Introduction
The heart’s electrical system produces signals that control the timing of every heartbeat. During an EP study, cardiologists track how these signals move between beats. Examining the electrical activity of your heart can help your healthcare provider identify any issues with your heartbeat signals. Typically, the signals that prompt your heart to beat follow a consistent and organised pathway each time. Occasionally, an irregular heartbeat, referred to as arrhythmia, may happen. To determine the specific type of arrhythmia, your healthcare provider might suggest electrophysiology therapy.
Symptoms of arrhythmia
A cardiac arrhythmia can sometimes be ‘silent’, meaning it doesn’t show any noticeable symptoms.
Following are some of the arrhythmia symptoms:
- Heart palpitations
- Dizziness or light-headedness
- Fainting episodes
- Shortness of breath
- Chest discomfort
- Weakness or fatigue
Causes of arrhythmia
Arrhythmia causes may include:
- Coronary artery disease
- Irritable tissue in the heart (due to genetic or acquired causes)
- High blood pressure
- Changes in the heart muscle (cardiomyopathy)
- Valve disorders
- Electrolyte imbalances in the blood
- Injury from a heart attack
- The healing process after heart surgery
- Other medical conditions
Cardiac electrophysiology diagnostic tests
Cardiac electrophysiology diagnostic tests play a crucial role in evaluating heart rhythm disorders and delivering precise diagnoses to inform effective treatment plans. These tests are either non-invasive or minimally invasive procedures that assist cardiologists in assessing the heart’s electrical activity and detecting any irregularities.
Some of the common diagnostic tests utilised in the electrophysiology of the heart include:
- Electrocardiogram (ECG or EKG): It records your heart’s electrical activity using small electrodes placed on your skin. It gives important insights into your heart’s rhythm and can help identify issues like atrial fibrillation, ventricular tachycardia or bradycardia.
- Holter monitor: It is a small, portable device that continuously records your heart’s activity for 24 to 48 hours. It helps catch any irregularities that might not show up on a regular ECG, offering a more complete picture of your heart rhythm over time.
- Event monitor: It works similarly to a Holter monitor but is worn for a longer period, from a few days to several weeks. The device is activated by the patient whenever they feel symptoms, capturing the heart’s rhythm during those specific episodes.
- Electrophysiology study (EPS): It is a procedure done in a specialised lab where thin, flexible wires (electrodes) are carefully threaded through blood vessels into the heart. This allows healthcare providers to record the heart’s electrical signals and pinpoint the source of arrhythmias.
- Transoesophageal echocardiogram (TEE): It is an ultrasound test where a probe is gently inserted into the oesophagus to capture detailed images of the heart, especially the atria and left atrial appendage. It is especially useful for checking heart valve function, spotting blood clots and assessing stroke risk.
- Electrophysiological mapping: This technique is used to create detailed 3D images of the heart’s electrical activity. These maps help healthcare providers to diagnose the issue and plan treatments, such as cardiac ablation, more accurately.
- Tilt table test: It is used to investigate unexplained fainting or dizziness. During the test, the patient is placed on a table that tilts to trigger changes in blood pressure and heart rate, helping doctors pinpoint the cause of fainting episodes.
Cardiac electrophysiology treatment
Cardiac electrophysiology provides a variety of advanced procedures and treatment options to manage heart rhythm disorders and boost overall heart health. These innovative techniques are carried out by experienced electrophysiologists and are customised to meet each patient’s unique needs. Some of the main procedures and treatments include:
- Cardiac ablation: It is a minimally invasive procedure that uses heat or radiofrequency energy to target and remove the abnormal heart tissue causing arrhythmias. By carefully eliminating the problematic tissue, it helps restore the heart’s electrical signals to their normal rhythm.
- Atrial fibrillation ablation: This procedure targets and removes areas in the heart causing irregular, fast heartbeats, helping restore a normal rhythm and improve heart function.
- An electrophysiology study (EPS): It involves placing thin electrodes in the heart to record its electrical signals, helping healthcare providers pinpoint the cause of arrhythmias and make informed treatment choices.
- Left atrial appendage closure devices: They seal off a small area in the heart where blood clots can form, lowering the risk of those clots travelling to the brain and causing a stroke.
- DC cardioversion: It is a procedure that delivers a controlled electrical shock to reset the heart’s rhythm, helping restore normal heartbeats in those with certain arrhythmias.
- Pacemaker implantation: It is a routine procedure where a small electronic device, called a pacemaker of the heart, is placed under the skin near the collarbone. The pacemaker monitors the heart’s rhythm and sends electrical impulses when necessary to help maintain a steady heart rate.
- Defibrillator implantation: It involves placing a small device under the skin that continuously monitors the heart. If it detects a dangerous irregular heartbeat that could lead to cardiac arrest, the defibrillator delivers a lifesaving shock to restore a normal rhythm.
- Laser lead extraction: It is a minimally invasive procedure that uses laser energy to carefully remove pacemaker or defibrillator leads that are causing complications or not functioning correctly.
- Cardiac resynchronisation therapy (CRT): It improves heart function in people with heart failure by using a specialised pacemaker to synchronise the heart’s ventricles, boosting its pumping efficiency.
- CCM therapy: It is also called optimiser and adjusts pacemaker settings to improve heart function, especially for individuals with heart failure.
- Guardian device: It is implanted in the chest to keep an eye on the heart for early warning signs of a heart attack. If it detects the presence of any suspicious activity, it sends an alert to the monitoring centre for prompt medical response.
Conclusion
Advanced imaging and mapping technologies such as catheter ablation techniques, mapping systems, remote monitoring, and wearable devices in the field of heart electrophysiology enable electrophysiologists to conduct procedures with greater precision and minimal risk to the patient. For the best care and cutting-edge treatments, Fortis, the best hospital in India, provides world-class services in heart electrophysiology.
Mustafa Mehdi, Guest Post Marketing Officer at slate.com.in, shares meaningful stories, building heartfelt connections through impactful guest posts.