Emad F. Aziz, DO, MB ChB, FACC

Intracardiac electrophysiology study (EPS) is a test to look at how well the heart's electrical signals are working. It is used to check for abnormal heartbeats or heart rhythms. Wire electrodes are placed in the heart to do this test. These electrodes measure electrical activity in the heart. The procedure is done in a hospital laboratory. The staff will include a cardiologist, technicians, and nurses. To have this study:

-Your groin and/or neck area will be cleaned and numbing medicine (anesthetic) will be applied to the skin.
-The cardiologist will then place several IVs (called sheaths) into the groin or neck area. Once these IVs are in place, wires or electrodes can be passed through the sheaths into your body.
-The doctor uses moving X-ray images to guide the catheter into the heart and place the electrodes in the right places.
-The electrodes pick up the heart's electrical signals.
-Electrical signals from the electrodes may be used to make the heart skip beats or produce an abnormal heart rhythm. This can help the doctor understand more about what is causing the abnormal heart rhythm or where in the heart it is starting.

You may also be given medicines that may also be used for the same purpose.

Atrial premature complexes (irregular heart beats from the atrium) are usually precursor to atrial fibrillation, so having so many of them is alarming. As a matter of fact studies have shown APCs >70/hour are considered as risky as atrial fibrillation and should be managed accordingly with anticoagulant to prevent stroke.

There is no interaction between coffee drinking and echocardiography. It utilizes ultrasound waves that are not affected by coffee.

I am not sure it was related! it could be coincidence of you might have been anxious enough that you raised your heart rate unconsciously or because of increase of your sympathetic tone (high adrenaline levels) which at times can unmask undiagnosed abnormal rhythms.

Arrhythmia (abnormal heart rhythm) is a very generic term and a need to be more specific. There are multiple causes for arrhythmia. That can range from abnormalities in the rhythm of the upper chamber the heart which can be further classified to atrial fibrillation or atrial flutter which are quivering of the left atrium of the heart or a more regular fast rhythms which are summarized as supraventricular tachycardias. There also tachycardias that originate from the lower chamber the heart which could also be a regular some of them are single premature contractions which we call in short PVCs or even ventricular tachycardia. All these tachycardias can have very effective therapies once diagnosed my suggestion is to see and electrophysiologist who then will order an event monitor for up to 30 days to be able to capture the arrhythmia and then establish a management plan for mom. Most common arrhythmia that happen and elderly is atrial fibrillation with an incidence of about 20 to 25% in that case blood thinners are prescribed and the option of medical management furthers catheter-based management which called ablation procedure can be offered

Atrial fibrillation particularly when it is paroxysmal (Twice / year) need to be monitoring longitudinally (Prolonged monitoring). This is typically done by utilizing an implantable loop recorder (a small computer chip that is injected under the skin, that typically has a 3 year battery)

A cardiac electrophysiologist is a physician who specializes in the electrical abnormalities of the heart mainly abnormal heart rhythms. These can include abnormal rhythms originating from the upper chambers of the heart typically called supraventricular tachycardias such as atrial fibrillation, atrial flutter, or any reentrant circuits that can cause abnormal rhythms. Or abnormal rhythms from the lower chambers of the heart that are called ventricular tachycardias. Electrophysiologists also can perform catheter ablations to eliminate some of these abnormal rhythms or implant subcutaneous devices like pacemakers or defibrillators to help regulate and control any heart arrhythmias.

For any heart arrhythmias, it is preferable to see a specialized cardiologist, these are called cardiac electrophysiologist which are doctors that specializes in any abnormal heart rhythm and can guide your dad through management. Management for irregular rhythm can range from adding special medications called antiarrhythmic drugs to implanting devices to regulate the heart rhythm or performing a specialized catheter procedure which is called an ablation procedure to eliminate any of these abnormal rhythms.

"Irregular heartbeats" is a very generic term and could mean abnormalities in the heart rhythm from either the upper or lower chamber the heart. Certainly, your mom will need to be evaluated by an electrophysiologist who can then order an event monitor, which will allow him to precisely evaluate what kind of abnormal rhythm your mom had. After that, he can structure a plan for management.

Unlikely. The most common cause of night coughing is because of postnasal drip (dripping of mucous in the back of the throat from the sinuses). It typically indicates chronic fluid accumulation in the nasal sinus (you might need to be checked by an ENT physician). That being said, certainly patients with heart failure or weakness of the heart muscle who retain fluids can have nocturnal orthopnea (shortness of breath at night).

What is high heart rate? Is it above 100? If so, this is not normal and you might need to have some blood tests checked like thyroid function, anemia, etc.

There are different ways for monitoring arrhythmia (which is a very generic name for abnormal rhythm). Intermittent monitors like a 24/48 H Holters, 30-day event monitors, or implantable long-term monitors like the Medtronic Linq or Biotronic BioMonitor-II.

It certainly would help to have an ECG for initial evaluation. However, depending on your age and risk factors for heart disease you might need to be checked by a cardiologist who might ask you to perform a stress testing for further evaluation.

There are a lot of conflicting studies about the risk and benefits of alcohol intake. Certainly, moderation is the key. This means an average of one to two drinks per day for men and one drink per day for women. (A drink is one 12 oz. beer, 4 oz. of wine, 1.5 oz. of 80-proof spirits, or 1 oz. of 100-proof spirits.)

Red wine in general is thought to be healthier because it contains antioxidative components like resveratrol, proanthocyanidine, quarcetin, etc. and these active components exert protective functions like free radical scavenging effects, decreasing the oxidative stress and reducing the inflammatory atherosclerotic lesions.

That been said, drinking more alcohol increases such dangers as alcoholism, high blood pressure, obesity, stroke, breast cancer, suicide and accidents.

Cardiac cachexia is a condition that can happen to people who have heart failure. It means you lose a serious amount of body fat, muscle, and bone. Doctors often call this “body wasting.” Once it begins, you can’t reverse it simply by eating more. It’s a complex disorder that has to do with the way your body absorbs and uses the nutrients and calories you eat.
The condition also has serious effects on many parts of the body, including the digestive tract, lungs, and heart, and the body’s ability to make blood cells. You will need an expert heart failure specialist who work closely with a nutritionist to help tackle this issue.

No. This is very, very rare. Since the introduction of implantable pacemakers in the 1950's, there has been less than a handful of pacemaker rejections.

Weak heart typically means a weakness in the left lower chamber in the heart (Left Ventricle), which is the main pumping chamber of the heart. This is also called "Heart Failure." People with weak hearts tend to feel fatigue easily, shortness of breath during minimal exertion, and swelling of the legs caused by water retention.

The question is why do you want to run very fast? There are so many studies that suggest enduring exercise can be actually very harmful to the heart because it can cause unwanted upper chamber dilation, which in turn can cause arrhythmias like atrial fibrillation. So, moderation is best!

Prolonged monitoring is the key. This can be achieved initially by a portable 30-day event monitor and if atrial fibrillation detected and the suspicion is still high then an implantable small monitors are used these are called "Loop Recorders" like the Medtronic Linq device. These devices can record the heart beats 24/7 for up to 3 years and transmit data remotely to your physician on a daily basis.

There are so many! Mainly, "chest pains" which are not sharp or tingling or numbness, "cramping of the heart muscle," progressive shortness of breath, particularly going up hills or during simple exercise, easy fatigue, sweating on minimum activities. Coronary calcium score can be an easy way to find and predict risk for premature arterial blockages.