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Posted on in Heart Health

Electrophysiology's Important Role in Cardiology

Many heart patients know about a cardiologist, whose role is to test and diagnose heart problems. And they know about cardiac surgeons, who open chests for bypass or other heart surgery. There is a subset of cardiologists, who receive additional training in the electrical rhythms of the heart. This subspecialty is called electrophysiology.

The heart muscle is kept in rhythm, pumping blood, by a series of electrical signals from nerves,” says McLeod Electrophysiologist Dr. Rajesh Malik. “When those signals are irregular, the patient suffers what we call arrhythmia, fibrillation or tachycardia. The heart may beat too fast, too slow or vary between too fast and too slow.”

Symptoms of these heart problems can be shortness of breath, dizziness or fatigue.

Electrophysiology Study. To find out what is happening in the heart, the cardiologist conducts an electrophysiology study (EPS). The patient is given a local anesthetic and a sedative, while a small wire is threaded from a vein in their groin to their heart.

Using a live image of the heart, the electrophysiologist monitors the heart’s electrical impulses to find out where the problem signals are being produced. It can take two hours or more to draw this electrical map of the heart. Patients may feel some pressure at the site, where a wire or catheter is inserted. During EPS, a patient may feel some discomfort as the various areas of the heart are tested.

Results of the heart study may lead the cardiologist to prescribe medication to control the faulty rhythms. If medications won’t help, an ablation may be performed – sometimes immediately after the EPS.

Radio Frequency Ablation (RFA). In general, the word ablate means “to remove.” The electrophysiologist views the heart in real time while maneuvering a small wire into the heart chamber. Radio frequencies (much like a microwave) are transmitted through the wire to destroy the section of the heart causing problems. Patients should feel relief shortly after the procedure.

What happens afterward?

The EP study and the Ablation treatment are conducted as “same-day” procedures. The patient spends a few hours in a recovery room and is then released to go home. Most people can return to their normal routine the next day. In addition to any specific instructions from the cardiologist, the following cautions are suggested:

  • Avoid strenuous work or exercise for a few days. 
  • For 24 hours after you leave the hospital, don’t drive or drink alcohol. 
  • Call your doctor if the site where the wire was inserted becomes red, infected or bleeds steadily.

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Sources: National Institutes of Health, American Heart Association, British Heart Foundation, Cardiac Arrhythmia Research & Education Foundation,, Heart & Stroke Foundation of Canada, University of Ottawa Heart Institute. 

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