Cardiac Electrophysiology (EP) describes the study of the heart’s electrical system to identify the mechanisms of cardiac arrhythmia. Despite only being developed during the mid-1960s to 1970s, technological advancements have, and continue to, occur rapidly within this field.
Catheters were first used for intra-cardiac recording in the mid- 1960s, with dedicated protocols for ‘programmed’ stimulation or testing, developed in the mid- 1970s. The first microprocessor based stimulator was developed in 1980, with the ability to deliver a pulse of current through a catheter in the heart to study a patient’s conduction system. A year later, the first ablation procedures were performed, using direct current (DC) shocks through an external defibrillator to ablate a patient’s AV node. All of these involved the sole use of X-ray to place catheters and identify the location of cardiac structures. Unfortunately, DC energy creates a large area of injury lacking the precision required to treat many arrhythmia circuits.
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