Cardiology

Physician Information

The Department of Cardiology has set-up an electrophysiology program since 1995. The electrophysiology program primarily deals with abnormal cardiac rhythm & rate.

ELECTROPHYSIOLOGY PROGRAM :

1. Arrhythmia clinic

Electorphysiological studies (EPS) are performed in the cardiac catheterization laboratory that has special equipment to record electrograms from within the heart. In the study three or more catheters (long, flexible wires 1.5 to 2.0 mm diameter) are inserted into the heart (figure 1). The X-ray equipment is used to position the catheters in the chambers of the heart. The heart rhythm is monitored on a special screen to show the electrical pathway of each beat. The patient needs to be admitted to the hospital the day before, or the morning of the EPS. Blood tests, X-rays, ECGs and echocardiogram may be required when the patient is admitted. Fasting for 6 hours is required before the EPS. All anti-arrhythmic medications may be stopped for 48 to 72 hours before the procedure. An informed consent would be taken. Pregnant patient are deferred from EPS. The procedure is performed under local anesthesia and mild sedation would generally be used. For young children, general anesthesia would be used. Through the femoral route cahteters are introduced into the cardiac chambers. Tachycardia can be started with the help of these catheters and during tachycardia electrograms recorded through these catheters are used to study the presence of accessory pathway or abnormal foci. Once the abnormal circuit is determined, a special catheter is used to deliver radiofrequency current at that spot which would eliminate the accessory pathway or extra connection and prevent tachycardia. The procedure takes anywhere from 90 minutes to 3 hours. When the procedure is finished, the catheters are removed and hemostasis achieved. The patient is advised rest for 4 to 6 hours and the next day the dressing is removed and patient discharged. Strenous physical exercise and lifting heavy weights is to be avoided for 15

Figure 1: Placement of catheters in cardiac chambers

days to allow healing at the puncture sites in the groin. However the person can resume duty or job within next couple of days of the procedure. After successful ablation half a tablet of aspirin is prescribed for three months to allow endocardial healing.

Appointment & waiting list :

The appointment for EPS & radiofrequency ablation is given in the arrhythmia clinic after the patient is seen in detail with all the ECGs & other reports. There is a waiting period of 15 days to 1 month for this procedure. Telephonic appointments are given to out of station patients who have already sent referring physicians notes and all ECGs and reports in advance.

3. Pacemaker implantation

4. AICD implantation