Cardiac electrophysiology
Cardiac electrophysiology is a branch of
Description
Electrophysiological (EP) studies are performed to assess complex
Electrophysiological study
The cardiac electrophysiology (EP) study typically measures the response of myocardium to programmed electrical stimulation (PES) on specific pharmacological regimens in order to assess the likelihood that the regimen will successfully prevent potentially fatal sustained ventricular tachycardia (VT) or ventricular fibrillation VF (VF) in the future. Sometimes a series of EP study drug trials must be conducted to enable the cardiologist to select the one regimen for long-term treatment that best prevents or slows the development of VT or VF following PES. Such studies may also be conducted in the presence of a newly implanted or newly replaced cardiac pacemaker or ICD.[1]
Physician specialists
A specialist in cardiac electrophysiology is known as an electrophysiologist, or "heart electrician" in layman' terms. Cardiac electrophysiology is a subspecialty of
Research cardiac electrophysiologist
Cardiac electrophysiologists specialize in a sub-area of electrophysiology, which in turn is a sub-area of physiology. This specialization usually requires education at the doctoral (PhD, DSc, or MD/DO) level to become a principal investigator for research projects. The area of research is often multi-disciplinary involving chemistry, bioelectrics, biology, and biomedical engineering. The flagship tools used by cardiac electrophysiologists overlap with the toolbox of the neuroscientist including patch clamp and optical mapping.[3]
Allied professionals
Mapping specialists (EP techs, EP physiologists) are typically educated up to the Bachelor's or Master's level and are employed by either a cardiac electrophysiology company or department. Often international certification such as Certified Electrophysiology Specialist (CEPS) by the International Board of Heart Rhythm Examiners (IBHRE) or EHRA Certified Electrophysiology Specialist (ECES) or equivalent is required.
Subdiscipline
Cardiac electrophysiology is a relatively young subdiscipline of cardiology and internal medicine. It was developed during the mid-1970s by
Textbook
The author of the definitive textbook in the field is by the late
Professional societies
The Heart Rhythm Society, founded in 1979, promotes education and advocacy for cardiac arrhythmia professionals (including cardiac electrophysiologists) and patients. European Heart Rhythm Association, a part of European Society of Cardiology, is active in Europe.[6]
Certification
Founded in 1985 as NASPExAM, the International Board of Heart Rhythm Examiners (IBHRE) offers knowledge based board exams for physicians and allied health professionals working in the field of cardiac electrophysiology and cardiac rhythm device management.[7] European Heart Rhythm Association (EHRA) provides knowledge and practical competency based certification to physicians and allied health professionals[8] as well as accreditation of cardiac electrophysiology training centres[9] in Europe and neighbouring countries.
Mapping systems
Electroanatomic mapping uses electric and magnetic fields to create three dimensional models of heart structures using specialized catheters.
Notable cardiac electrophysiologists
- Kenneth Ellenbogen, American[10]
- Richard N. Fogoros, American
- Michel Haïssaguerre (born 1955), French
- Mark Josephson (1943–2017), American
- George Klein, Canadian[11]
- Bruce Lerman, American
- John Alexander MacWilliam (1857–1937), British/Scottish
- Michel Mirowski (1924–1990), Polish-Israeli-American
- Eric Prystowsky, American [12]
- Amiran Revishvili (born 1956), Russian
- Hein Wellens (1935–2020), Dutch
See also
- Clinical cardiac electrophysiology
- Electrical conduction system of the heart
- Electrocardiogram
- Electrophysiology study
- Radiofrequency ablation
References
- ^ a b c Fauci, Anthony, et al. Harrison's Textbook of Medicine. New York: McGraw Hill, 2009.
- ^ Braunwald, Eugene, ed. Heart Disease, 6th edition. Philadelphia: Saunders, 2011.
- PMID 31768502.
- ^ Josephson, Mark E. Clinical Cardiac Electrophysiology: Techniques and Interpretations, Fourth Edition. Philadelphia: Lippincott Williams and Wilkins, 2008.
- ^ "Josephson's Clinical Cardiac Electrophysiology: Techniques and Interpretations". www.wolterskluwer.com. Retrieved 2022-07-03.
- ^ "European Heart Rhythm Association (EHRA)". www.escardio.org. Retrieved 2022-07-03.[permanent dead link]
- ^ "History | IBHRE". ibhre.org. Retrieved 2022-07-04.
- ^ "EHRA Certifications". www.escardio.org. Retrieved 2022-07-04.
- ^ "EHRA Recognised Training Centres". www.escardio.org. Retrieved 2022-07-04.[permanent dead link]
- ^ "Kenneth A. Ellenbogen, MD, FHRS | Heart Rhythm Society". www.hrsonline.org. Retrieved 2022-07-03.
- ^ "George Klein". www.schulich.uwo.ca. Retrieved 2022-07-03.[permanent dead link]
- ^ "Eric N. Prystowsky, M.D. | Heart Rhythm Society". www.hrsonline.org. Retrieved 2022-07-03.