The heart is a muscular pump, weighing an average of 10 ounces. In a minute, an average heart pumps 1.3 gallons of blood, which translates into 1,900 gallons per day and almost 700,000 gallons per year.
While the blood volume statistics might be surprising, people understand the heart's function is as a pump. What often gets overlooked is the fact that electricity is crucial to proper pumping.
Electrophysiology is the study of the electrical properties of biological cells and tissues. As an electrophysiologist, I correct problems with the heart's built-in electrical system.
To understand what an electrophysiologist does, it helps to have some background. The pumping, the synchronized contraction, and relaxation of the heart's chamber are controlled by a special group of cells that have the ability to generate electrical activity on their own. These cells separate charged particles and spontaneously leak certain charged particles into the cells. This produces electrical impulses in the pacemaker cells that spread over the heart, causing it to contract. These cells do this more than once per second to produce the normal heartbeat of 72 beats per minute.
If the electrical signals are disrupted, irregular rhythms known as arrhythmias occur. An arrhythmic heart might beat too quickly, too slowly, or the chambers, which usually squeeze in concert, might contract out of sync. In complicated cases, both the speed and the synchronicity might be affected.
Some indicators that you might need to see an electrophysiologist include: a very slow or very fast heart rhythm, heart palpitations, or the feeling that your heart is "skipping a beat" or is "in your throat." If you ever faint, it might be a signal of a dangerous rhythm.
It's vital to get abnormal rhythms checked out by a medical professional as soon as possible because the earlier they are discovered, the more easily they can be treated. The heart, like other muscles, has muscle memory and can ''learn'' an improper heartbeat. If arrhythmias are allowed to continue, they will generally worsen and not resolve themselves. A very common arrhythmia affecting the heart's top chambers causes them to quiver instead of contract. Scar tissue can form, making treatment much more difficult.
The good news is that most arrhythmias can be treated successfully using a wide variety of tools, ranging from medications and implanted devices to a curative procedure called an ablation.
A pacemaker can be placed to correct a slow heartbeat; an implantable cardioverter defibrillator can be placed to save your life when you have heart failure, which puts you at risk for dangerous arrhythmias in the heart's lower chambers; and a cardiac resynchronization therapy device can be placed to help failing hearts synchronize the ventricles and assist hearts that are squeezing too weakly.
An ablation is a cutting-edge technique that allows the electrophysiologist to use catheters (long, flexible tubes inserted through a vein in a patient's groin and threaded to the heart) to correct structural problems in the heart that cause an arrhythmia. Cardiac ablation works by scarring or destroying tissue in the heart that triggers an abnormal heart rhythm. In some cases, ablation prevents abnormal electrical signals from traveling through the heart and thus stops the arrhythmia.
Thanks to technology in the electrophysiology lab, electrophysiologists can pinpoint specific malfunctioning cells in the heart, usually covering an area of 2 millimeters. The team of skilled nurses and technicians uses medicines and pacing techniques to trigger the arrhythmia in a controlled environment, so a 3-D map of the heart's electrical current is made to find the ''broken circuit.''
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