Electrophysiology

Cardiac electrophysiology is the science of elucidating, diagnosing, and treating the electrical activities of the heart. The term is usually used to describe studies of such phenomena by invasive (intracardiac) catheter recording of spontaneous activity as well as of cardiac responses to programmed electrical stimulation (PES). These studies are performed to assess complex arrhythmias, elucidate symptoms, evaluate abnormal electrocardiograms, assess risk of developing arrhythmias in the future, and design treatment. These procedures increasingly include therapeutic methods (typically radiofrequency ablation) in addition to diagnostic and prognostic procedures. Other therapeutic modalities employed in this field include antiarrhythmic drug therapy and implantation of pacemakers and implantable cardioverter-defibrillators.
 A specialist in cardiac electrophysiology is known as a cardiac electrophysiologist, or (more commonly) simply an electrophysiologist. Cardiac electrophysiology is considered a subspecialty of cardiology, and in most countries requires two or more years of fellowship training beyond a general cardiology fellowship. Cardiac electrophysiologists are trained to perform interventional cardiac electrophysiology studies (EPS) as well as surgical device implantations.

Cardiac electrophysiology is a relatively young subdiscipline of cardiology and internal medicine. It was developed during the mid-1970's jointly by Mark E. Josephson, of the University of Pennsylvania School of Medicine in Philadelphia, Pennsylvania, now of Beth Israel Deaconess Medical Center at Harvard Medical School in Boston, Massachusetts, and Hein J. J. Wellens, of the Academic Hospital in Maastricht, The Netherlands.


Today, Aiden and I met with one of the electrophysiologists (Dr. Pediatric Heart Electrician) from the OU Children's Hospital. (You know, our other second home... LOL! I hate to joke about it, but I have to. I really do. Otherwise I wouldn't be able to deal with the situation.) And it took an hour. Why does cardiac appointments last sooooooo freaking long?) He was called in by Dr. Pediatric Cardiologist regarding Aiden's episode of ventricular tachycardia in November.

Well, his thoughts on the v-tach episode (since Aiden hasn't had another one since then) is that maybe the pacemaker picked up a false reading. Instead of being an episode of v-tach, he thinks that maybe the episode was really a 10 beat run of atrial tachycardia (a-tach). (Confused yet? V-tach is extra beats in the lower chamber - BAD! While a-tach is extra beats in the upper chamber - not so bad.) Aiden has lots of runs of a-tach, which is why Dr. Pediatric Cardiologist put Aiden on the sotalol a few years ago. However, the sotalol worked a little too well, causing the ventricular bradycardia (slow heart beat) resulting in the pacemaker.

Dr. Pediatric Heart Electrician is putting Aiden on a beta blocker to control the episodes of a-tach as he wasn't too happy about the quantities of a-tach Aiden is having. Granted, a-tach isn't life threatening like the v-tach, but still... needs to be controlled. The new medication (Don't ask the name, don't know. Pharmacy issue there, but I'll get into that later in the post.) takes a while to kick in and do it's job, so Aiden will return to cardiology on the 24th of this month for his annual check up and the ever stylish Holter monitor. We will also return to see Dr. Pediatric Heart Electrician in 3 - 4 months at either the Tulsa or OU clinic. I'm not opposed to driving to Oklahoma City. He's only in Tulsa once a month and those slots fill up quickly.

He also wants to follow Aiden's pacer readings at his OU office. Not sure how that is going to work out since the Tulsa pacer clinic is the one who gets the readings and then sends them to Dr. Pediatric Cardiologist who would then have to send them on to OU.

After the appointment, Aiden had a play date with his physical therapist. Since he pretty much walked all over the Heart Center (had to return the defective pacer reader also, located on a different floor), he really wasn't too interested in walking or standing at therapy. He wanted to sit a lot. Until it was time to leave and then Aiden was willing to climb all over things in order to go down the foam slide.

I also asked about getting the orthotist out for a new Sure Steps fitting. The PT agreed that Aiden does indeed need new "feet". By the time they come in, he will have outgrown his current pair.

Before we came home we stopped at the pharmacy for Aiden's new medication. I ran in and dropped the script off and then Aiden and I went to get lunch from one of the local restaurants. Then we went back to the pharmacy. Unfortunately, they don't carry the medication in stock. In fact, the pharmacist hadn't even heard of it and had to look it up. Then he had to call and order it. It should be in tomorrow morning. It's not one that has to be compounded, so that is a plus for me LOL!