Clinical cardiac electrophysiology

Clinical cardiac electrophysiology

Cardiac Electrophysiology (also referred to as clinical cardiac electrophysiology , Arrhythmia Services , or electrophysiology), is a branch of the medical specialty of clinical cardiology and is concerned with the study and treatment of rhythm disorders of the heart. Cardiologists with expertise in this area are usually referred to as electrophysiologists. Electrophysiologists are trained in the mechanism, function, and performance of the electrical activities of the heart. Electrophysiologists work closely with other cardiologists and cardiac surgeons to assist or guide therapy for heart rhythm disturbances (arrhythmias).They are trained to perform interventional and surgical procedures to treat cardiac arrhythmia.

The training required to became an electrophysiologist is long and requires 7 to 8 years after medical school (in the U.S.). Three years of Internal Medicine residency, three years of Clinical Cardiology fellowship, and one to two (in most instances) years of Clinical Cardiac Electrophysiology.

An electrophysiology study is a term used to describe a number of invasive (intracardiac) and non-invasive recording of spontaneous electrical activity as well as of cardiac responses to programmed electrical stimulation. These studies are performed to assess arrhythmias, elucidate symptoms, evaluate abnormal electrocardiograms, assess risk of developing arrhythmias in the future, and design treatment.

In addition to diagnostic testing of the electrical properties of the heart, electrophysiologists are trained in therapeutic and surgical methods to treat many of the rhythm disturbances of the heart. Therapeutic modalities employed in this field include antiarrhythmic drug therapy and surgical implantation of pacemakers and implantable cardioverter-defibrillators.


Scope of practice, tests and procedures

Diagnostic testing

  • Ambulatory electrocardiographic monitoring - Holter recording and interpretation, loop recording and interpretation;
  • Tilt table testing;
  • T-wave alternans testing;
  • Signal-averaged electrocardiogram (SAECG) interpretation, also referred to as "late potentials" reading;
  • Electrophysiology study (EPS) consists in the insertion of pacing and recording electrodes either in the oesophagus (intra-oesophageal EPS) or, through blood vessels, directly into the heart chambers (intra-cardiac EPS) in order to measure electrical properties of the heart and, in the case of intra-cardiac EPS, to electrically stimulate it in the attempt to induce arrhythmias for diagnostic purposes ("programmed electrical stimulation").

Medical treatment

  • Initital administration and monitoring of the effect of drugs for treatment of heart rhythm disorders. Electrophysiologists are often involved when severe or life threatening arrhythmias are being treated, or when multiple drugs must be used to treat an arrhythmia.

Catheter ablation

  • Ablation therapy - Catheter based creation of lesions in the heart (with radiofrequency energy, cryotherapy (destructive freezing), or ultrasound energy) to cure or control arrhythmias (see radiofrequency ablation). Ablation is usually performed during the same procedure as the electrophysiology study which induces and confirms the diagnosis of the arrhythmia for which ablation therapy is sought.
  • "Non-complex" ablations include ablation for arrhythmias such as: AV nodal reentrant tachycardia, Accessory pathway mediated tachycardia, atrial flutter. These procedures are usually performed using intracardiac catheters (as are used during an electrophysiology study), fluoroscopy (a real-time X-ray camera), and electrical recordings from the inside of the heart.
  • "Complex" ablations include ablation for arrhythmias such as multifocal atrial tachycardia, atrial fibrillation, and ventricular tachycardia. In addition to the apparatus used for a "non-complex" ablation, these procedures often make use of sophisticated computer mapping systems to localize the source of the abnormal rhythm and to direct delivery of ablation lesions.

Surgical Procedures: Pacemaker and Defibrillator implantation and follow up

  • Implantation of single and dual chamber pacemakers and defibrillators
  • Implantation of "biventricular" pacemakers and defibrillators for patients with congestive heart failure
  • Implantation of loop recorders (implanted ECG recorders for long term monitoring of ECG to allow for diagnosis of an arrhythmia)
  • Clinical follow up and reprogramming of implanted devices

See also

External links

Wikimedia Foundation. 2010.

Игры ⚽ Нужен реферат?

Look at other dictionaries:

  • Cardiac electrophysiology — is the science of elucidating, diagnosing, and treating the electrical activities of the heart. The term is usually used to describe studies of such phenomena by invasive (intracardiac) catheter recording of spontaneous activity as well as of… …   Wikipedia

  • cardiac electrophysiology — clinical cardiac electrophysiology the mechanisms, functions, and performance of the electrical activities of specific regions of the heart; the term is usually used in describing studies of such phenomena by invasive (intracardiac) recording of… …   Medical dictionary

  • Clinical electrophysiology — is the application of electrophysiology principles to medicine. The two main branches of this discipline are electrotherapy and electrophysiologic testing (EEG, electromyography, etc.) See also Clinical cardiac electrophysiology References Andrew …   Wikipedia

  • Cardiac dysrhythmia — Arrhythmia redirects here. It is not to be confused with Erythema. Cardiac dysrhythmia Classification and external resources Ventricular fibrillation (V Fib or VF) an example of cardiac arrhythmia. ICD …   Wikipedia

  • Cardiac arrhythmia — Dysrhythmia redirects here. For the American band, see Dysrhythmia (band). ICDO = OMIM = MedlinePlus = 001101 eMedicineSubj = eMedicineTopic = MeshID = D001145 Cardiac arrhythmia (also dysrhythmia) is a term for any of a large and heterogeneous… …   Wikipedia

  • Cardiac output — (Q or or CO ) is the volume of blood being pumped by the heart, in particular by a left or right ventricle in the time interval of one minute. CO may be measured in many ways, for example dm3/min (1 dm3 equals 1000 cm3 or 1 litre). Q is… …   Wikipedia

  • Cardiac muscle — Dog Cardiac Muscl …   Wikipedia

  • Cardiac stress test — Not to be confused with Cardiac arrest. Cardiac stress test Intervention A male patient walks on a stress test treadmill to have his heart s function checked ICD 9 CM …   Wikipedia

  • Pacing and Clinical Electrophysiology —   Abbreviated title (ISO) Pacing Clin. Electrophysiol …   Wikipedia

  • Mark Josephson — Residence Boston Citizenship United States Fields …   Wikipedia

Share the article and excerpts

Direct link
Do a right-click on the link above
and select “Copy Link”