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Normally, the sinus node delivers electrical impulses at a rate of 60-100 beats per minute. This is called sinus rhythm. Your heart, brain and body determine the optimum heart rate depending on your activity. For example, you heart may beat slower when sleeping or faster when exercising. You can check your own pulse by pressing gently on the inner aspect of your wrist (beneath the thumb), counting the number of beats over 6 seconds and multiplying this by ten (or you can count for the entire minute).
Problems Related to The Heart's Electrical System (What is cardiac electrophysiology? What are arrhythmias?)
For example, heart rates below 60 beats per minute are called bradycardia. When your heart rate exceeds 100 beats per minute, that's known as tachycardia. If the tachycardia comes from the upper chambers of the heart it is called supraventricular tachycardia or SVT. If it comes from the lower chambers it is ventricular tachycardia or VT. Examples of specific arrhythmias are listed on the following table:
Symptoms (What does one feel if he/she has an arrhythmia?)
Both heart rates that are too slow or too fast may cause these symptoms. If the heart beats too slowly, not enough blood (which carries oxygen) is able to circulate in your body. Similarly, if the heart beats too fast, there isn't enough time for it to relax and fill with enough blood for the next heart beat. The result is the same, with not enough blood able to circulate to meet your body's needs.
Diagnostic Studies or Tests (How will I be evaluated? What kinds of tests will my doctor order and why?)
Tests are broadly categorized into 2 types: non-invasive (meaning, no big needles, catheters or cutting involved) and invasive.
NON-INVASIVE TESTS (What are the non-invasive tests and why are they ordered?)
Non-invasive tests include an electrocardiogram (ECG or EKG),stress test, echocardiogram, holter monitor, event monitor, signal averaged ECG, tilt test, T-wave alternans test and a cardiac magnetic resonance imaging (MRI) test.
The invasive tests that cardiac electrophysiologists use include: cardiac catheterization, placement of an implantable loop recorder (ILR, Reveal or Reveal Plus) and electrophysiological testing (EP test).