Your Health - Electrophysiology Study

Electrophysiology Study

(EPS)

Definition

Electrical signals in your heart make the heart muscles contract which pumps blood to your body. If the electrical signals are not flowing well through the heart, this can create serious problems.

An electrophysiology study is a test where a catheter (tube) is passed through a blood vessel and into your heart. This catheter can record or create electrical activity. This can help find any problems in the flow of electricity in your heart.

The Heart

Reasons for Procedure

An electrophysiology study is performed for the following reasons:

Find the cause of abnormally slow heart rhythms (bradycardias)
Find the source of abnormally fast heart rhythms (tachycardias)
Provoke and diagnose heart arrhythmias (irregular heart beats) that occur infrequently
Reveal suspected arrhythmias
Evaluate a person’s risk for sudden death
Assess symptoms of unknown cause, including:
- Chest pain
- Shortness of breath
- Fatigue
- Dizziness/fainting ( syncope )
Assess your:
- Response to anti-arrhythmic therapy
- Need for a pacemaker
- Need for an implantable cardioverter defibrillator
- Need for cryoablation (destruction of some heart cells by freezing)

Possible Complications

If you are planning to have an electrophysiology study, your doctor will review a list of possible complications which may include:

Bleeding
Infection
Blot clot formation
Injuries to blood vessels or the heart
Abnormal heart rhythm
Heart attack

A person’s risk level is very individual. It may relate to the specific arrhythmia suspected and any underlying medical conditions.

What to Expect

Prior to Procedure

Follow your doctor’s instructions.

Do not drink or eat anything after midnight the night before the procedure.

You doctor may order:

Blood tests
Electrocardiogram—recording of heart's electrical activity
Chest x-ray

Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure like:

Aspirin or other anti-inflammatory drugs
Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)

Anesthesia

A local anesthetic will be given by needle. It will numb the area where the catheter will be inserted. You will also receive a mild sedative through an IV in your arm. This will help you to relax during the test.

Description of the Procedure

You will be asked to lie down on an examination table. Electrodes will be placed on your chest. The electrodes will help to monitor your heart rhythm during the test. An area on your thigh, neck, or just below your collarbone will be cleaned. A thin tube (catheter) will be inserted into a blood vessel in that area.

The Catheter will be passed through the blood vessel and into your heart. Your doctor will be able to see the progress of the catheter with the help of x-rays on a screen. The tip of the catheter can send electrical signals to your heart. The signals will make the heart beat at different speeds. Your heart rhythm will be recorded to look for abnormalities. Also the tip of the catheter can record electrical activity at specific spots in your heart muscle.

How Long Will It Take?

The length of the test will vary based on what your doctor is investigating. The test may take two, four, or even more hours to complete.

Will It Hurt?

You may feel some mild discomfort with the initial injection. As the doctors induce an arrhythmia, you may feel palpitations, shortness of breath, chest discomfort, or you may even lose consciousness. The medical team can usually control arrhythmias with medications, but they may need to administer a shock to stop some rhythms. If they need to do this, you will receive more sedation.

Average Hospital Stay

If your doctor does not need to do additional procedures, you may be able to go home after about six hours. However, you may need to remain in the hospital for up to 24 hours if additional procedures are done during the study.

Post-procedure Care

At the Care Center

EKG and blood studies may be done.
You will likely need to lie still and flat on your back for a period of time. A pressure dressing may be placed over the area that the catheter was inserted to help prevent bleeding. It is important to follow the nurses directions.
You will need to rest in bed until the sedative has worn off. Your heart rate and blood pressure will be monitored. You will also be checked for swelling or infections. If necessary, you may be given pain medicine. After resting for at least 4-6 hours, your doctor will let you know if you can go home that day or if you need to be admitted for more treatment or observation. If you are discharged on the same day as the test, you should have someone drive you home.

The results of the study may be available before you leave the hospital, or in the next few days. Your doctor will notify you if you need any treatment.

At Home

When you return home, do the following to help ensure a smooth recovery

Do not lift heavy objects or engage in strenuous exercise or sexual activity for at least 24 hours.
Change the dressing around the catheter insertion area as instructed.
Take medications as instructed.
Ice may help decrease discomfort at the insertion site. You may apply the ice for 15-20 minutes each hour, for the first couple days.
Be sure to follow your doctor's instructions

Call Your Doctor

After arriving home, contact your doctor if any of the following occurs:

Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or any discharge from the insertion site
Cough, shortness of breath, or chest pain
Your leg feels cold, turns white or blue, or becomes numb or tingly
Discomfort in the jaw, chest, neck, arms, or upper back
Dizziness or weakness

In case of emergency, call 911.

RESOURCES:

American Heart Association
http://www.americanheart.org/

Texas Heart Institute
http://www.texasheartinstitute.org/

CANADIAN RESOURCES:

Heart and Stroke Foundation of Canada
http://ww2.heartandstroke.ca/Page.asp?PageID=24

University of Ottawa Heart Institute
http://www.ottawaheart.ca/UOHI/Welcome.do

References:

HeartCenter Online website. Available at: http://www.heartcenteronline.com . Accessed November 22, 2004.

North American Society of Pacing and Electrophysiology website. Available at: http://www.hrspatients.org/patients/heart_tests/electrophysiology_study.asp . Accessed November 22, 2004.

Texas Heart Institute website. Available at: http://texasheartinstitute.org/ . Accessed November 22, 2004.

Last reviewed October 2009 by Michael J. Fucci, DO and Brian P. Randall, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.