Cardiac Electrophysiology (or Clinical Cardiac Electrophysiology, Arrhythmia Services , or simply Electrophysiology), is a branch of the medical specialty of Cardiology and/or Cardiac Surgery dealing with the study and treatment of rhythm disorders of the heart. Cardiologists with expertise in this area are usually referred to as Electrophysiologists. Electrophysiologists are trained in the mechanisms of the electrical activities of the heart. Electrophysiologists work with other Cardiologists and Cardiac Surgeons to help guide therapy for heart rhythm disturbances (arrhythmias). They are trained to treat cardiac arrhythmia by medical and surgical means.
An electrophysiologic study is a term used to describe a number of invasive and non-invasive recording of electrical activity of the heart as well as of cardiac responses to programmed electrical stimulation. These studies are performed to delineate arrhythmias, understand symptoms and abnormal electrocardiograms, and to assess risk of developing future arrhythmias as well as guide treatment. Therapeutic methods include antiarrhythmic drug therapy and surgical implantation of pacemakers and implantable cardioverter / defibrillators. Medical treatment might include administration and monitoring of the effect of drugs. Electrophysiologists are often involved when severe or life threatening arrhythmias are treated or when multiple drugs must be use in the treatment of an arrhythmia. Ablation therapy involves the use of a catheter inserted through the vascular system and placed in the proper position by fluoroscopy withthe subsequent creation of lesions in the heart with radiofrequency energy, cryotherapy (destructive freezing), or ultrasound to cure or control arrhythmias. Ablation is usually performed during the same procedure as the electrophysiology study which makes the diagnosis of the arrhythmia for which ablation therapy is used. Other surgical procedures may include placement of an internal pacemaker and/or defibrillator.