Electrophysiology

The right pace at the right time.

Keeping a Steady Beat

Your heart's electrical system keeps you alive every single day, directing how fast your heart beats and determining how it beats. When it malfunctions, the results can be very serious.

Cardiac electrophysiology at INTEGRIS Health is the study of your heart's electrical system. Through the use of a variety of advanced diagnostic procedures, we can narrow down the cause of the problem in your heart's electrical system.

• Electrocardiogram (ECG): An electrocardiogram is a measurement of the electrical activity of your heart. By placing electrodes at specific locations on your body (chest, arms, and legs), a graphic representation, or tracing, of the electrical activity can be made as the electrical activity is received and interpreted by an ECG machine. An ECG can show the presence of arrhythmias, damage to your heart caused by ischemia (lack of oxygen to the heart muscle), or myocardial infarction (MI, or heart attack), a problem with one or more of the heart valves or other types of heart conditions.

There are several variations of the ECG test:

• Resting ECG: An ECG done while you are lying down.
• Exercise ECG, or Stress Test: You are attached to the ECG machine as described above. However, rather than lying down, you exercise by walking on a treadmill or pedaling a stationary bike while the ECG is recorded. This test is done to assess changes in the ECG during stress, such as exercise.
• Signal-Averaged ECG: This procedure is done in the same manner as a resting ECG, except that your heart's electrical activity is recorded over a longer period of time, usually 15 to 20 minutes. Signal-averaged ECGs are done when arrhythmia is suspected, but not seen on a resting ECG. The signal-averaged ECG has increased sensitivity to abnormal ventricular activity called late potentials.

• Echocardiogram (Echo): This procedure evaluates the structure and function of your heart by using sound waves recorded on an electronic sensor that makes a moving picture of the heart and heart valves.
• Electrophysiologic Studies (EPS): A nonsurgical but invasive test in which a small, thin tube (catheter) is inserted into a large blood vessel in your leg or arm and advanced to your heart. This lets your doctor find the site of the arrhythmia's origin within your heart tissue to determine how to best treat it. Sometimes, your doctor can treat the arrhythmia by doing an ablation at the time of the study.
• Holter Monitor: Problems with your heart's electrical system may be transient in nature and not seen during the shorter recording times of the resting ECG, so a Holter Monitor is a continuous ECG recording done over a period of 24 or more hours. Electrodes are attached to your chest and connected to a small portable ECG recorder by lead wires while you go about your daily activities.
• Event Monitor: This is similar to a Holter monitor, except that you start the ECG recording only when you feel symptoms.
• Mobile Cardiac Monitoring: This is similar to both a Holter and event monitor. The ECG is monitored constantly to allow for detection of arrhythmias, which are recorded and sent to your doctor regardless of whether you have symptoms. You can also start recordings yourself when you have symptoms. These monitors can be worn up to 30 days.
• Implantable Loop Recorder: This is a miniature heart recording device that is implanted underneath the skin overlying your heart. It can record the heart rhythm for up to 2 years and is useful in diagnosing intermittent or rarely occurring arrhythmias.

These diagnostic procedures are instrumental in narrowing down the source of your cardiac condition, and are also helpful in managing ongoing treatment and evaluating the efficacy of treatment for conditions such as:

• Arrhythmia
• Angina (Chest Pain)
• Heart Attack
• Advanced Heart Failure
• Congenital Heart Disease
• Peripheral Vascular Disease (PVD)
• Aneurysm
• Atrial Fibrillation
• Carotid Artery Disease
• Heart Valve Disease