Everything about Cardiac Electrophysiology totally explained
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 cardiac responses to
programmed electrical stimulation (PES). These studies are performed to assess complex
arrhythmias, elucidate symptoms, evaluate abnormal
electrocardiograms, assess risk of developing arrhythmias in the future, and design treatment. These procedures increasingly include therapeutic methods (typically
radiofrequency ablation) in addition to diagnostic and prognostic procedures. Other therapeutic modalities employed in this field include
antiarrhythmic drug therapy and implantation of
pacemakers and
implantable cardioverter-defibrillators (AICD).
The cardiac electrophysiology study (EPS) typically measures the response of the injured or cardiomyopathic myocardium to PES on specific pharmacological regimens in order to assess the likelihood that the regimen will successfully prevent potentially fatal sustained
ventricular tachycardia (VT) or
ventricular fibrillation (VF) in the future. Sometimes a series of EPS drug trials must be conducted to enable the cardiologist to select the one regimen for long-term treatment that best prevents or slows the development of VT or VF following PES. Such studies may also be conducted in the presence of a newly-implanted or newly-replaced cardiac pacemaker or AICD.
A specialist in cardiac electrophysiology is known as a cardiac electrophysiologist, or (more commonly) simply an electrophysiologist. Cardiac electrophysiology is considered a subspecialty of
cardiology, and in most countries requires two or more years of
fellowship training beyond a general cardiology fellowship. Cardiac electrophysiologists are trained to perform interventional cardiac electrophysiology studies (EPS) as well as surgical device implantations.
Cardiac electrophysiology is a relatively young subdiscipline of cardiology and internal medicine. It was developed during the mid-1970's jointly by
Mark E. Josephson, M.D., of the
University of Pennsylvania School of Medicine in
Philadelphia, Pennsylvania, now of
Beth Israel-Deaconess Hospital at
Harvard Medical School in
Boston, Massachusetts, and
Hein J. J. Wellens, M.D., of the Academic Hospital in
Maastricht, The Netherlands.
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