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Causes, symptoms, and treatment options for electrical system issues of the heart


Dr. David Schwartzman discusses causes, symptoms, and treatment options for electrical system issues of the heart.


When you think of electricity, there are several things that likely come to your mind ranging from appliances, power lines, and maybe even Benjamin Franklin with a kite. One thing that is not normally invoked is a thought of the human heart. However, Director of Cardiac Electrophysiology at WVU Medicine Uniontown Dr. David Schwartzman explains just how vital it is to understand the electrical workings of the heart.


What is Cardiac Electrophysiology?

Cardiac electrophysiology is the area of medical care focused on the electrical system of the heart. The heart is a pump, and its job is to move blood around a circular series of pipes we call the circulation. Blood acts a delivery truck in one part of the circulation and the trash pickup truck in another part of the circulation. The heart’s job is to move the trucks. Like your washing machine which also pumps and moves fluid around, your heart is also driven by electricity. The brain serves as the electrical source for the heart – sending signals and information to the “switching station” within the heart via the nerves. A cardiac electrophysiologist (or EP for short) is a physician who specializes in the care of the switching station and cables. Problems with these components can lead to issues with heart rate causing it to beat too fast or too slow which can make people feel badly and/or put them in danger.


What are some diseases or conditions of the heart’s electrical system?

Included are atrial fibrillation, tachycardia (supraventricular or ventricular), premature beats (atrial or ventricular), bradycardia, and heart block.


What are some of the symptoms which can occur when people have issues with their heart’s electrical system?

People may experience one or more of the following: irregular heartbeat (palpitation - racing or extra beats), low energy, shortness of breath, chest pain, dizziness, and fainting. It is important to note that not all people with cardiac electrical system issues have symptoms. This is because nature has built significant redundancy into our heart and circulation. As such, it can tolerate a significant amount of malfunction before stressing the system to a degree which would make you aware that there is a problem. On rare occasion, the first manifestation of a heart electrical problem may be a life threatening, sometimes lethal, event.


What causes the heart to develop electrical problems?

We are not sure why, but age seems to be the primary driver. I like to tell my patients that there is a price to pay for the accumulation of wisdom. Heredity can also play a role, but for most people this factor is subtle and does not influence how we treat you. The other primary driver I refer to as “poor metabolic health.” In this situation your body utilizes its energy unwisely, which can cause multiple diseases, including overweight/obesity, high blood pressure, diabetes, sleep apnea, gout, kidney failure, heart attack, and stroke. It is crucial to understand that, unlike age, poor metabolic health can be reversed, which may prevent, reverse, or make treatment easier.


How is the heart’s electrical system assessed?

The electrical function of the heart can be recorded using devices placed on the skin. The devices are worn briefly to provide a snapshot of activity or for a period of days to weeks to show more of a moving picture. Wearable devices such as watches, rings and cards can be purchased without a prescription and are able to provide useful information as well. In some patients who require extensive monitoring is necessary, a device can be placed under the skin and provide information for years.


What are some of the things you can do to treat diseases of the heart’s electrical system?

There are several tools in our electrical system repair toolkit:

·       Medicines: there are several different types of medicines which can help to regulate the heart’s electrical system.

·       Devices: there are several different types of devices which can be implanted in your body to assist in regulating the heart’s electrical system and/or protecting you from danger. These devices include pacemaker and defibrillator.

·       Ablation: this is a minimally invasive procedure in which we enter the inside of the heart with wires to locate and eliminate “short circuits” which are causing irregularities.


When should you make an appointment? 

If you are experiencing any of the symptoms described above and feel you may have a problem with the electrical system of your heart, don’t wait to schedule an appointment. Call 724-430-5600 to schedule an appointment today.­­


David Schwartzman, MD

Cardiac Electrophysiology


WVU Heart & Vascular Institute at Uniontown Hospital

100 Woodlawn Ave., Suite 2

Uniontown, PA 15401