by Vinay Mehta, M.D.
Electrophysiology is a branch of cardiology dealing with diagnosis and treatment of heart rhythm disorders. Electrophysiologists are cardiologists who undergo additional years of training so they are able to treat abnormalities in our heart's electrical system.
Most of us don't realize that our heart depends on an intricate electrical network to keep it functioning. Electricity is generated in special cells in our heart's upper chamber, and an electrical spark is carried through circuits that make contact to produce a heartbeat. When this system fails the heart muscle can't supply blood to the body, particularly the brain. As with power outages during natural disasters, in sudden cardiac arrest, the heart's electrical events are short-circuited, unable to pump effectively if untreated can result in death.
We often visualize a person clutching their chest and dying immediately as a result of a heart attack. However, sudden death in that setting is usually caused by ventricular fibrillation--severely abnormal heart rhythm (VF) or ventricular tachycardia--extremely fast heart rhythm (VF). These arrhythmias can occur in patients with a history of heart attack, or in those with a “weak heart muscle" who are at the highest risk.
Arrhythmias in the lower heart chambers can decrease blood supply to vital organs, including the brain, causing irreversible brain damage or sudden cardiac death. Immediate treatment with electrical shock is essential to restore the heart's natural rhythm. This is why access to automatic external defibrillators (AEDs) in public places is important. But often these incidents occur at home where AEDs and trained personnel are unavailable. By the time resuscitation is attempted it is too late.
But what if you could have a team of emergency medical personnel sitting inside your chest, waiting to revive you immediately during a life-threatening incident? A device known as an implantable cardioverter-defibrillator or ICD, now makes that possible! It is a small battery-powered electrical generator, that can be implanted in patients at risk of sudden cardiac death. Unlike pacemakers, which correct a slow heartbeat, ICDs treat life-threatening arrhythmias in real time by delivering electrical therapy to the heart. They can be programmed by a skilled electrophysiologist, so often life-saving electrical therapy is painless to the patient.
ICDs are positioned just under the skin, outside the ribcage, and implanted during a minor procedure while a person is under mild sedation. ICDs also come with “remote monitoring” so the device can be tested via a landline phone without requiring an office visit.
This is one of the tools in the vast array of incredible technology available to physicians today, allowing us to save lives in ways we could have never imagined.
WNY Resource:
Vinay Mehta, M.D. specializes in Clinical Cardiology and Electrophysiology at Buffalo Heart Group. He is affiliated with Buffalo General Medical Center, Mercy Hospital of Buffalo, Millard Suburban Hospital and Gates Vascular Institute. To learn more visit www.buffaloheartgroup.com or call 716.835.2966.
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