Although relatively new, Cardiac Electrophysiology is one of the fastest progressing fields in medicine. Cardiac Electrophysiology (EP) is the study of the heart’s electrical system; aimed at analysing, diagnosing, and treating its electrical activities. The human heart pumps 4,300 gallons of blood each day through the body’s intricate vascular network and although displacement of blood is its principal function, the heart instigates and finely regulates electrical impulses to create the beats.
Cardiac EP studies this phenomena by recording the electrical activity of the heart using an invasive catheter. These studies help assess complex Arrhythmias/ Heart Rhythm Disorders. These procedures include therapeutic methods (typically RF Ablation) along with other diagnostic and prognostic procedures. Cardiac EP also includes antiarrhythmic drug therapy, implantation of pacemakers and Implantable Cardioverter-Defibrillators (ICDs).
Cardiac Electrophysiologists perform interventional cardiac Electrophysiology Studies (EPS) and surgical device implantations. Narayana Health network hospitals are among the very few cardiac centres in India with state-of-the-art facilities and expert faculty capable of performing EP study.
Electrophysiology (EP) Study: Basis
The electricity that flows throughout the heart in a regular pattern causes heart muscle contractions; any disruption in the electrical pathway disturbs the heart rhythm. An EP study involves the precise diagnosis and treatment of such heart rhythm disorders.
Arrhythmias/HRD are unpredictable and irregular and hence may not be picked by tests like ECG and Holter. A trained Electrophysiologist can provoke Arrhythmia events and gather data about the flow of electricity. Such EP studies help locate the precise heart tissue that cause the abnormal electrical impulses resulting in Arrhythmias.
Purpose of EP Study:
- Diagnose the source of arrhythmia symptoms
- Assess the efficiency of certain medications used to control HRD
- Forecast the risk of a future cardiac event (a sudden cardiac arrest)
- Check for the need for artificial pacemakers or other treatments (like RF Ablation)
Electrophysiology Study: Procedure
EP study is an invasive test similar to angiography and is performed in a Cath-lab. After the patient is administered with local anaesthesia (or in some cases, general anaesthesia) a catheter is inserted into a blood vessel through a site in the groin or neck and the catheter is guided by fluoroscope images of the catheter and the heart muscles. Once the catheter reaches the heart, electrodes at its tip gather data and a variety of electrical measurements are made. This “electrical mapping” helps the cardiac arrhythmia specialist identify the location of the area disrupting the electrical flow.
The Electrophysiologist then administers different medications or electrical impulses to determine their ability to terminate the arrhythmia and restore normal heart rhythm. Sometimes the specialist will perform cardiac ablation or place an Implantable Cardioverter Device (ICD) or a pacemaker. The procedure usually lasts for about two hours.