An electrophysiologist is a doctor who studies and works on the electrical system in the heart. As opposed to a general or interventional cardiologist who works primarily on the heart's pumping system, an electrophysiologist helps to manage heart rhythm disorders, which are due to problems of the electrical system of the heart.
There are two basic types of heart rhythm disorders. Electrical problems that cause slow or fast heart rates. There are many types of fast heart rhythm but the most common disorder that makes the heart beat fast is atrial fibrillation (AFib). Slow heart rhythms are usually due to a dysfunction of the electric conduction system.
Rhythm disorders that slow the beat of the heart are generally treated in one of two ways. If medications are the cause of slow heart rate, often adjusting medications can resolve this issue. If medication adjustment is not successful or feasible to improve heart rate then a pacemaker can be implanted.
A weak heart condition or cardiomyopathy may also cause a rhythm disorder leading to a very rapid abnormal heart rhythm called ventricular tachycardia or ventricular fibrillation. For these cases, an electrophysiologist may implant a defibrillator.
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Similar to the procedure to implant a pacemaker, this device works from inside the body to protect the patient from a potentially fatal arrhythmia.
Afib, the most common heart rhythm disorder, causes the atrial rhythm to become very chaotic, leading to irregular heartbeats, weakness, shortness of breath and fatigue. Though there are medications available to treat Afib, some people do not respond to this treatment and require an ablation procedure.
In a cardiac ablation, an electrophysiologist guides a catheter from the femoral vein in the patient's groin to the left atrium of your heart to ablate — or scar — the source of the arrhythmia. The scarring helps to reset the rhythm of the heart.
Electrophysiologists began using cardiac ablation for Afib in the late 1990s, but the procedure has advanced greatly over the last 15-20 years. The procedure can be 80-90 percent effective for patients depending on the persistence of their Afib.
If left untreated, Afib can lead to a number of health concerns including blood clots, heart failure, stroke and other debilitating or even life threatening issues. The initial symptoms of Afib present with rapid heartbeat, fatigue, shortness of breath or fluid retention. A individual patient may not immediately know the electrical system of the heart is the problem. However, the best course of action is to share those concerns with a primary care provider, cardiologist or electrophysiologist.
Primary care providers know their patients' health history and can serve as the quarterback of their care. They can identify if the symptoms may be caused by a potential heart rhythm disorder and direct the patient to the appropriate specialist for further consultation and treatment.