Cardiac Electrophysiology

Cardiac electrophysiology is the field of assessing the heart’s electrical system and activity, as well as the treatment of any abnormal heart rhythms (arrhythmias). Electrophysiologists are cardiologists who subspecialises in cardiac electrophysiology.

What are some Cardiac Electrophysiology conditions?

• Bradycardias – Abnormally slow heartbeat
• Tachycardias – Abnormally fast heartbeats
• Atrial fibrillation – An irregular heartbeat originating in the upper chambers of the heart
• Atrial or ventricular ectopic beats – Extra heartbeats originating in the upper or lower chambers of the heart
• Palpitations – The sensation of a noticeably fast, strong or irregular heartbeat

How are abnormal heartbeats diagnosed?

• Electrocardiogram – The recording of electrical activity of the heart through electrodes attached on the chest.
• Echocardiogram – The evaluation of the heart structure and function through ultrasound imaging.
• 24 / 48-hour Holter monitor – The recording of electrical activity of the heart over a 24 or 48-hour period.
• Stress testing – The recording of electrical activity of the heart through electrodes attached on the chest while the heart undergoes stress during exercise.
• Implantable loop recorder – The recording of electrical activity of the heart through a small device, which is inserted under the skin of the chest, continuously over a period of about 3 years. The device is easily removed via a small incision on the chest.
• Electrophysiology Study (EPS) – An invasive test where catheters are inserted into the heart to record electrical activity within the heart chambers. This technique is also used to treat some causes of arrhythmias.

How are abnormal heartbeats treated?

• Pacemakers – These small devices are put under the skin in the chest wall to treat abnormally slow heartbeats.
• Cardioversion – Shock is delivered to the heart to treat abnormally fast heartbeats and restore normal electrical activity.
• Catheter ablation – A catheter is put into the heart to treat abnormal heartbeats with radiofrequency or cryo-energy. This procedure is usually done in combination with Electrophysiology Study (see above).
• Medication – Some abnormal heartbeats can simply be treated with medication.
• Lifestyle changes – Some abnormal heartbeats do not require treatment and only a simple lifestyle modification or observation is required.