EP Study – New Hope for the Treatment of Heart Arrhythmia

Heart arrhythmia is caused by changes in the heart’s electrical system preventing the electrical current that begins each heartbeat from working properly. Arrhythmia can affect patients at any time even though they take good care of their health. It is also considered a silent threat because, in some cases, doctors cannot detect any irregular heartbeat during an examination. As a result, the condition remains undiagnosed and untreated. To prevent arrhythmia, it is important to watch out for the warning signs and symptoms. When heart arrhythmia is identified, medical advice from specialists in combination with the latest technology can help you solve the problem before it is too late.
Due to the latest advances in medical technology, heart arrhythmia can now be effectively diagnosed and treated with an Electrophysiology Study (EP Study). Dr. Koonlawee Nademanee, a specialist in cardiac electrophysiology at Bumrungrad Hospital, explains that arrhythmia is a general term that describes a variety of heart rhythm disorders – the heart may beat too fast, too slow, or with an irregular rhythm.
There are various types of heart arrhythmias,” explained Dr. Koonlawee. “Some are not life-threatening. However, other types are potentially fatal and require medical treatment. Ventricular Tachycardia and Atrial Fibrillation are the most common types of arrhythmias that require timely and appropriate treatment. Of these, Atrial Fibrillation is the most common heart rhythm disorder and highly prevalent in people over 75 years old. The risk for people in this age group is around 13 times higher compared to people under 50 years of age.”
Heart arrhythmia can be caused by many different factors. “Arrhythmia can be congenital, or sometimes the heart muscle can be affected by physical abnormalities, such as heart failure from coronary artery disease, high blood pressure, hypothyroidism, genetic disorders and electrolyte imbalance, which lead to changes in the heart’s electrical system,” added Dr. Koonlawee.
Dr. Koonlawee explained that heart arrhythmia can be detected from several symptoms, such as a fast heartbeat (fluttering of the heart or palpitations), shortness of breath, chest pain, sweating, and blackouts. “When these symptoms appear, a patient should seek immediate medical attention,” said Dr. Koonlawee. “In assessing the risk of arrhythmia, the doctor will take other factors into consideration as well. For example, the risk of fatality is higher in patients with arrhythmia and heart muscle weakness than it is for patients with arrhythmia alone, and so the treatment procedures differ accordingly.”       
“To find the accurate cause and treatment option for each patient, the doctor must have reliable information, especially for patients exhibiting the signs of arrhythmia or those whose heart is at risk of stopping. Medical imaging technology, software and processing chips in combination with the cardiologists’ knowledge and experience are key factors in the success of an Electrophysiology Study (EP Study).”

An EP Study is a test performed to analyze and treat the abnormal electrical activity of the heart which is the cause of the arrhythmia. Electrodes are placed on the chest in order to evaluate the heart rhythms. The doctor then inserts a small tube through a blood vessel and runs it to the heart. The electrodes are positioned to receive signals from inside the heart chambers. The doctor may perform the test by sending electrical signals to stimulate the heart so as to gather data for analysis or perform any additional tests as and if required.
Data obtained from the EP Study is imported to software, and 3-dimensional images are generated enabling the exact location of the arrhythmia to be identified. The doctor will choose the most appropriate treatment based on the cause of the arrhythmia. The EP study provides real-time images of the heart that help the doctor observe the heart from different angles and record its electrical activity. Abnormal rhythms in any location are color coded to highlight where the arrhythmia is being caused, and catheters with special tips are placed over that area. The tips are heated, which causes the abnormal tissue to die. This immediately stops abnormally fast and/or irregular impulses being transmitted from that area.

Using the latest medical technology, the EP Study provides effective treatment for patients with arrhythmia because it enables the exact cause of the abnormal electrical activity to be identified and treated, resulting in the heart arrhythmia being permanently cured following the procedure.
“However, although the EP Study is effective in treating patients with arrhythmia and helping them to return to their normal daily activities, it does not change the other risk factors that affect heart disease,” warned Dr. Koonlawee. “If patients have problems of high blood pressure, coronary artery disease, or cardiac fibrosis, those risks will still persist. Therefore, even though the heart arrhythmia is cured, the patients still have to manage the other factors that will affect their heart.”
Keep in mind that heart arrhythmia can occur at any time and it should not be left untreated. In many cases, when patients are not properly diagnosed and treated, the arrhythmia can cause permanent damage to the heart. When any of the warning signs of arrhythmia are observed, medical attention should be sought immediately.”        

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