158:(EPS) consists in the insertion of pacing and recording electrodes either in the esophagus (intra-esophageal EPS) or, through blood vessels, directly into the heart chambers (intra-cardiac EPS) in order to measure electrical properties of the heart and, in the case of intra-cardiac EPS, to electrically stimulate it in the attempt to induce arrhythmias for diagnostic purposes ("programmed electrical stimulation"). Frequently, an EPS is combined with an ablation in the same procedure if deemed the appropriate therapy.
237:. In addition to the apparatus used for a "non-complex" ablation, these procedures often make use of sophisticated electro-anatomic mapping systems to localize the source of the abnormal rhythm and to direct delivery of ablation lesions. Additionally, most of our current electro-anatomic mapping systems have the ability to integrate CT or MR images of the heart to allow electrical activity to be superimposed on anatomic structures.
64:, and two years of clinical cardiac electrophysiology. This is necessary due to the significant complexity of patients that electrophysiologists usually treat, the constant advances in methods and equipment used in their daily practice, making the field of electrophysiology one of the most demanding subspecialties of modern medicine.
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In addition to diagnostic testing of the electrical properties of the heart, electrophysiologists are trained in therapeutic and surgical methods to treat many of the rhythm disturbances of the heart. Therapeutic modalities employed in this field include
200:). Ablation is usually performed during the same procedure as the electrophysiology study during which arrhythmias are attempted to be induced as well as elucidating the mechanism of the arrhythmia for which ablation therapy is sought.
39:. Cardiologists with expertise in this area are usually referred to as electrophysiologists. Electrophysiologists are trained in the mechanism, function, and performance of the electrical activities of the
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Ablation therapy is a catheter based ablation of lesions in the heart (with radiofrequency energy, cryotherapy (destructive freezing), microwave, or ultrasound energy) to cure or control arrhythmias (see
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Initial administration and monitoring of the effect of drugs for treatment of heart rhythm disorders. Electrophysiologists are often involved when severe or life-threatening
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An electrophysiology study is any of a number of invasive (intracardiac) and non-invasive recording of spontaneous electrical activity, as well as of cardiac responses to
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Electrophysiologists will commonly employ the following diagnostic tests and may be performed or interpreted exclusively by the electrophysiologist. Other tests such as
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Additionally, there are, at times, indications to remove these devices and extraction (ie, removal) of these devices can also be performed by electrophysiologists.
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The training required to become an electrophysiologist is lengthy and requires eight years after medical school (in the U.S.), entailing three years of
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43:. Electrophysiologists work closely with other cardiologists and cardiac surgeons to assist or guide therapy for heart rhythm disturbances (
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Once implanted, long-term clinical follow up and reprogramming of implanted devices also falls to the electrophysiologist.
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is an implanted ECG recorders for long-term monitoring of ECG to allow for diagnosis of an arrhythmia
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may be included in an evaluation but are not exclusive to electrophysiology.
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Surgical procedures: pacemaker and defibrillator implantation and follow up
152:(SAECG) interpretation, also referred to as "late potentials" reading
262:"Biventricular" devices for patients with congestive heart failure
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204:"Non-complex" ablations include ablation for arrhythmias such as:
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225:"Complex" ablations include ablation for arrhythmias such as
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Clinical
Cardiac Electrophysiology: A Practical Guide
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331:Katritsis, Demosthenes G.; Morady, Fred (2022).
187:are commonly used to try to control rhythms.
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31:concerned with the study and treatment of
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99:Scope of practice, tests and procedures
93:implantable cardioverter-defibrillators
87:therapy and surgical implantation of
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103:Common rhythms dealt with include
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333:"1. Classification of arrythmias"
150:Signal-averaged electrocardiogram
69:programmed electrical stimulation
246:Implantation of devices include
278:Left atrial appendage occlusion
206:AV nodal reentrant tachycardia
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227:multifocal atrial tachycardia
113:supraventricular tachycardias
265:Subcutaneous defibrillators
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339:. Philadelphia: Elsevier.
57:, three years of clinical
367:Cardiac electrophysiology
307:Cardiac electrophysiology
256:Single- and dual-chamber
250:Single- and dual-chamber
21:cardiac electrophysiology
145:T-wave alternans testing
312:Electroanatomic mapping
235:ventricular tachycardia
198:radiofrequency ablation
156:Electrophysiology study
109:ventricular tachycardia
125:cardiac stress testing
173:Antiarrhythmic agents
19:(also referred to as
268:Leadless pacemakers
231:atrial fibrillation
105:atrial fibrillation
85:antiarrhythmic drug
302:Cardiac arrhythmia
140:Tilt table testing
119:Diagnostic testing
77:electrocardiograms
346:978-0-323-79338-4
191:Catheter ablation
163:Medical treatment
132:Electrocardiogram
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318:References
297:Cardiology
252:pacemakers
185:amiodarone
181:dofetilide
177:flecainide
111:, and the
89:pacemakers
62:fellowship
59:cardiology
29:cardiology
23:or simply
214:catheters
55:residency
361:Category
291:See also
175:such as
280:devices
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41:heart
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