Huntington’s electrophysiologists, cardiologists with special training in the diagnosis and treatment of problems related to the heart’s electrical system, provide patients with a comprehensive electrophysiology assessment to identify potential problems as well as the most effective measures to treat and prevent them.

• Electrophysiology Study
A test in which insulated electric catheters are placed inside the heart to study the heart’s electrical system. During this test, a small catheter (hollow tube) is inserted through the groin or neck into the heart. This gives the physician the capability of finding the site of an arrhythmia's origin within the heart tissue, thus, determining how to best treat it.

• Radiofrequency Ablation
This procedure uses radio waves to silence an abnormal area in the heart's electrical system, which is usually found during an electrophysiology study as described above. During this procedure, a catheter (hollow tube) is inserted into the heart through a vessel in the groin or arm. Once the site of the abnormality has been determined, the catheter is moved to the site. Very high frequency radio waves are applied to the site, heating the tissue until the site is destroyed.

• Cryoablation
During this procedure, cardiologists freeze abnormal tissue in the heart in order to correct an ahrythmia. During this procedure, a catheter (hollow tube) is inserted into the heart through a vessel in the groin or arm. Once the site of the abnormality has been determined, the catheter is moved to the site. An ultra-cold substance is applied to the site, freezing the tissue and destroying the site.

• Tilt table studies
During this test, the patient is strapped to a table which tilts from a lying to a standing position. Throughout the test, the patient is connected to both electrocardiogram (ECG) and blood pressure monitors which are used to determine if the patient is prone to sudden drops in blood pressure or slow pulse rates with position changes.

• Permanent pacemaker implantation
A permanent pacemaker is inserted into the patient's heart and upper chest to provide a reliable heartbeat when the heart's own rhythm is too fast, too slow, or irregular. A permanent pacemaker is a small device that is implanted under the skin (most often in the shoulder area just under the collar bone) which sends electrical signals to start or regulate a slow heart beat. A permanent pacemaker may be used to make the heart beat if the heart's natural pacemaker (the SA node) is not functioning properly and has developed an abnormal heart rate or rhythm or if the electrical pathways are blocked.

• Internal cardiac defibrillator implantation
A defibrillator is inserted into the patient's heart and chest to send out a small amount of electricity when needed to jolt the heart rhythm back to normal.
An implantable cardioverter defibrillator (ICD) is a small device, similar to a pacemaker, that is implanted under the skin, most often in the shoulder area just under the collarbone. An ICD senses the rate of the heartbeat. When the heart rate exceeds a rate programmed into the device, it delivers a small electrical shock to the heart to slow the heart rate. Many newer ICDs can also function as a pacemaker by delivering an electrical signal to regulate a heart rate that is too slow. ICDs are typically used for fast arrhythmias such as ventricular tachycardia.

• Cardiac resynchronization therapy
A treatment for heart failure patients in which a specialized pacemaker is inserted into the chest in order to re-coordinate the movements of the left and right ventricles of the heart and improve pumping ability. Depending on the patient’s specific condition one of two devices are implanted, a biventricular pacemaker or a biventricular ICD (implantable cardioverter defibrillator.) Both devices send electrical impulses to synchronize the right and left ventricles of the heart, but the biventricular ICD is also able to correct life-threatening heart rhythms.

Click here for more info on “Keeping the Beat with Cardiac Resynchronization Therapy”

• T-wave alternans studies
This is a non-invasive test using an electrocardiogram (ECG) tracing to determine if a patient is at increased risk for sudden cardiac death or cardiac arrest due to dangerous cardiac arrythmias. The slightest variations in the T-wave portion of the ECG are detected using sensitive, state-of-the-art equipment. This test is usually used to determine if the patient would benefit from the placement of an implantable cardioverter defibrillator (ICD.)

• Loop recorder implantation
A small device which records the electrical activity of the heart is inserted under the skin usually in the upper chest area. Approximately the size of a stick of gum, the loop recorder is used to identify any irregular heart rhythms. This procedure usually takes less than 30 minutes and requires only a local anaesthetic. Patients with an implantable loop recorder (ILR) are required to press a button on a hand held activator when they are experiencing symptoms in order to capture and record each cardiac episode.

• Cardioversion
In this procedure, an electrical shock is delivered to the heart through the chest to correct an abnormal heart rhythm. The patient is connected to an ECG monitor which is also connected to a defibrillator. The electrical shock is delivered at a precise point during the ECG cycle to convert the rhythm to a normal one. This synchronized electrical shock is delivered to the heart through special paddles which are applied to the skin of the chest and back.

What to expect before, during and after your procedure in the Electrophysiology Laboratory:

Before the procedure, the electrophysiologist will meet with you to answer any questions you may have. At this time you may be asked to stop taking certain medications, such as heart rhythm medications or blood thinners, a few days prior to the procedure. You may also be instructed to have certain laboratory tests in the hospital’s presurgical testing area, such as blood tests, prior to your procedure. Unless instructed otherwise by your doctor, please do not eat or drink anything after midnight the day before your procedure. Always follow your doctor’s specific instructions.

During the procedure, you may receive pain medication if necessary. For procedures requiring an electronic catheter, skin in the groin or neck area is washed, and shaved if necessary. A local anesthetic is used to numb the skin and a small needle is used to puncture the vein or artery in which the catheter is inserted. X-rays help guide the catheter to the appropriate place. An IV (intravenous) line may be inserted to administer medications and fluids during the procedure. When the procedure is completed, the catheters are removed and pressure is applied to the puncture site.

After the procedure, you may be taken to the recovery room to rest for up to several hours at which time you may be able to return home. Depending upon your condition and the specific procedure, you may be required to stay overnight in the hospital. It’s always a good idea to have a friend or family member drive you home. In most cases, you will be able to return to your normal routine a few days following the procedure. But you may be asked to avoid strenuous activities for a short while.