| Electrophysiology
is used in the diagnosis and treatment of cardiac rhythm disorders. While
a normal heart beats at a regular rate and with a steady rhythm,
certain conditions can cause the heart to
beat too rapidly or irregularly. These abnormal rhythms are diagnosed
in our clinic using noninvasive methods such as electrocardiograms
(EKGs), Holter monitors (twenty-four hour EKGs) and other "event
monitors.” Treadmill testing can be used to evaluate conditions
triggered by exercise. Finally, some children with fainting spells
may be diagnosed using “tilt table” testing, which can mimic sudden
positional changes that often lead to fainting spells.
Electrophysiologic testing uses long, thin
flexible tubes (catheters) that are passed through veins and
arteries into the heart. These
catheters are used to test the heart’s electrical system and to
look for arrhythmias (irregular rhythms) and their causes.
Certain fast heart rhythms can be cured
using a procedure called catheter ablation,
during which the few cells responsible
for the rapid rate are destroyed. This allows the remaining normal
heart cells to beat regularly. Successful catheter ablation can
prevent the need for life-long medications. Depending on the mechanism
of the abnormal heart rhythm under treatment, success rates of
ablation
approach 90%.
The electrophysiology department also performs
pacemaker implantations. Pacemakers
are small battery-powered devices that are implanted in the body
in order to treat slow heart rates (bradycardias). They stimulate
the heart to beat at a higher rate. In other cases, implantable
defibrillators can be used to interrupt dangerous fast heart rhythms.
What to Expect Electrophysiology procedures are performed in the cardiac catheterization
laboratory. Parents are allowed to accompany their children as
far as the door of the room, but then will need to wait in the
waiting room. A mild sedative is given by mouth to calm the patient
prior to entering the catheterization laboratory.
After administration of anesthesia the procedure
lasts from three to five hours. Afterwards the patient will
spend an hour in the recovery room and then be admitted to the
ward for four to six
hours of observation. Many patients are discharged home on the
day of the procedure.
A follow-up visit with the cardiologist will
be arranged one week following the procedure. Children
are allowed to resume all regular activities including bathing
and swimming two days
following discharge.
Further details including timing, risks,
and benefits of the procedure will be discussed beforehand with
the cardiologist. All
questions regarding electrophysiology procedures should be directed
to Dr. Kishor Avasarala. |
