Diagnostic Electrophysiology Procedures

Electrophysiology is a subspecialty of Cardiology. Most of the patients we see for heart rhythm disorders have already been seen by the cardiologist and have also had several tests of the heart performed already. However, there are specialized tests that can help us to diagnose the cause of your heart rhythm problems.

One of the most valuable pieces of information that we need includes an ECG (a recording of your heart's electrical rhythm) during symptoms. We will often prescribe a heart monitor that you can wear at home for up to 30 days. This is called a loop recorder. This device allows you to record your own ECG at the time that you are experiencing your symptoms. At times, we need to monitor your heart for longer periods of time. In this case we can implant a tiny heart monitor under your skin which can provide ECG monitoring for up to 2-3 years. These devices, called implantable loop recorders, are monitored wirelessly and allow you to make recordings at the time you are experiencing symptoms. However, if your heart goes too slowly or too quickly, the monitor will automatically record your ECG so that we can review them at a later time.

Sometimes we need to observe a specific symptom or heart rhythm directly. In patients who have fainting spells, we often perform a tilt table test. This is a test designed to elicit a fainting spell while we are observing your heart rhythm and blood pressure. This not only helps us to make a diagnosis, but may also help to guide treatment. Similarly, electrophysiology tests are invasive tests of the heart's electrical system. By placing special wires called catheters through the veins into the heart, we can record electrical activity associated with every heartbeat. We can also measure the timing of the electrical signals traveling from the top of the heart to the bottom of the heart. Finally, we can test to see if the heart is prone to rapid or dangerous heart rhythms. This test provides a lot of diagnostic information about your heart's electrical system. This test can also help us to decide upon an appropriate treatment.