Cardiac Electrophysiology : Scope & Spectrum of Services
Electrophysiology Study (EPS) and radio-frequency ablation (RFA) for various heart rhythm diseases which can manifest with blackout episodes, loss of consciousness, palpitations, shortness of breath,
Implantable cardiac electric devices for rhythm disorders like pacemakers for slow heart rates, ICD (for sudden cardiac arrest)
Cardiac resynchronization therapy (CRT P and CRT D) for suitable patients with poor heart
State of art pacemakers – cardiac conduction system pacing.
Medical management of various cardiac muscle diseases (cardiomyopathies)
Electrophysiology is a highly specialized field of cardiology that deals with rhythm and rate related abnormalities of the heart. The heart has its own spontaneous rhythm and beats regularly at about 60 to 80 times per minute at rest. It increases appropriately with exertion and emotions such as anger and excitement and decreases naturally during sleep. This rhythm results from a regular synchronous electrical activity within the heart and any disturbance in it, for instance, inappropriately fast or slow heart rate or irregular rhythm is called cardiac arrhythmia.
Patients with cardiac arrhythmias have varied complaints. Common ones being abrupt palpitations, lightheadedness or head reeling leading to falls, loss of consciousness, choking sensation, extreme fatigue and even sudden cardiac arrest. Some arrhythmias may be potentially fatal but most often they cause significant symptoms without having to be life-threatening consequences. Rhythm disorders can also cause cardiac pump dysfunction and heart failure if persistent for a long time. Patients with irregular rhythms run the risk of suffering strokes or paralysis attacks. Cardiac arrhythmias are poorly tolerated by patients with pre-existing heart dysfunction (eg. patients with previous heart attacks). Early medical attention should be sought in such cases.
As any other medical field, cardiac electronic devices like pacemakers, implantable defibrillators (ICD) and cardiac resynchronization therapy (CRT) have seen some remarkable advancements in the last few years and become an integral part of contemporary cardiac care. The devices comprise of a pulse generator implanted under the subcutaneous fat below the collar bone. One or more leads that are connected to the device are positioned in the appropriate chambers in the heart via a vein. The procedure is usually carried out under local anesthesia.
A subgroup of patients with severe cardiac pump dysfunction and heart failure Are eligible for cardiac resynchronization therapy. Well-selected patients show an improvement in exercise capacity and cardiac function in weeks to months after implantation. CRT D is a combination of CRT and ICD and combines the benefit of both devices.
All patient with cardiac devices is advised at least a biannual check. Some may need more frequent visits. The pulse generator is usually replaced every 8 to 12 years with a minor procedure. When used in appropriate patients these devices may be life-saving or changing.