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.
Heart rhythm management services at Baylor Scott & White Heart and Vascular Hospital – Dallas include:
- Pacemaker (heart beats too slow)
- Defibrillator (heart beats too fast)
- Heart failure device (for dysynchronous ventricles)
- Implantable loop recorder
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 Scott & White Heart and Vascular Hospital – Dallas, 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.
Diagnosis and Treatment in the Lab
At Baylor Scott & White Heart and Vascular – Dallas, 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.
Before treatment options can be determined, several factors must be considered including age, personal and family medical history, current medications, any existing diseases or conditions, and signs and symptoms of the current arrhythmia.
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 non-invasive, 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).
To find an electrophysiologist on the medical staff at Baylor Scott & White Heart and Vascular Hospital – Dallas, call 1.844.BSW.DOCS or visit our Physician Finder