Answers In A Heartbeat

ANSWERS IN A HEARTBEAT

Dr. Ishu V. Rao

Board Certified in Clinical Cardiac Electrophysiology, in practice since 2003

Your Heart is electric. Click to learn more

The study and treatment of electrical activities of the heart

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What is Electrophysiology

Electrophysiology, or EP, is the sub-specialty of Cardiology that addresses electrical problems of the heart. It is well known that the heart has arteries, the coronary arteries, that can become blocked over time and lead to heart attacks. What is not as well recognized by many is that the heart also has it’s own electrical system that keeps the four chambers, or parts, of the heart beating in an organized, rhythmic fashion. When extra circuitry develops or becomes apparent, or when there is a failure of the heart’s own electrical wiring, the heart may beat too fast or too slow. Patients will often complain of symptoms of palpitations, fatigue, shortness of breath, lightheadedness or may even pass out. The Electrophysiologist’s task is to determine the cause of those symptoms as they relate to the electrical system of the heart, and to then remedy the cause. In a manner of speaking, the Electrophysiologist is the electrician of the heart!

Heart Diseases treated by an Electrophysiologist

There are numerous ways in which the heart’s electrical system may malfunction. Age and various conditions can lead to failure of the heart’s own wiring, often leading to Sick Sinus Syndrome or Heart Block. A Pacemaker may be required to alleviate the symptoms that can result from these conditions.

Fast heart rhythms can result from a variety of causes. Some are from extra circuitry that a patient is born with, such as is the case in Wolff-Parkinson-White (WPW) Syndrome. Other conditions, such as SVT, AVNRT, Atrial Flutter, or Atrial Fibrillation, may develop over time. All of these conditions are treatable (and in many cases, curable in 90% of situations) by the Electrophysiologist by performing anAblation Procedure.

Some conditions are life threatening. Chief among them are Ventricular Tachycardia (VT) and Ventricular Fibrillation (VF).  These rapid heart rhythms originate from the bottom chambers of the heart, the ventricles, and are most often the result of heart attacks that may have occurred years before. When a patient has a heart attack, one of the arteries supplying blood to the heart is blocked by a “thrombus”, a blood clot that forms when a fatty plaque lining the artery ruptures.The heart muscle that is being supplied with blood and Oxygen by this artery will die if the artery is not opened rapidly with a balloon angioplasty procedure. If the artery is not opened, the dead muscle becomes scar tissue which can give rise to the arrhythmias VT and VF in time.

VT and VF result in Sudden Cardiac Arrest (SCA) in 95% of patients. Sudden Cardiac Arrest is the number one cause of death in this country, accounting for almost 1000 deaths per day! To prevent SCA, the Electrophysiologist can implant a Defibrillator device, or ICD, which can deliver a high energy shock if VT or VF are detected, thus saving the patient’s life.

Your Heart is Electric

Simply put, the heart is a pump made of muscle. It is divided into four chambers: two upper (the right and left atria) and two lower (the right and left ventricles). The chambers squeeze in a coordinated fashion to effectively pump blood forward, thus continuously supplying the body with Oxygen. The timing that keeps the chambers working in a synchronized fashion is dictated by a system of complex electrical wiring within the heart.

Whats the worst that can happen?

This video depicts the worst possible electrical malfunction of the heart–Sudden Cardiac Arrest, caused by an arrhythmia called VF–and how an otherwise tragic event can be averted. The patient in the video is Belgian soccer player Anthony Van Loo, who had previously undergone implantation of an ICD, an implantable defibrillator, as he was felt to be at high risk for Sudden Cardiac Arrest. As it turns out, his physicians’ suspicions were warranted, and he suffered an episode while on the soccer field. Cameras captured the event as seen below. Luckily, his ICD shocked his heart back to a normal rhythm and disaster was averted. Watch!