Electrophysiology (EP) Study
An Electrophysiologist is a trained cardiac specialist who would be performing an EP Study. This is a specialized procedure in which one or more thin, flexible wires, called catheters are inserted into a blood vessel (usually the groin) and guided into the heart. Each catheter has two or more electrodes to measure the heart’s electrical signals as they travel from one chamber to another.
EP study or Electrophysiological study is mainly performed to diagnose cardiac rhythm abnormality, to help determine the best treatment, and to pinpoint the exact site where therapy may be useful.
Electrophysiology
An electrophysiology (EP) study is a test used to identify irregular heartbeats or arrhythmias. It evaluates the electrical system or activity of your heart. Catheters are inserted through blood vessels that enter the heart. These catheters which are inserted have wire electrodes, which measure electrical activity of the heart.
The Electrophysiology study has two parts:
- Assessing the electrical function via recording the heart’s own electrical signals
- Pacing the heart to induce specific fast regular/irregular rhythms to study under controlled observation
Electrophysiology analyses are used to look at:
- Where the source of an arrhythmia is.
- The effectiveness of several medications in treating arrhythmia.
- Requirement of catheter ablation which is a procedure used when a condition is treated by eradicating the area of your heart responsible for the aberrant electrical signal.
- If an implantable cardioverter defibrillator (ICD) or pacemaker could be of assistance.
- If you are susceptible to heart issues including dizziness or abrupt cardiac death from sudden cardiac arrest.
- To examine symptoms including fainting, dizziness, palpitations, weakness and others in order to determine if a rhythm issue may be to blame. When previous tests have come up negative and there is a strong suspicion that there might be a heart rhythm issue, this procedure may be used.
What is Electrophysiology?
Cardiac Electrophysiology is a specialized branch of cardiology that deals with disorders of the heart’s electrical system, in other words it deals with misbehaving heart beats.
Who is at Risk?
The problem of heart beats can strike across all age groups, right from a baby inside the mother’s womb to individuals in their 90s. Though heart beat disorders are more common in patients with heart disease, it can be found in individuals with normal heart.
What are the symptoms of heart beat disorders?
Palpitations (Irregular, Fast, Missed Heartbeats)
Blackout (loss of consciousness)
Fall
Shortness of Breath
Effort Intolerance
Sudden Death can be the presenting symptoms in cases of some life-threatening arrhythmias/faster heart beats
How are these patients treated?
Diagnosis of heart beat problems is the first step.
Many of them are benign and require treatment just to improve quality of life, while others put patients at a high risk of sudden death, CV stroke and heart failure.
The treatment has to be individualized and involves medicines, DC cardioversion, RF ablation and implanting electronic devices like pacemakers and defibrillators.
What is RF Ablation? Is it always necessary?
RF ablation is the treatment of choice in the majority of arrhythmia since it is curative in the majority and palliative in others by reducing the burden of arrhythmia. It also becomes the treatment of choice because the drugs for arrhythmia treatment have limited efficacy with concerning side effects. Radiofrequency waves are used to heat and destroy the problematic tissue of the heart. This energy is delivered through the catheter inserted via the vein of the lower limbs.
What is 3D Mapping?
It is a specialized way of creating a 3D map of an arrhythmia by using an electromagnetic field or non-contact mapping (impedance based system) to localize the catheter tip inside the chamber of the heart. It requires specialized machines and catheters. It can create anatomical, activation, voltage and propagation map of the heart chambers and arrhythmia.