The electrophysiology (EP) study is done in a room (called the EP lab) that has special equipment and heart-monitoring machines. A trained team of doctors, nurses and technicians are present during the test. You may be awake during the test (unless you are told otherwise). Here’s what will happen in the EP lab:
- The areas where the catheters are to be inserted will be shaved and scrubbed with an antiseptic solution.
- The doctor will numb these areas with a local anesthetic.
- Catheters may be inserted into veins in your arm and groin and positioned in your heart. You may feel some pressure or slight discomfort as the catheters are inserted.
- Using the catheter, the doctors will try to start, and then observe, any abnormal heart rhythm.
- If an abnormal rhythm is found and does not stop by itself, the doctors will try to restore the regular rhythm with medication or by pacing the heart.
- If the medication and pacing are unable to stop a very fast rhythm, it may be necessary to deliver an electrical shock using patches placed on your chest and back prior to the procedure.
When it is finished, the catheters will be removed and pressure will be applied to prevent bleeding. A pressure dressing may be applied and kept on for at least six hours. Sometimes other procedures are scheduled after the EP study.The electrophysiology (EP) study is done in a room (called the EP lab) that has special equipment and heart-monitoring machines. A trained team of doctors, nurses and technicians are present during the test. You may be awake during the test (unless... More
Typically, an EP study takes 1 to 2 hours. A combined procedure (EP and cardiac ablation) may take 3 to 4 hours or longer. You will sleep through the procedure.
The first step in an EP study is inserting one or more catheters.
Typically, an EP study takes 1 to 2 hours. A combined procedure (EP and cardiac ablation) may take 3 to 4 hours or longer. You will sleep through the procedure. The first step in an EP study is inserting one or more catheters. Anesthesia:... More
- Anesthesia: First, medication will be given so you go to sleep and sleep through the procedure.
- Preparation: A nurse will prepare each patch of skin where a catheter will be inserted.
- Monitoring: You will have monitoring devices attached to check your heart rate, breathing, and other information.
- Inserting catheters: Your doctor will first insert a sheath (a short plastic tube) into a blood vessel. Each catheter will be put into the sheath and threaded through the blood vessel to the heart. Guidance is provided by x-ray imaging techniques.
- Recording the heart’s electrical signals: The healthcare team uses sensors in the catheters to gather information about how electrical signals travel through your heart. It’s like an ECG (echocardiogram, or “heart ultrasound”) measured directly from the heart muscle, rather than from the surface of your chest.
- Pacing the heart: Next, the doctor uses a catheter to stimulate the heart. The goal is to reproduce your heart rhythm problem. This way, doctors can measure the electrical signals while the problem happens. The measurements can show the cause of the problem and help doctors find the tissue that is operating abnormally.
- Evaluating medications: You might be given medications through the IV to see whether they are effective in reducing the problem.
- Removing the catheter(s): Numbing medication will be applied to the catheter sites. Each catheter will be threaded back through the vein and removed. Then the sheath will be removed.
- Sealing the catheter site: A doctor or nurse will apply pressure to the site to prevent bleeding, and a bandage or pressure bandage will be placed on the site.
A local anesthetic is injected into your skin at the insertion site. This is usually in your groin or neck. When the area is numb, a doctor called a cardiac electrophysiologist inserts the catheter through your skin and into the vein. The doctor... More
- A local anesthetic is injected into your skin at the insertion site. This is usually in your groin or neck. When the area is numb, a doctor called a cardiac electrophysiologist inserts the catheter through your skin and into the vein.
- The doctor slowly pushes the catheter through the vein toward your heart. Usually several catheters are used. The doctor moves the catheters into various places in the heart. An X-ray screen shows the doctor where to move the catheters.
- The catheters have small electrical conductors, called electrodes, on their ends. The doctor can use the electrodes to do what is called "pacing." This means sending electrical currents through the catheters to try to re-create your heart rhythm problem. This can tell the doctor what kind of problem you have and the best way to treat it. The doctor may also use pacing to see how well medicines work to control your problem.
- The electrodes also send information to a computer. The computer uses the information to draw pictures of your heart and its rhythm problems. This is called "mapping," because the pictures serve as maps that show the doctor exactly where the problem areas are.
- A nurse or other assistant will help you stay comfortable and resist the urge to move around. Be careful not to touch the sheets or reach for your groin area, because you could contaminate the sterile areas and increase the risk of infection.
- Your doctor may let you watch the video monitor so you can see the pictures of your heart.
- The test takes 1 to 3 hours. Catheter ablation usually takes 2 to 6 hours. In rare cases, it can take longer.