A clinical cardiac electrophysiologist, or cardiac EP, is a healthcare provider who treats heart rhythm problems. It is a specialty of cardiology which deals with the study of the heart’s electrical system. The term “electrophysiology study” or “EP study” applies to any procedure that requires the insertion of an electrode catheters into the heart to make electrical measurements. Electrode catheters are long flexible wires that allow electrical measurements and stimulation of the heart muscle and its electrical system.

Heart’s Electrical System

What does the heart’s electrical system do?
• Causes the heart to beat.
• Controls the heart rate (the number of beats per minute)
• Has special pathways (conduction pathways) that carry the electrical signals throughout the lower heart chambers (ventricles) for each heartbeat

Diseases of the Electrical System

An irregularity in the heart’s electrical system is called an arrhythmia, or heart rhythm disorder. Rhythm disorders can cause the heart to beat too slowly (Bradycardia) or too fast (Tachyarrhythmia).

When would you see a Clinical Cardiac EP?

A Clinical Cardiac EP is not your primary healthcare provider. This healthcare provider only works with patients who need special heart-related care. Your healthcare provider may refer you to a cardiac EP if you have symptoms of heart rhythm problems. These may include dizziness, fainting, and fluttering feelings in your chest. Or you may see a cardiac EP if you have risk factors for a dangerous arrhythmia, such as heart disease.

What does a Clinical Cardiac EP do?

Clinical Cardiac EP’s test for, diagnose, and treat electrical abnormal heart rhythms. Abnormal heart rhythms are called arrhythmias. Clinical Cardiac EP’s need to know how the heart works, what kind of arrhythmias there are, and what may cause them. They also know how to do different kinds of tests. They also know how to access the heart for treatment or for the correction of certain conditions by implanting special devices such as Pacemakers or ICD Insertion into the body to regulate the heartbeat. They also do special procedures such as Cardiac Ablation to fix heart rhythm problems. They can prescribe medication, suggest lifestyle changes, and make other recommendations.

A Clinical Cardiac Electrophysiologists Can Diagnose and Treat conditions such as:
• Atrial Fibrillation: This is an irregular, fast heart rhythm in the upper chambers of the heart.
• Bradycardia: This is a heartbeat that is too slow.
• Tachycardia: This is a heartbeat that is too fast.
• Ventricular Tachycardia: This is a dangerous type of very fast heartbeat.
• Supraventricular Tachycardia: This is a sudden, very fast heartbeat from the top chambers of the heart
• Ventricular Fibrillation: This is a dangerous fluttering of the heart muscle that doesn’t let the heart pump blood. This condition can be fatal.
• Sudden Cardiac Arrest: This is when the heart suddenly stops beating.
• Long QT Syndrome: This is a disorder of the heart that can cause sudden arrhythmias.
• Wolff-Parkinson-White (WPW) Syndrome: This is a condition that causes episodes of a fast heartbeat. These are caused by an extra electrical pathway in the heart.
• Other Arrhythmias: Arrhythmias can be caused by pregnancy, medicine interactions, or metabolic problems.

Testing for Arrhythmias

To help diagnose an arrhythmia, a cardiac EP can order or perform tests such as:
• Electrocardiogram (ECG or EKG): This uses electrodes attached to your chest to record your heart’s electrical activity.
• Blood Tests: These are done to check the levels of certain minerals, enzymes, and other chemicals in your blood.
• Echocardiogram: This uses sound waves to show images of your heart structure and gives information about the heart’s function
• Stress Testing: This looks at how your heart performs when you stress it with exercise.
• Holter Monitor: This is a device you wear for 24 to 48 hours. It records your heartbeats using ECG.
• Event Recorder: This is a device you wear that records any abnormal rhythms of your heart. Typically this is worn for 7, 14, or 30 days consecutively.
1. Electrophysiology Study: This is an invasive test in which a special thin tube (catheter) is placed into a large vein usually in your groin or neck and threaded into the heart. It shows problems with the heart’s electrical system. There are two parts to the Clinical Cardiac Electrophysiology Study. First, there is the recording the heart’s electrical signals to assess the electrical function; and second, is the pacing the heart to bring on certain abnormal rhythms for observation under controlled conditions.
• Tilt Table Testing: This looks at how the heart is affected when your body is moved from a lying position to a standing position on a tilting table.
• Implantable Loop Recorder: This is a small device put in the chest under the skin. It records your heartbeat all the time and has a battery life of about 3 years. The device records your heart rhythm and sends it to the EP automatically. You can also write down in a diary when you have symptoms, such as dizziness or feeling faint.

Treating Arrhythmias

A Clinical Cardiac Electrophysiologist can perform certain procedures and prescribe treatments which include the following:
• Cardioversion or Defibrillation: This is the use of a device to send a shock of electricity to the heart and restore normal electrical activity.
• Catheter Ablation: In this procedure, a thin tube (catheter) is put into a blood vessel in the groin and sent up to the heart. A small part of the heart that is causing arrhythmia is destroyed with radiofrequency or cold energy.
• Cardiopulmonary Resuscitation (CPR): This includes pressing on the chest and breathing into the mouth of someone with cardiac arrest (not breathing and no heartbeat). It helps send blood through the body and can be lifesaving.
• Medications: These can help control heart rhythm and prevent blood clots.
• Lifestyle Changes: Changes in diet or exercise can help with some heart rhythm problems.

A Clinical Cardiac Electrophysiologist can also implant devices into the body to help reset or control heart rhythm which include the following:
• Pacemaker: This is a small device that’s put under the skin of the chest. It sends out electrical signals to help the heartbeat at a normal rate.
• Implantable Cardioverter Defibrillator (ICD): This is a small device that is put under the skin of the chest or in the abdomen. It can reset the heart rhythm when dangerous arrhythmias occur.
• Biventricular Pacemaker. This is a small device that is put under the skin of the chest. It helps the lower chambers of the heartbeat at the same time. This is known as cardiac resynchronization therapy.

Contact Southwest Cardiovascular Interventional Center (SWCVIC) Ambulatory Surgical Center (ASC) today by Clicking Here to setup a consultation with one of our Clinical Cardiac Electrophysiologists if you or your family have any questions or concerns regarding your cardiac health. We are here to help you improve your cardiac health for a better and healthier tomorrow!