SIDNEY PEYKAR M.D., F.A.C.C. J.C. ESTRADA, M.D., M.P.H.
CLINICAL CARDIAC ELECTROPHYSIOLOGY COMPLEX ARRHYTHMIA ABLATION AND CARDIAC DEVICES
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What is an ELECTROPHYSIOLOGIST (EP)?

An Electrophysiologist is a cardiovascular disease specialist with subspecialty training in cardiac arrhythmias, as such they are experts in cardiac rhythm disorders. Your heart has an electrical system just as a house or a car. Different medical problems can lead to abnormal heart rhythms or they can occur sporadically, typically in younger patients. EPs use different modalities to diagnose and treat slow (brady) or fast (tachy) rhythm disorders. Although cardiology training includes some basic knowledge of abnormal heart rhythms, EPs' additional training makes them experts in this field. EP training involves implantation of cardiac devices – such as pacemakers and defibrillators, diagnostic electrophysiology studies and catheter ablation.

Not all EP's are skilled in all aspects of therapeutic and curative ablations. Some ablations – such as for atrial fibrillation, have only been done in the last 10-15 years, as such newer trained physicians have more experience and training with the latest procedures.

Diagnostic Tests

Electrocardiogram (ECG/EKG)

A special recording machine is attached to legs, arms and chest via 10 electrodes and takes a snapshot of the electric signals creating heart rhythms.

Echocardiogram

A special imaging machine with a microphone-like attachment creates a videotaped image of heart structures that shows the heart's four chambers, valves and movements.

Holter Monitoring

To detect irregular heart rhythms, patients wear a Walkman-size recording box attached to their chest by five adhesive electrode patches for 24-48 hours.

Event Recorder

Patients carry a pager-sized event recording box so they can make a one- to two-minute recording of their heart rhythm when they actually experience symptoms. This is useful for patients with relatively infrequent and brief symptoms. It is worn for up to 30 days.

Tilt Table Test

This test evaluates the potential reasons for fainting, or syncope. Heart rhythm and blood pressure are carefully monitored while a patient rests on a special table. The table tilts the patient upright at a 70-80 degree angle for 30-45 minutes. If the patient faints, it usually means that he or she has a condition called vasovagal or neurocardiogenic fainting, which is not life threatening.

Electrophysiology Study (EPS)

Under sterile conditions, thin tubes called electrode catheters are inserted into veins in the groin or neck area and threaded into the heart. The heart's electrical conduction system is measured. Electrical impulses are applied to the heart to provoke and analyze a fast heart rate. This study can diagnose symptomatic and potentially life-threatening slow and fast heart rates. [more]