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Arrhythmia Disorders encompass a range of cardiac ailments which involve the rate at which the heart beats.The normal heart beats with a regular synchronous pattern of the four chambers at 60 to 100 beat per minute.

Electrophsiological Studies (EPS) are a definitve testing of the hearts pacing and conduction system. It can detect and diagnose the various arrhythmias that afflict the heart. It is performed in a cardiac catheterization suite. It is minimally invasive. It is performed by an electrophysiologist by transvenous percutaneous placement of catheters in various chambers of the heart . Intra-cardiac electrograms are recorded to establish the origin and pattern of conduction during the basic intrinsic rhythm which is called sinus rhythm as it originates in the Sino atrial Node when the heart beats normally.

Some of the common arrhythmias include Nodal tachycardia(AVNRT), Pathways , Flutter, Ventricular Tachycardia. Various arrhythmias can be induced by stimulating the cardiac chambers which are then studied . Their mechanism of occurrence and circuit within the heart is determined and the tachycardia is treated by Radiofrequency ablation which causes small 3-4 mm coagulation endocardially . This achieves cure and complete freedom from the illness in over 95 % patients permanently.

The average length of the procedure is 40-45 minutes. It is commonly done under local anaesthesia with anticoagulation with short acting heparin.
After the procedure the catheters are removed. Firm pressure is applied to the puncture sites .Common side effects are transient local stiffness, bruising, discoloration of puncture site.

Rare complications like perforation, bleeding ,permanent heart block can occur .The incidence is less than 2-5% in most reported series .That easily makes it among the safest clinical procedures in invasive cardiology. It can be done at any age ,in both sexes except pregnant ladies.

Cardiac Pacing It is life saving in the extremely sick patents whose rhythm of pacing is abnormal.

The hearts intrinsic rhythm may slow down abnormally in Sinus node dysfunction. The conduction of the electrical impulses may be blocked in Heart Blocks. These are treated by Pacemakers (Single /Double chamber). In cardiac disorders prone to fulminant ventricular arrhythmias life saving shocks can be delivered automatically by implantation of Automatic Internal Cardiac Defibrillator (Single/Double chamber).

Cardiac pacing in heart failure . Hearts enlarge and fail in various cardiac disorders. The muscle can no longer beat synchronously. The failure can be relieved by improving cardiac contraction by Cardiac resynchronization therapy withBiventricular device.

Combo Device is a complex pacing device which can relieve cardiac failure , shock for fulminant rhythm and pace the failing heart.
 

 

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