Electrophysiologists are cardiologists who have received additional specialized training in the diagnosis and treatment of heart rhythm disorders.

Electrocardiographic Tests

Arrhythmias are often diagnosed or identified through the use of electrocardiographic techniques. These techniques, called electrocardiograms (also known as ECG or EKG) are performed by placing small patches, called electrodes, on the body to measure the three major waves of electrical signals. Each wave of electrical signals corresponds to different parts of one’s heartbeat. The first wave is referred to as the P wave, and it shows the activity of the heart’s atria. The second and largest wave is the QRS wave, or the wave that records the electrical activity of the ventricles. Finally, there is the T wave and it allows doctors to see the heart return to its resting state. By examining the size, shape and rate of the waves, doctors are able to see the patterns of a patient’s heartbeat and make conclusions about the heart’s rhythm.


Treadmill Testing
Additional diagnostic techniques for patients with arrhythmias include treadmill testing, a technique which allows doctors to examine irregular heartbeats that may be exercise induced.


Electrophysiologic Testing
To diagnose tachycardias, some doctors place catheters into the heart to get an intracardiac reading, while others may use electrophysiologic testing. Electrophysiologic testing is able to show where the tachycardia originates with more clarity than any other test. This method involves using local anesthesia and placing electrode catheters in the peripheral veins of the heart using a fluoroscope. These catheters are then placed into the atria and/or ventricles at strategic locations along the conduction system. Here they are able to record the cardiac electrical signals and show the course of each impulse during one heartbeat. In addition to these electrical tests, echocardiograms also are used because their ultrasound recordings offer valuable information about the heart.

Implantable Devices

Depending on the severity of the arrhythmia, the patient may or may not need treatment. If necessary, the patient may receive implantable devices that control the heart’s rhythm. One such device is a cardioverter defibrillator, which is an implantable electrode patch that provides automatic shock therapy. Implanted pacemakers are similar and send small electrical impulses to the heart muscle in order to maintain a suitable heart rate. A pacemaker defibrillator combines both treatments to restore and maintain a healthy, steady pace in the heart.


Ablation
Some patients require more invasive treatments such as a radio frequency catheter ablation. This is used if a part of the heart tissue is responsible for the arrhythmia. The treatment uses high frequency radio waves that are inserted into an artery to “zap” the heart tissues and correct the rhythm.