved in this test.
- Diagnostic invasive electrophysiology studies
- Three dimensional mapping systems to assist ablation of complex arrhythmias
With advanced resources, including leading edge technology in the hands of experienced clinicians, Saint Thomas Heart offers our patients several options to help manage arrhythmias. Available treatments include:
- Antiarrhythmic medications
- Implantable cardioverter defibrillators (ICDs)
- An ICD is a device that is placed within the body and is designed to recognize certain types of abnormal heart rhythms (arrhythmias) and correct them. ICDs continuously monitor the heart rhythm in order to detect dangerously rapid heart rhythms. They automatically function as pacemakers for heart rates that are too slow and deliver life saving therapies if an overly rapid heartbeat is detected. They correct the heart rhythm by delivering precisely calibrated and timed electrical therapies which may include shocks and are 99% effective in stopping ventricular fibrillation - the major cause of sudden cardiac death.
- Pacemaker insertion
- A pacemaker is a system that monitors and regulates the rhythm of the heart if it is beating too slowly by transmitting electrical impulses. Pacemakers may function continuously and stimulate the heart at a fixed rate, or they may function at an increased rate during exercise. A pacemaker can also be programmed to detect an overly long pause between heartbeats and then stimulate the heart.
- Implantable loop recorder insertion
- Catheter ablation for SVT, atrial fibrillation and ventricular tachycardia using the technologies of radiofrequency ablation and cryoablation
- During this non-surgical procedure a catheter (thin, flexible tube) is guided via x-ray into a specific area of the heart. A special machine directs energy through the catheter to small areas of the heart muscle that cause the abnormal heart rhythm. This energy "disconnects" the pathway of the abnormal rhythm by destroying very small areas of tissue that give rise to abnormal electrical signals. It can also be used to disconnect the electrical pathway between the upper chambers (atria) and the lower chambers (ventricles) of the heart.
- Cardiac resynchronization therapy (CRT)
- Electrical cardioversion
- Left atrial appendage closure to prevent strokes due to atrial fibrillation
- Pacemaker and ICD lead extraction using a laser system
For more information and to schedule an appointment with a Saint Thomas Heart electrophysiologist, please call 800.345.5016.