|Most Frequently Asked Questions: (please scroll down)
What is cardiac electrophysiology?
What causes an irregular heart beat?
What symptoms result from arrhythmias?
What is an EP study?
What is ablation?
What is syncope?
What is a pacemaker?
What is an implantable cardioverter defibrillator?
What is atrial fibrillation?
What is cardiac electrophysiology? Cardiac electrophysiology (EP) is the science of the
electrical system of the heart. Cardiac electrophysiology evaluates the normal and
abnormal transmission of electrical impulses and their influence on the contraction of the
heart muscle, thus creating a heart beat. A specialist in cardiac electrophysiology is known
as an electrophysiologist.
What causes an irregular heart beat? Irregular heart beats or arrhythmias may be
caused by many different factors, including: Misfiring cells within the heart ; Coronary
artery disease - such as clogged arteries; Electrolyte imbalances in blood - such as
sodium or potassium; Changes in the heart muscle structure- such as injury from a heart
attack, heart valve disease or healing process after heart surgery; Sensitivity to
stimulanants - such as caffeine; Congenital presdisposition - such as extra circuits present
What symptoms result from arrhythmias? Arrhythmias most commonly result in racing
of the heart or tachycardia, or an irregularity of the heart called palpitations. They may also
result in dizziness, fainting, shortness of breath, chest pain, stroke and cardiac arrest.
What is an EP study? An electrophysiological study (EPS) is an invasive test to study the
electrical activity of the heart by inserting one or more catheters from the blood vessels in
the groin region to inside the heart chambers. Arrhythmias may be diagnosed very
accurately with this testing modality. EPS is used to help diagnose and risk stratify
individuals with wide variety of rhythm disturbances of the heart
What is ablation? It is treatment for an abnormal electrical circuit that causes an irregular
or rapid heart rhythm. The procedure is utilized in conduction with 3-D mapping
technology, similar to a GPS navigation mapping system in automobiles, which allows for
very accurate localization of the abnormal short circuit. The procedure involves destroying
(ablating) areas of the heart that are causing arrhythmias. In a radiofrequency (RF)
ablation, Dr. Kosar pinpoints the troubled area and then uses radiofrequency energy to
"cauterize" and eliminate the tiny part of the heart muscle causing the heart rhythm
What is syncope? Syncope is a sudden loss of consciousness or fainting. A common and
serious cause of syncope is arrhythmia. Bradycardia, or slow heart rates, can be treated
effectively with a pacemaker. Tachycardia, or rapid and erratic heart beats, may be treated
with medication, catheter ablation, or an implanted defibrillator. Additionally, tilt table testing
may be used to diagnose neuro-cardiogenic syndromes.
What is a pacemaker? Pacemakers are battery-powered implantable devices that
function to electrically stimulate the heart to contract and thus keep pumping blood.
Pacemakers consist of a coin-sized housing device which contains a battery and the
electronic circuitry that runs the pacemaker, and one or two long thin wires that travel
through a vein in the chest to the heart. Pacemakers are usually implanted in patients who
have bradycardia or an abnormally slow heart rate or pulse, which causes weakness or
What is an implantable cardioverter defibrillator? A defibrillator (ICD) is a heart
monitor that can automatically deliver electrical shocks to restore normal cardiac rhythm,
similar to the paddles found in an ambulance. ICD is a device that is implanted with minor
surgery beneath the skin of the chest. It connects to the heart with leads inserted through
the veins near the shoulder region. Open-heart surgery is not necessary for installation.
These leads are used to deliver electrical shocks, monitor the cardiac rhythm and
sometimes pace the heart, as needed. When an ICD detects ventricular tachycardia, it may
pace or shock the heart to restore the normal rhythm. It corrects a cardiac arrest, and
Cardiac resynchronization is a type of ICD/ pacemaker used to coordinate and
strengthen weak hearts in congestive heart failure by improving the ejection fraction, and
decreasing fluid retention and valve leakage.
What is atrial fibrillation? It is a common form of arrhythmia affecting over 2 million
Americans, where the heart's two small upper chambers (the atria) quiver instead of
beating effectively. Blood isn't pumped completely out of them, so it may pool and clot. If a
piece of a blood clot in the atria leaves the heart and becomes lodged in an artery in the
brain, a stroke may result. Also since the heart does not beat effectively, congestive heart
failure may develop. Treatment options include medications, blood thinners, catheter
ablation, electrical cardioversion (shock treatment), or pacemaker implantation.
Please contact Dr Kosar with any further questions.
| EROL KOSAR, MD