Electrophysiology

What is Electrophysiology?

Clinical Cardiac Electrophysiology is a subspecialty of cardiology. This area of study is focused on the electrical activity of the heart. Because each heartbeat is triggered by electrical impulses, heart rate and rhythm disorders – called arrhythmias –  are often treated by electrophysiologists. Coastal Cardiology physicians include highly trained specialists with advanced training in this subject.

Heart Rate & Rhythm

In most circumstances, electricity follows a particular path through the heart. Beginning in the sinoatrial (SA) node, referred to as the “heart’s pacemaker,” electrical impulses contract first the upper chambers of the heart or atria. Electricity then moves through the atrioventricular (AV) node that connects the atria and the ventricles, or lower chambers of the heart. The rhythmic relaxation and contraction of first the upper chambers, then the lower chambers, is triggered as electrical impulses travel. It is this rhythm that pumps blood in and out of the heart and through the rest of the body. Changes to the heart rate and rhythm can be caused by many things, including different electrical processes in the heart. Some medical conditions, diet, activity levels, alcohol/drug use, age and other factors can make arrhythmias more likely.

Common arrhythmias include atrial fibrillation (AF), atrial flutter (AFL) and supraventricular tachycardia (SVT). Estimates vary but arrhythmias are relatively common. For instance, approximately 6 million people have been diagnosed with atrial fibrillation. While some persons describe symptoms like fatigue, being short of breath or dizzy, others don’t have any symptoms. Learning more about your heart and finding the right treatment, can reduce your risk of associated complications such as strokes.

Arrhythmia Treatment

Not every arrhythmia requires treatment, but some do. Working with your physician to find the right treatment includes understanding your symptoms, knowing how frequently the arrhythmia occurs and what triggers episodes. Common treatment goals include:

  • Returning your heartbeat to a normal rhythm
  • Treating the causes of the abnormal rhythm
  • Preventing blood clots that could cause strokes
  • Reducing risk factors that could complicate your arrhythmia.

 
There are a number of treatment strategies that are relevant to different persons at different times. Speak with your healthcare team to learn more about what is best in your situation. General categories are listed below.

  • Medications: There are a number of new and old medications that may address your specific needs. Your physician can answer questions about the benefits and drawbacks associated with rate control medications.
  • Ablations: An non-surgical procedure performed at a designated lab by highly trained specialists, ablations use catheters to prevent electrical transmission in the heart where it negatively impacts your heart functions. 
  • Cardioversion: This simple, outpatient procedure uses an electrical current to “shock” the heart back into a normal, sinus rhythm. 
  • Medical Devices: Depending upon your circumstances, your physician may recommend a medical device implanted in the body to reduce the risk of complications associated with your arrhythmia. 
  • Lifestyle Modification: Some arrhythmias can be addressed through treating other conditions that cause them, such as hypertension (high blood pressure), high cholesterol, sleep apnea and obesity. For some persons, eating well and staying active resolve arrhythmias. There are associations between alcohol and recreational drugs with abnormal heart rhythms. Anyone concerned about their heart health is encouraged to limit alcohol consumption and avoid illegal stimulants.

 

Questions for your Healthcare Team

If you believe you have an arrhythmia, speaking with your healthcare provider is crucial. As a team, you can identify resources and design an action plan.

  1. Do I have an arrhythmia? If so, what is my diagnosis?
  2. How do we know it isn’t another heart rhythm problem?
  3. Is this a temporary condition? Is treatment needed?
  4. Is my condition likely to get better or get worse? Will it affect my quality of life?
  5. Am I at increased risk of having a stroke?
  6. What are my treatment options? What are the risks and side effects of each option?
  7. Where can I learn more?

Online Education & Resources

More information about common cardiac arrhythmias, rate and rhythm control, stroke prevention and heart health are available at the following sites.