Cardiac Electrophysiology

Cardiac Electrophysiology Overview

Cardiac electrophysiology is the science of diagnosing and treating the electrical activities of the heart. Cardiac electrophysiology helps to identify the source of arrhythmia, or abnormal heartbeat. The procedure takes place in a lab while the patient is mildly sedated. Results from this help determine the course of treatment, such as cardiac ablation, surgery or perhaps the need for a pacemaker. During EPS, doctors insert a thin tube, called a catheter, into a blood vessel that leads to your heart. A specialized electrode catheter designed for EP studies lets them send electrical signals to your heart and record its electrical activity.

Hattiesburg Clinic offers several cardiac electrophysiology procedures, including:

Biventricular Pacemaker ICD
Cardioversion
Electrophysiology Studies
Lead Extraction
Pacemaker/Defibrillator Implantation

Biventricular Pacemaker ICD

A biventricular pacemaker synchronizes the rhythm from one side of the heart to the other and is typically used in patients who have congestive heart failure. Implantation of a biventricular pacemaker is similar to that of a standard pacemaker. This pacemaker typically has three leads. One lead is attached to the right ventricle, one to the left and the third is typically at the right atrium. When implanted, the device monitors the heartbeat, and if it drops too low or too high, it will send electricity through the leads to normalize the heartbeat.

Cardioversion

Cardioversion is a procedure intended to restore a normal rhythm as a result of arrhythmia, or abnormal heartbeat. A heartbeat the goes too fast or unevenly can be hazardous to the health of the patient. Potential consequences of arrhythmia include stroke or death.

Electrical cardioversion is a procedure where paddles are placed on your chest, and while sedated, you’re given a mild electrical shock to help your heart return to a normal rhythm. Cardioversion does not always completely resolve arrhythmia, and medication or a pacemaker may also be suggested to manage the heart’s rhythm.

Electrophysiology Studies

An electrophysiology study looks at how the electrical system of the heart is functioning. Multiple IVs will be inserted into the groin area, and then wires will be fed through your body. Electrodes at the end of the wires will pick up the heart’s electrical signals and give the doctor an understanding of any abnormalities of the patient’s heartbeat, or arrhythmia. This study is used to help identify the best course of therapy for the patient’s heart condition and can also determine if the patient is at risk for future, potentially dangerous heart events.

Pacemaker/Defibrillator Implantation

Your doctor may recommend the implantation of a pacemaker or implantable cardioverter defibrillator (ICD) if you have serious arrhythmia, or irregular heartbeat.

A pacemaker uses electoral pulses to control abnormal heartbeats, telling the heart to slow down or speed up. A defibrillator monitors the heartbeat and only if it senses an irregularity does it deliver a shock to normalize rhythm. The procedure to have a pacemaker or defibrillator implanted is a minor procedure and most patients are able to return to normal activities within a week.

Lead Extraction

Cardiac lead extraction is a procedure where one or more leads from inside the heart is removed. A lead is the wire that sends electricity between a pacemaker or defibrillator to the heart. Your doctor may determine that lead extraction is necessary for a variety or reasons, including damage, scar tissue development, an infection or blockage.

There are two directions where lead extraction can start. Subclavian is when an incision is made on the upper chest. Femoral is when for some reason subclavian is not accessible and the lead is removed through an incision that begins in the groin area. Over time, the lead connecting the pacemaker or defibrillator to the heart develops scar tissue, which can create a strong attachment. One means to extract the lead is with a sheath that passes over the lead and frees it from the scar tissue. There are a variety of different sheaths that can be used for lead extraction.