Historical Perspectives on Clinical Cardiac Electrophysiology

Abstract

Cardiac electrophysiology is an extremely new and dynamic discipline. Although its roots may be traced to the beginning of the twentieth century, clinical cardiac electrophysiology proper was born in the late 1960s. During this short time period, cardiac electrophysiology has undergone several major paradigm shifts. At the onset, clinical electrophysiologists strove to understand the physiology of the conducting system and cardiac arrhythmias. This initial phase of exploration evolved into a diagnostic field, in which electrophysiologic studies could be used to assess risk and to define the arrhythmia diagnosis, although therapeutic interventions were relatively modest. The past decade has witnessed a virtual explosion in interventional electrophysiology, with an increasing reliance on nonpharmacologic therapies. Throughout this period, cellular electrophysiologists, animal researchers, and more recently, molecular geneticists, have worked to advance our understanding of the mechanisms of arrhythmias at a more basic level than previously appreciated.