CARDIOLOGY

Cardiology (from Greek καρδίᾱ, kardiā, "heart"; and -λογία, -logia) is a subspecialty of internal medicine dealing with disorders of the heart and blood vessels. The field includes diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology. Physicians specializing in this field of medicine are called cardiologists. Cardiologists should not be confused with cardiac surgeons who are surgeons who perform cardiac surgery - operative procedures on the heart and great vessels.

The term cardiology is derived from the Greek word καρδιά (transliterated as kardia and meaning heart or inner self).

Interventional cardiology is a branch of the medical specialty of cardiology that deals specifically with the catheter based treatment of structural heart diseases.

A large number of procedures can be performed on the heart by catheterization. This most commonly involves the insertion of a sheath into the femoral artery (but, in practice, any large peripheral artery or vein) and cannulating the heart under X-ray visualization (most commonly fluoroscopy, a real-time x-ray. Many experienced interventionist now use the wrist (radial) artery in preference to the femoral, as it has 10 times less local complications, immediate recovery and much less bleeding compared to procedures via the femoral artery. Cardiologist performing cardiac interventions via the radial artery are referred to as "radialists" and are growing in number as their experience increases.

The main advantage of using the interventional cardiologic approach, is the avoidance of the scars, pain and long post operative recovery associated with surgery. Additionally, the interventional cardiology procedure of primary angioplasty, is now the gold standard of care for an acute myocardial infarction ( heart attack). It involves the extraction of clots from occluded coronary arteries, deployment of stents and balloons through a small hole made into a major artery,leaving no scars, which has given it the name "pin-hole" ( as opposed to "key-hole") surgery"

Cardiac Electrophysiology (also referred to as clinical cardiac electrophysiology , Arrhythmia Services , or electrophysiology), is a branch of the medical specialty of clinical cardiology and is concerned with the study and treatment of rhythm disorders of the heart. Cardiologists with expertise in this area are usually referred to as electrophysiologists. Electrophysiologists are trained in the mechanism, function, and performance of the electrical activities of the heart. Electrophysiologists work closely with other cardiologists and cardiac surgeons to assist or guide therapy for heart rhythm disturbances (arrhythmias).They are trained to perform interventional and surgical procedures to treat cardiac arrhythmia.

The training required to became an electrophysiologist is long and requires 7 to 8 years after medical school (in the U.S.). Three years of Internal Medicine residency, three years of Clinical Cardiology fellowship, and one to two (in most instances) years of Clinical Cardiac Electrophysiology.

An electrophysiologic study is a term used to describe a number of invasive (intracardiac) and non-invasive recording of spontaneous electrical activity as well as of cardiac responses to programmed electrical stimulation. These studies are performed to assess arrhythmias, elucidate symptoms, evaluate abnormal electrocardiograms, assess risk of developing arrhythmias in the future, and design treatment.

In addition to diagnostic testing of the electrical properties of the heart, electrophysiologists are trained in therapeutic and surgical methods to treat many of the rhythm disturbances of the heart. Therapeutic modalities employed in this field include antiarrhythmic drug therapy and surgical implantation of pacemakers and implantable cardioverter-defibrillators.