Electrophysiology is the study of the electrical activity of the heart. An arrhythmia is when the heart beat has an abnormal rate or rhythm.  Abnormal heart rhythms may start in the upper chambers of the heart (atria) or the bottom chambers of the heart (ventricles).  When an arrhythmia occurs the heart may beat irregularly, too fast, or too slow. 

At Augusta University Cardiovascular Center, our electrophysiologists are board certified in internal medicine, cardiovascular disease, and cardiac electrophysiology.  They specialize in the treatment of patients with a wide range of heart rhythm conditions including:

  • Atrial Fibrillation
  • Atrial Flutter
  • Supraventricular Tachycardia (SVT)
  • Wolf Parkinson White
  • Ventricular Tachycardia
  • Bradycardia
  • Sick Sinus Syndrome
  • Heart Block
  • Congenital Related Arrhythmias
  • Syncope

Diagnostic Testing

After reviewing your medical history, our physicians may require additional diagnostic testing.  Some of these tests include:

  • Electrocardiograph (ECG/EKG) - recording of your hearts electrical activity
  • Holter monitor - recording of your hearts electrical activity for a 24-28 period of time
  • Event recorder - longer term recording of your heart rhythm, usually worn up to a month at a time
  • Implantable Loop Recorder (ILR) - a small device which is implanted under the skin on the chest; it records the heart rate and rhythm continuously for up to 3 years; recordings are regularly transmitted to a monitoring center and are reviewed by your care team; most often used in patients with suspected, but intermittent abnormal rhythms
  • Echocardiogram - an ultrasound that provides pictures of the hearts valves, chambers, and pumping function
  • Exercise test (Stress test or treadmill stress test) - Helps to determine abnormal heart rhythms during exercise
  • Tilt table test - a procedure performed to evaluate causes of light-headedness or fainting; a table starts in a horizontal condition and tilts up at different angles while your blood pressure and heart rate are monitored
  • Cardiac Computerized Tomography (CT) - a radiology test that uses intravenous dye to obtain high resolution, three dimensional (3D) pictures of the moving heart and vessels surrounding the heart
  • Cardiac MRI - magnetic resonance imaging to evaluate the heart’s structure and function; no radiation is involved in this test
  • Diagnostic invasive electrophysiology study - an invasive procedure, similar to a heart cath, where catheters are placed in your heart to record your electrical activity

Treatment

Leading edge technology, along with advanced resources, allows our physicians to offer patients many options to manage and treat arrhythmias.  Some of our treatment options include:

  • Antiarrhythmic medications
  • Cardioversion- a procedure performed in the hospital with the patient under sedation in which an electrical shock is used to convert an abnormal rhythm back to a normal rhythm
  • Catheter ablation for supraventricular tachycardia, Atrial Fibrillation, and ventricular tachycardia using the technique of radiofrequency or cyroablation
  • During this non-surgical procedure, a catheter (thin flexible tube) is guided via xray through the blood vessels into a specific area of the heart. A special machine directs energy through the catheter to small areas of the heart muscle that cause the abnormal heart rhythm. This energy “disconnects” the pathway of the abnormal rhythm by destroying very small areas of tissue that give rise to abnormal electrical signals. It can also be used to disconnect the electrical pathway between the upper chambers (atria) and the lower chambers (ventricles) of the heart.
  • Maze procedure - a surgical procedure used to treat atrial fibrillation
  • Left Atrial Appendage Closure - an invasive procedure where a device is placed in the left atrial appendage to prevent strokes caused by atrial fibrillation; most often placed in patients who cannot tolerate anticoagulant therapy
  • Pacemaker Insertion (PPM)- an implanted device that monitors and regulates the heart rate
  • Implantable Cardioverter Defibrillator Insertion (ICD) - an implanted device that monitors and regulates the heart rate and rhythm; they can serve as pacemakers for slow heart rates and for dangerously fast rhythms they can deliver electrical therapies which may include rapid pacing or shocks
  • Cardiac Resynchronization Therapy (CRT) - this special PPM/ICD was designed for patients with heart failure, whose heart strength is weakened and whose lower chambers (ventricles) are not contracting together in “synchrony”. This device resycnhronizes the contractions by pacing both ventricles at the same time in an effort to improve the efficiency and strength of the heart. 
  • Lead Extraction - removal of PPM or ICD leads (wires)

Atrial Fibrillation Center of Excellence

Atrial Fibrillation is commonly referred to as A-Fib or AF.  It is the most common arrhythmia, affecting up to 6.1 million Americans per the Center for Disease Control (CDC).  AF is a rapid, disorganized rhythm that starts in the upper chambers (atria) of the heart that causes the lower chambers (ventricles) to beat irregularly.  Due to the rapid, irregular signals the atria “quiver” instead of contracting normally, causing the ventricles to contract irregularly, sometimes fast and sometimes slow.  

AF is classified by how frequently it occurs and long the episodes last.  Some patients may stay in AF and others may go in and out repeatedly throughout the day.  Below are the classifications:

  • Paroxysmal AF - starts and stops without treatment; it may last seconds, minutes, hours, or up to seven days before returning to normal rhythm; your heart rate may vary from slow to fast as the AF comes and goes
  • Persistent AF - occurs when AF does not stop by itself without treatment; medicines and/or cardioversion may be used to help the heart return to a normal rhythm; if not treated, your heart will remain in AF
  • Long-Standing AF - AF that cannot be corrected; medicines and cardioversion will not help return the heart to normal rhythm; the heart is always in AF and it is considered permanent

What are AF symptoms?

AF symptoms may resemble those of other heart disorders. While some patients may experience no symptoms, others may experience the following:

  • Irregular or fast heart beat
  • Fatigue
  • Light-Headedness/Dizziness
  • Shortness of Breath with our without activity
  • Exercise intolerance
  • Chest discomfort
  • Anxiety
  • Palpitations
  • Syncope

Why does it matter?

AF is treatable and generally not life threatening, however, it can lead to other serious medical problems. According to the American Heart Association (AHA), the most serious medical problems that it can lead to are:

  • STROKE - This is the GREATEST RISK OF HAVING AF; patients in AF are 5 times more likely to have a stroke than someone in normal rhythm
  • Heart Failure from the heart having to work too hard
  • Chronic Fatigue
  • It can lead to other heart problems over time

What are the risk factors for Atrial Fibrillation?

Even though AFib can occur at any age, it is most common in people 60 years of age or older.  Sometimes, atrial fibrillation has no identifiable cause, but your chances may increase if you have the following risk factors:

  • CAD
  • High BP
  • Heart Failure
  • Heart Valve Disease
  • Lung Disease
  • Overactive thyroid
  • Obesity
  • Sleep Apnea
  • Heavy alcohol intake
  • Use of medication or substances that stimulate the heart

What are the goals for treatment?

Treatment for AF depend on how severe the symptoms are and if there are any other medical diagnoses such as heart disease or stroke.

  • Relieve AF symptoms and improve quality of life
  • Prevent blood clots, to reduce the risk of stroke
  • Control heart rate
  • Restore and maintain a normal rhythm

The Augusta University Heart Rhythm Center Approach

The Heart Rhythm Center at Augusta University is the leader in clinical excellence for arrhythmia care.  The Electrophysiology (EP) Lab at Augusta University is the first and only EP accredited lab in the region and the state of Georgia through the American College of Cardiology.  Our team includes electrophysiologists (link to our EP’s), cardiothoracic surgeons (link to our CT surgeons), advanced practice providers (link to our APP’s) (nurse practitioners or physician assistants), registered nurses, medical assistants, cardiovascular technicians, pharmacists, and research coordinators.