Index
Ep Defined | Getting Started | Working in the EP Lab
Right Atrium | Right Ventricle | Left Atrium | Left Ventricule | Cardiac Conduction | Cardiac Cell Properties | Action Potential | Sympathetic or Not | Med Page
Electrograms Defined | Recording Modes | Electrode Spacing | Filters | EGM Interpretation | Arrhythmia Analysis
The Physical Lab | Tools of the Trade
Setting Up | Catheter Placement | Baseline Measurement | SNRT | Conduction Study | Arrhythmia Induction | Pacing Protocols | Ablation | Tilt Table | Secrets to Success
Bradycardia | Atrial Tach | Atrial Flutter | Atrial Fibrillation | AVNRT | AVRT | Ventricular Tachycardia
Surface ECG's | Intracardiac Questions | Med Challenge | Advanced

About Us...

The Author

Richard (Rick) Hood

Testamur

NASPExAM / AP/ ELECTROPHYSIOLOGY

NASPExAM / AP / PACING


Rick started working as a Monitor Technician in 1981. Over a period of 8 years he worked in Telemetry, Intensive Care, Coronary Care and the Emergency Department. In 1989 he transferred to the Cardiology Department and the Cardiac Cath Lab. Part of his duties here included working in the Pacemaker Clinic. It was here that his fascination with electrophysiology first began.

In the summer of 1996, the pacemaker clinic expanded to include ICD patients. Just over one year later, the electrophysiology program was started and Rick was asked to concentrate his efforts in this new area of cardiac medicine. Learning about EP was difficult as educational information was scarce. In 1998, Rick attended the Bard EP Courses and the NASPE Conference in San Diego California. In 1999, at the NASPE Conference in Toronto Canada, Rick passed the NASPE Exam in Electrophysiology for Allied Professionals. One year later, he succeeded in passing the NASPE Pacing Exam.

During the times that Rick studied for these exams, he became aware of the difficulty in finding educational materials about electrophysiology. In early 2001, he started this web site as an educational resource for people interested in learning more about this exciting field of medicine.

Early in 2002, Rick started work as an Field Clinical Engineer for Endocardial Solutions. Starting in the Pacific Northwest, Rick expanded his knowledge of EP into the realm of 3 dimensional cardiac mapping. In 2004, the opportunity to transfer to the EP Meca of the world, Minneapolis/St. Paul Minnesota was presented to Rick. It did not take long to make the decision to move. For the next two years, he worked in the FCE position supporting cases in Endocardial Solutions home territory.

Endocardial Solutions was incorporated into the St. Jude Medical family in spring of 2005 and one year later, Rick was presented the opportunity to move in house as the Program Manager of the AFib Division Education and Training. Since the transition in house, Rick has focussed on advancing the education programs that teach utilization of the most advanced cardiac mapping system in the world. In early 2007, he began a complete rewrite of The EP Lab web site.

A Note from the author...

  My own first experience in EP happened in a cardiac cath lab in California. A new physician had relocated to the area and wanted to start doing electrophysiology studies. As we were a "plumming lab", we had little knowledge of what doing an EP study entailed. So we contacted one of the labs in a more populous section of the west coast to get some advice as to how we should proceed. I didn't pick up on it at the time, but the tech we spoke with seemed to have a grim amusement over our planned foray into the world of cardiac EP.

     After we had spoken to this experienced adventurer, we set out to purchase a stimulator. We already had a recording system. It was the Midas System from E for M. Anyone remember that one? If you do, you have an idea as to what we were in for. The Midas System worked fine for caths, but for EP?!?!? Anyway, we purchased an EP3 Stimulator, some diagnostic catheters and what seemed like several crates of cables. After a brief perusal of the hookup, we set everything aside and figured we were ready to do EP. Stop laughing, this is really how it happened.

     The afternoon of our day of reckoning came and our senior tech took the reigns and went to show us how it was done. After all, he was the most experienced person in the lab. He had tackled every new procedure that had presented itself to the cath lab environment, today would be no different. (Snicker) Soon there were cables strung across the floor and catheters in several chambers of the heart. The catheters were hooked to more cables whcih, in turn, hooked to more cables, which connected to the amplifier for the Midas. A new configuration had been programmed into our workhorse of a monitor system and we were set to go. It wasn't even 1 oclock. We would be done in no time!! (Are you laughing yet?)

     That first case was a VT study. It was negative. It took 3.5 hours. The Midas shut down twice. The stimulator was put through multiple different configurations before we could actually deliver pacing stimuli to the patient. It was a mess, a nightmare of wires and cables that seemed to get tangled by themselves every time you looked away. Our senior tech was sweating and swearing by the time it was over. I really felt bad for him. There he was, our leader, ragged and worn from combat with an insidious foe. I felt obliged to do what I could to show support. After all, here was the guy who taught me about monitorring and scrubbing, had shown me how to handle those blasted 300cm angioplasty wires that tried to spring off the table every time you weren't looking. This was the guy who helped me master the monsterous old Jamison film processor in the dark room. He had stood by me, now I would stand by him!!!

     That one moment of consideration changed my life. I told our fearless leader that I though what they had done was... interesting. (It wasn't really much in the way of support, but it was the only thing that came to mind at the time.) It was probably not a good time to tell him that. He looked at me and said, "You thought THAT was interesting?!?!? Good!! From now on YOU are the EP tech!" And with that exclemation, he turned and left the room. I was stunned. What had I done?!?!?

     It didn't take to long before I decided that I was up to the challenge. I would learn everything I could about EP!! I would master this new procedure and all the information related to it!! I was sure it wouldn't take me more than a few months. (OK, you can laugh now). That was over ten years ago and I am still learning about EP. I imagine that ten years from now I will still be learning about EP. It is a wonderfully complex and challenging field to work in. The time I have spent working in EP has been very rewarding. I have gone from a simple cath lab tech to an instructor for advanced cardiac mapping. Now, I would like to share some of what I have learned with others who are looking to walk a similar path. If you have recently started in the EP lab, or if you have been there for awhile and are seeking to learn more, then I invite you to explore The EP Lab. It is my hope that the information provided here will be of some help to any who work in this field. If you do spend some time here, drop me a note. I would love to hear from you and find out what you liked about this site or what you would like to see added. So after you have had a chance to look around, click here to Contact Rick. Until then, enjoy....

Rick

The Web Master

Lorraine M. Hood CNMT

This web page was designed by my wife Lorraine. Most of the graphics and animations you see in this site were designed and drawn by her. We have had a great deal of fun working on this project and look forward to sharing our work with you.

Without Lorraine's efforts, this site would never have come into being. She has spent countless hours helping me bring this site to life. Her patience with me has been saintly as I have asked her to make changes time and time again. She has supported me when I have been tired and frustrated and she always gives me the strength to continue my work. So it is with humble appreciation that I dedicate this site to my dear sweet wife Lorraine.

A message from the Web Master:

As for myself, I built this page sitting beside my husband. My hope is that the graphics and flash animation's, will help as a visual aid in the understanding of the material offered here. As confusing as it is for those who are learning these pathways, try to imagine putting them to animation! (laughing) I now have a fair understanding of Ep myself.

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