Electrophysiology relates specifically to the diagnosis and treatment of the heart's electrical system, which controls the heart rhythm
Each day, the heart pumps approximately 2,000 gallons of blood throughout the body and beats about 100,000 times. The heart is located in the center of the chest, but because the bottom of the heart tips to the left, more of the heartbeat is felt on that side of your body. Normally, electricity flows through the heart and produces the familiar thump-bump pattern that can be heard through a stethoscope.
If you have a problem with irregular heart rhythms (arrhythmia), your heart may beat too fast, too slowly or erratically. A heart arrhythmia causes a dangerous disruption of blood flow and can result in stroke, organ damage or organ failure. It's clear that a prompt and thorough examination is called for.
At the electrophysiology lab at Baylor Scott & White Heart and Vascular Hospital – Dallas, both diagnostic and therapeutic services are conducted. We have earned national recognition as a leader in the treatment of heart and vascular disease, and our electrophysiology lab in Dallas is no exception. Under the direction of experienced electrophysiologists and cardiologists, our EP lab is equipped to care for all types of problems affecting the heart's electrical system.
Electrophysiology specialists may perform a variety of studies to diagnose heart rhythm problems (arrhythmias)
Most heart rhythm studies are simple and non-invasive, while others may involve catheterization lab procedures for a more in-depth check of the heart's electrical signals:
- Physical exam and patient history
- Electrocardiogram (ECG or EKG)
- Stress tests
- Tilt table tests that check for the source of lightheadedness and fainting
- Electrophysiology study
- Coronary angiography
Electrophysiology (EP) studies
Electrophysiology studies are commonly performed to identify the area in the heart that is causing the arrhythmia and to develop the best course of treatment. Information generated during these studies also may be used to:
- Predict a future cardiac event
- Evaluate the effectiveness of certain medications to control the irregular heartbeat
- Decide if certain procedures or implants are necessary, such as a catheter ablation procedure, an implantable defibrillator or a pacemaker
Heart rhythm devices
Depending on which kind of heart rhythm problem you experience, your heart doctor may recommend one of the following arrhythmia treatment options:
- Pacemaker (heart beats too slow)
- Defibrillator (heart beats too fast)
- Heart failure device (for dyssynchronous ventricles)
- Implantable loop recorder
What to expect at your electrophysiology procedure
Pre considerations
Before heart arrhythmia treatment options can be determined, several factors must be considered, including:
- Age
- Personal and family medical history
- Current medications
- Any existing diseases or conditions
- Signs and symptoms of the current arrhythmia
Night before the procedure
If you are scheduled to undergo an electrophysiology test in Dallas, you should not eat or drink anything after midnight the night before the procedure. Check with your heart doctor about continuing any medications.
If you have diabetes, talk to your doctor about food and insulin intake, which can affect blood sugar levels.
Prior to procedure
After arriving at our Dallas heart hospital and changing into a hospital gown, an intravenous line is started. You will be given a sedative to make you feel drowsy.
Once you are in the cardiac catheterization laboratory (sometimes shorted to "cardiac cath lab") where the procedure will take place, electrodes are placed on your chest.
An area in your groin is numbed, and access is gained using a small puncture where an electrophysiologist inserts a special catheter into a vein and then threads it to your heart using fluoroscopy, which provides continuous, real-time X-ray images of the moving heart.
During the procedure
The catheter can detect electrical activity in the heart, and doctors can administer small electrical impulses to make the heart beat at different speeds.
The heart's electrical signals normally move from the two top chambers of the heart (the atria), through the atrioventricular node and to the ventricles of the heart, or lower chambers.
After the procedure
An electrophysiology test at our heart hospital in Dallas typically lasts between two and four hours, but it may take longer if additional treatments are performed at the same time.
After the procedure is completed, the catheter is removed, and firm pressure is applied to the incision site to prevent bleeding.
Most people go home the same day.
Results
Abnormal results from an electrophysiology test can identify numerous conditions, such as
- Ventricular tachycardia or rapid heartbeats that start in the ventricles
- Supraventricular tachycardia, which includes atrial fibrillation or abnormal electrical discharges in the heart that cause an irregular heartbeat
- Wolff-Parkinson-White syndrome, where there is an extra electrical pathway in the heart