Arrhythmia Management

Electrophysiology study and catheter ablation

Electrophysiology studies test the electrical activity of your heart to find where an arrhythmia (abnormal heartbeat) is coming from. These results can help you and your doctor decide whether you need medicine, a pacemaker, an implantable cardioverter defibrillator (ICD), cardiac ablation or surgery.

Catheter ablation is a non-surgical technique where a thin electrode catheter (a specially insulated electrical wire) is used to localise the abnormal site in the heart causing the arrhythmia (electrical disorder of the heart). Radiofrequency energy is then delivered via the catheter to ablate (or destroy) it. It is an extension of the electrophysiological study (EPS).

Device Implantation

The pacemaker sends electrical pulses to your heart to keep it beating regularly and not too slowly. Having a pacemaker can significantly improve your quality of life if you have problems with a slow heart rate. The device can be lifesaving for some people. In the UK, pacemaker implantation is one of the most common types of heart surgery carried out, with many thousands of pacemakers fitted each year.

An implantable cardioverter defibrillator (ICD) is a device similar to a pacemaker. It sends a larger electrical shock to the heart that essentially “reboots” it to get it pumping again. Some devices contain both a pacemaker and an ICD. ICDs are often used as a preventative treatment for people thought to be at risk of cardiac arrest at some point in the future. If the ICD senses the heart is beating at a potentially dangerous abnormal rate, it will deliver an electrical shock to the heart. This often helps return the heart to a normal rhythm. A conventional ICD has a pacing lead that’s implanted along a vein (transvenously). There’s also a newer type of ICD where the pacing lead is implanted under the skin (subcutaneously).

Cardiac resynchronization Therapy (CRT-D) refers to the insertion of electrodes in the left and right ventricles of the heart (pumping chambers of the heart), as well as on occasion the right atrium (top chamber of the right heart), to treat severe heart failure by coordinating the function of the left and right ventricles via a pacemaker, a small device inserted into the interior chest wall.