In 1992, clinical cardiac electrophysiology became a recognized
sub-speciality of the American Board of Internal Medicine. The
formal recognition of this highly specialized and technical field
of medicine represents the culmination of thirty years of
remarkable scientific and intellectual discovery. Beginning in the
1950s, cardiologists realized that cardiac arrhythmias were the
cause of significant morbidity and the sudden death of at least
350,000 patients every year in the United States alone. At that
time the only tools available for analyzing abnormal heart rhythms
were the standard EKG machine and careful deductive reasoning.
During the early 1960s, cardiac pacemakers reflected the first
foray in the electrical therapy of cardiac arrhythmias. Pacemakers
were first implanted in order to control syncopal episodes related
to bradycardic heart rhythms. Although crude and bulky devices,
their utility was immediately obvious to physicians and patients
alike. The recognition that electrical signals could be recorded
from inside the heart and that the heart's rhythm could be
controlled by the application of electrical energy began the era of
clinical cardiac electrophysiology which was to follow. In the late
1960s and early 1970s and at the peak of the Vietnam conflict. a
group of cardiologists with special training in cardiac
electrophysiology were sequestered at the US Public Health Service
Hospital at Staten Island.
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