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Focus - Heart

The electricians of the heart

  • 1 min to read

A person’s heartbeat can tell doctors a story about their health that goes beyond just blood, veins and muscle. The heart also has electricity flowing through it, and doctors who specialize in making sure the flow stays on track.

Dr. Maria De Benedetti, an electrophysiologist at Great Plains Health, said doctors in her field sometimes call themselves “the electricians of the heart.”

“We have nothing to do with the ‘plumbing’ — the arteries,” De Benedetti said. “The electrical system is totally separate.”

A human heart has a natural pacemaker called the sinus node, which produces electricity that is passed along by the AV node to keep the heart beating steadily. Variations in the electricity’s path can lead to changes in the heartbeat, causing either bradyarrhythmia (a slow heartbeat) or tachyarrhythmia (a fast heartbeat). That’s where the “electricians” come in.

Electrophysiologists can place ambulatory monitors on patients, which act as a mobile EKG. The monitors can tell doctors if the symptoms a patient is experiencing are correlated with a slowed or rapid heartbeat. De Benedetti said there are several hundred patients in North Platte alone with these monitors.

But these monitors only last about 30 days, De Benedetti said. An alternative is a loop monitor, which is implanted under the patient’s skin and records the heart’s activity for up to three years. De Benedetti said these small pieces of technology alone save many lives.

De Benedetti once saw a patient who experienced blackouts while driving. If De Benedetti had not insisted that she receive a loop monitor, she would not have received her diagnosis and treatment, putting herself and others in danger.

An electrophysiologist’s job can also include placing a pacemaker or defibrillator inside a patient’s chest to regulate the heart.

A pacemaker “is like a fence,” De Benedetti said. It will not let the heart rate drop. But a pacemaker can only watch a heart that beats too fast. A defibrillator can pace the heart, but it will also deliver a shock to help the heart when needed.

Defibrillators can also save hundreds of lives. Imagine a scenario in which 20 people all have a heart attack. None of them has a defibrillator implanted, so only one of them is likely to survive, De Benedetti said. In the same scenario, if all the people have defibrillators, only one is likely to die.

“Very few therapies in medicine have this dramatic a response,” De Benedetti said.

The field requires special training, De Benedetti said. Many physicians can install pacemakers, but they must also know what to do if problems arise later. And a pacemaker isn’t always right for every patient.

“My role is to know what is going to help you,” De Benedetti said.

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