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What is an Electrophysiology Lab?


Each day, the heart pumps approximately 2,000 gallons of blood throughout the body and beats about 100,000 times. The heart is located in the center of the chest but, because the bottom of the heart tips to the left, more of the heartbeat is felt on that side of your body. Normally, electricity flows through the heart and produces the familiar thump-bump pattern that can be heard through a stethoscope. But if there's an irregular heartbeat, or arrhythmia, your cardiologist may recommend you go to an electrophysiology lab to determine the cause of the abnormal rhythm. Cardiac arrhythmias are disturbances in the rate or rhythm of the heart's electrical system. These disturbances can range from inconvenient to life-threatening.

Heart rhythm management services we provide include:

  • Pacemaker (heart beats too slow)
  • Defibrillator (heart beats too fast)
  • Heart failure device (for dysynchronous ventricles)
  • Implantable loop recorder

Electrophysiology Studies

Electrophysiology relates specifically to the diagnosis and treatment of the heart's electrical system, which controls the heart rhythm. Electrophysiology studies are commonly performed to identify the area in the heart that is causing the arrhythmia and to develop the best course of treatment. Information generated during these studies also may be used to predict a future cardiac event, evaluate the effectiveness of certain medications to control the irregular heartbeat or decide if certain procedures or implants are necessary, such as a catheter ablation procedure, an implantable defibrillator or a pacemaker.

Electrophysiologists are cardiologists who have additional education and training in the diagnosis and treatment of abnormal heart rhythms. At the electrophysiology lab at Baylor Jack and Jane Hamilton Heart and Vascular Hospital, both diagnostic and therapeutic services are conducted.

If you have a problem with irregular heart rhythms (arrhythmia), your heart may beat too fast, too slowly or erratically. This causes a dangerous disruption of blood flow and can result in stroke, organ damage or organ failure. It's clear that a prompt and thorough examination is called for.

Symptoms of Arrhythmia

It is important to note that not all arrhythmias are accompanied by symptoms. However, some noticeable signs of arrhythmia are:

  • Fluttering in the chest
  • Racing heartbeat
  • Slow heartbeat
  • Chest pain
  • Ongoing fatigue and tiredness
  • Shortness of breath
  • Lightheadedness, dizziness or fainting

Diagnosis and Treatment in the Lab

At Baylor Jack and Jane Hamilton Heart and Vascular Hospital, we have earned national recognition as a leader in treatment of heart and vascular disease, and our electrophysiology lab is no exception. Under the direction of experienced electrophysiologists and cardiologists, our EP lab is equipped to care for all types of problems affecting the heart's electrical system.

In addition to a physical exam and patient history, EP specialists may perform a variety of studies to diagnose heart rhythm problems. Most are simple and noninvasive, such as blood tests, EKGs, stress tests and tilt table tests that check for the source of lightheadedness and fainting. Others, such as EP study and coronary angiography, may involve catheterization lab procedures for a more in-depth check of the heart's electrical signals.

What to Expect in the Lab

If you are scheduled to undergo an electrophysiology test, you should not eat or drink anything after midnight the night before the procedure. Check with your doctor about continuing any medications. If you have diabetes, talk to your doctor about food and insulin intake, which can affect blood sugar levels.

After arriving at the hospital and changing into a hospital gown, an intravenous line is started. You will be given a sedative to make you feel drowsy. Once you are in the cardiac catheterization laboratory where the procedure will take place, electrodes are placed on your chest. An area in your groin is numbed and an incision is made where a special catheter is inserted into a vein and then threaded to your heart using fluoroscopy, which provides continuous, real-time X-ray images of the moving heart.

The catheter can detect electrical activity in the heart and doctors can administer small electrical impulses to make the heart beat at different speeds. The heart's electrical signals normally move from the two top chambers of the heart (the atria), through the atrioventricular node and to the ventricles of the heart, or lower chambers. During the procedure, you may feel some mild discomfort but, usually, no pain. Because the test involves provoking irregular heartbeats, it is performed in a hospital by specially trained staff that includes cardiologists, technicians and nurses.

An electrophysiology test typically lasts between two and four hours, but may take longer if additional treatments are performed at the same time. After the procedure is completed, the catheter is removed and firm pressure is applied to the incision site to prevent bleeding. You will need to rest for several hours, after which you will be allowed to go home.

Abnormal results from an electrophysiology test can identify numerous conditions, such as atrial fibrillation (abnormal electrical discharges in the heart that cause an irregular heartbeat), ventricular tachycardia (rapid heartbeats that start in the ventricles) or Wolff-Parkinson-White syndrome (a condition in which there is an extra electrical pathway in the heart).

We continue to be recognized as a leader in electrophysiology in the Metroplex and the nation because of our focus on successful outcomes, patient satisfaction, and our commitment to research. We achieve this through experience--experience that only a high-volume electrophysiology program can provide. Research studies have shown that the more experience a physician or institution has in performing a certain procedure, the more likely it is to achieve good outcomes.

Physicians on the medical staff at Baylor Jack and Jane Hamilton Heart and Vascular Hospital have participated in many of the developments in electrophysiology and continue to be involved in numerous ongoing research projects, including:

  • Atrial fibrillation
  • Congestive heart failure
  • Defibrillation
  • Pacing, including therapies for the management of heart failure, such as cardiac resynchronization therapy (CRT) (biventricular pacing, combined CRT and pacing and combined CRT and defibrillation)

Listen to Dr. Kowal, Co-Medical Director of Electrophysiology, discuss new pacemaker the size of a nickel, the Micra pacemaker, now available at Baylor Hamilton Heart and Vascular Hospital.

Full-Service Offerings

Before treatment options can be determined, several factors must be considered:

  • Your age
  • Your personal and family medical history
  • All medications you are taking
  • Any other diseases or conditions you may have
  • Signs and symptoms of your current arrhythmia

Wired for Life

An educational class pertaining to Implantable Cardioverter Defibrillators (ICDs)

The Electrophysiology Team is here to provide you with the guidance, encouragement and support you need to live a healthy life with your Implantable Cardioverter Defibrillator (ICD). If you suffer from Cardiomyopathy, Congestive Heart Failure or have experienced Sudden Cardiac Arrest, the ICD can be your life vest and has been described by many to be like having a paramedic by your side at all times. Join us for this free workshop designed for you and your loved ones to learn in a group setting how exactly the ICD works.

Class topics include:

  • Cardiac Disease
  • Lifestyle Changes
  • Shock plan
  • Understanding your device
  • Returning to daily activities
  • Emotional concerns
  • Eating for health

Please call to register for a Wired for Life class.

Baylor Hamilton Heart & Vascular Hospital
621 N. Hall Street, Suite H-030
Dallas, TX 75226
Classrooms A/B

Baylor Jack and Jane Hamilton Heart and Vascular Hospital is the first North Texas hospital dedicated solely to the care and treatment of patients with cardiovascular diseases and related conditions. As part of Baylor Scott & White Health, Baylor Hamilton Heart and Vascular Hospital strives to provide quality and safety in the delivery of patient care. To learn more about understanding or treating atrial fibrillation, or to schedule an appointment, call 214.820.0160, or click Find a Physician today.

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