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Electrophysiology: Part of Your Heart Care Team

Electrophysiology is one of the best tools for diagnosing and treating heart arrhythmias and Henry Mayo now has the ability to provide this critical heart care tool.

Shervin Sadrpour, MD, joins the show to discuss the important role of an Electrophysiologist as a part of your heart care team.
Electrophysiology: Part of Your Heart Care Team
Featured Speaker:
Shervin Sadrpour, MD
Dr. Sadrpour is a cardiac electrophysiologist with Cardiovascular Consultants Medical Group who recently joined Henry Mayo at the Medical Director of Cardiology Services.

Melanie Cole (Host): You may never have heard of an electrophysiologist, but they play a very important role in your heart care team. My guest is Dr. Shervin Sadrpour. He’s a cardiologist and cardiac electrophysiologist at the Director of Arrhythmia Services at Henry Mayo Newhall Hospital. Dr. Sadrpour, what is an electrophysiologist?

Dr. Shervin Sadrpour, MD (Guest): Hi Melanie. Electrophysiology is a sub-division under the cardiology that deals with the electrical problems of the heart, it deals with the rhythm of the heart. And basically, it studies that, it looks at its abnormalities and through procedures and different methods will try to improve the health of the heart through manipulating the electrical system of the heart.

Melanie: So, people tend to think of heart related disorders and working with a cardiologist Doctor, so, what’s the difference between an electrophysiologist and a cardiologist?

Dr. Sadrpour: Cardiology is a very wide field. There are a lot of things that happens under the cardiology. There are different specializations under umbrella of cardiology. For example, you have interventional cardiologists that deal mostly with the arteries of the heart, the blockages in your arteries of the heart. Then you have also the valve issues of the heart and the heart also has an electrical system that runs and regulates its beating, its rhythm. And electrophysiology is a sub-section of cardiology that deals with the problems of this part of the heart.

Melanie: So, I’m glad you mentioned the electrical system and that the heart is really a pump, but it kind of works on an electrical system and people don’t really understand that. So, explain the different kinds of heart conditions that you would treat and why someone like you would treat them as opposed to someone who is listed as a cardiologist.

Dr. Sadrpour: Sure. The electrical system of the heart is really the part of the heart that regulates the heart and the mechanical activity of the heart follows the electrical activity of the heart. The heart has its own sort of brain that lives in the upper chamber of the heart and regulates the mechanical activity of the heart. The electrical problems of the heart that could come in abnormal rhythm, like if the heart is beating too fast, beating too slow or beating irregularly. And there are also some electrical delays sometimes that would cause a delay in the mechanical activity of the heart. So, these are all things that would be addressed in the field of electrophysiology. There are a lot of advancements in these fields and frankly, the scope of it is such that it is hard for the cardiologist to be an expert in all those fields while they are taking care of the other problems that are in the field of cardiology.

Melanie: And as you are a cardiologist, and a cardiac electrophysiologist; so, most electrophysiologists are cardiologists as well, yes, so if you are dealing with these things like an irregular heartbeat or arrhythmia, why types of arrhythmia do you deal with and what are some of the options? I mean do people feel a symptom of an irregular heartbeat? Would they know that they have one? Speak about arrhythmias for a minute.

Dr. Sadrpour: Sure. So, firstly yes, all the electrophysiologists are cardiologists. In order to be a cardiac electrophysiologist, you have to become a cardiologist and then do further training to become a cardiac electrophysiologist. So, all cardiac electrophysiologists are cardiologists. Now for the rhythms of the heart, the symptoms, the spectrum of the symptoms you could see with abnormal rhythms are very wide. They could cause fatigue, lightheadedness, dizziness, syncope, especially with slow heart rates we could see a lot of fatigue. With rapid heart rates, we may still see the same type of symptoms. We may see dizziness, we may see syncope, sometimes it could even present as sudden death. Then some of these abnormal rhythms can cause other conditions. For example, they could cause heart failure, atrial fibrillation which is the most common sustained abnormal rhythm that we deal with in cardiology can cause stroke by causing basically very rapid heart rate in the upper chamber of the heart that can cause clot formation and then the clot can then leave the heart and go to the brain and cause a stroke. So, the spectrum of the symptoms that one can have with abnormal rhythms is pretty wide. Sometimes a patient may feel like that it is coming from the heart through feeling of rapid heart rate or slow heart rate or irregular heart beating, but sometimes you may not necessarily feel it in the heart itself, you just come with some other generalized symptoms that through the studying and through different tests we would realize that this is originating because of an abnormal rhythm of the heart.

Melanie: So, Doctor, would a patient start with their cardiologist if they feel like they have some of these things or they have some of the symptoms or they have been diagnosed with atrial fibrillation or one of those and then they come to see you for treatment? How does that all work or would they see you right from the beginning? How would they know to do that?

Dr. Sadrpour: Sometimes that is the case. Sometimes they go see a cardiologist first. Now quite a number of cardiologists feel competent in doing medical therapy for these conditions. The procedural therapies are those that are almost exclusively under the umbrella of electrophysiology. So, some of these conditions could be treated with medical therapy and those patients might just end up staying in the cardiologist’s practice. But there are some patients that need more advanced treatments that an electrophysiologist would be able to offer them. So, a lot of times patients may start with seeing a general practitioner or primary care doctor and then the primary care doctor may make a diagnosis or may need the help of a cardiologist or a cardiac electrophysiologist to make a diagnosis and eventually, if the patient needs specialized treatment, or if the patient feels like he or she wants to know about specialized treatments then they will end up seeing a cardiac electrophysiologist. Every now and then also we see direct patients who come and find a cardiac electrophysiologist for conditions like atrial fibrillation or SVT which is a rapid electrical activity again coming from the upper chamber of the heart that they will come and see an electrophysiologist directly.

Melanie: Thank you for clarifying that Doctor, so let’s speak about some of the treatments that you and the procedures that you do electrical cardioversion or catheter ablation. Explain just a few. Give us a broad overview of some of the treatments that you provide.

Dr. Sadrpour: Sure. The treatment options are again very wide because the rhythm abnormalities are really wide. So, for slow heart rate a lot of times we could treat them with a pacemaker for example. Some of the rapid heart rates are such important rhythms, so life threatening that we would implant a defibrillator for example. That’s a device that monitors the rhythm of the heart and if the heart goes into an abnormal rhythm that’s life threatening; it will shock the heart out of that rhythm. And then there are ablation procedures. These are the procedures that we go in the heart. We try to find the source of abnormal electrical activity and literally try to get rid of that abnormal tissue. We could burn it, we could freeze it, we have different ways of trying to get rid of that tissue and by getting rid of the source of abnormal rhythm, regularize the rhythm of the heart. So, really pretty wide range of treatment options. There are also different tests that we could do. There are some devices that we could implant just to look and monitor the rhythm of the heart to find the abnormalities of the heart.

Melanie: What would those devices be called? If people want to ask their doctor about some of these things and they have questions for their physician. What would a monitor like that, if someone wants to know about it; what is it called?

Dr. Sadrpour: Sure. There are some wearable monitors, we call them Holter monitor or thirty-day monitor and there are also implantable monitors that are called loop implants. And then the – as I mentioned, the devices that deal with the slow heart rate are called pacemakers. The devices that deal with the rapid heart rate are called defibrillators. Now all defibrillators have built in pacemakers in them nowadays so if you – if a patient has a defibrillator, they also do have a pacemaker built into that defibrillator. There are also devices called biventricular defibrillators. These are specialized devices that we use in the specific subset of patients who have heart failure and the goal of this is to improve their heart function, not only it improves the heart function through overcoming a delay in the electrical system of the heart. So, these are the spectrum of the usual devices we use in electrophysiology. There are also some other devices that we could deploy in the heart to minimize the risk of clot formation in atrial fibrillation to minimize the chance of a stroke in patients with atrial fibrillation.

Melanie: Absolutely fascinating. So, wrap it up for us Dr. Sadrpour. What would you like listeners to know about your field as an important part of their heart care team when they may not have heard about what you do?

Dr. Sadrpour: Sometimes it’s on the patient to sort of probe the potential for improvement of their heart condition. So, if a patient has an abnormal rhythm of the heart; it might be a reasonable option for them to ask their primary care doctor or their cardiologist to see if there are more advanced treatments available out there for them to go and seek in order to improve how they feel. Electrical abnormalities of the heart are fairly common. They sometimes coexist with other abnormal conditions in the heart and sometimes they might be a sole problem with the heart and really this is a very fast-growing field in medicine and I think we have really good options for some of these patients.

Melanie: Thank you so much Doctor, for being with us today and explaining your field of cardiology. You’re listening to It’s Your Health Radio with Henry Mayo Newhall Hospital. For more information, please visit that’s . This is Melanie Cole. Thanks so much for tuning in.