SIDNEY PEYKAR M.D., F.A.C.C. J.C. ESTRADA, M.D., M.P.H.
CLINICAL CARDIAC ELECTROPHYSIOLOGY COMPLEX ARRHYTHMIA ABLATION AND CARDIAC DEVICES
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ELECTROPHYSIOLOGY STUDY

During electrophysiology testing, catheters (thin, flexible wires) with electrodes at the tips are threaded through the patient's blood vessels at several places within the heart. These wires have electrodes on them which sense the electrical activity inside the heart- much like an ECG does from the chest surface. During the test, the electrophysiologist may use the electrodes to stimulate the heart to beat at rates that may trigger, or halt, an irregular heartbeat . By pacing at different sites inside the cardiac chambers, the normal conduction system of the heart and the heart's normal pacemaker functions can be studied. With additional pacing maneuvers attempts can be made to induce an abnormal heart rhythm (arrhythmia). For example, if the physician determines that catheter radiofrequency ablation (a minimally-invasive procedure that uses catheters to reach the heart and destroy abnormal heart tissue) is the appropriate treatment, the procedure can be performed during EP testing.

Catheter ablation can then potentially cure this rhythm, or if the EPS is looking to see if someone is at risk of dying suddenly, a positive test can lead to a defibrillator implant.

Preparing for the EP study

  • We will tell you ahead of time whether to stop taking any of your medications. Do not modify your medications without prior approval.
  • You will have to sign an Informed Consent form, which details any risks or problems that may occur.
  • You do not to eat or drink after midnight the night before the procedure
  • The area where the catheter will be inserted will be thoroughly cleaned and shaved. This is usually in the groin, but may be in the neck. You will receive a local anesthetic in that area.
  • You will be given a mild sedative for some procedures and general anesthesia for certain ablations.

During the EP study

A team of people will work together to assist in the procedure and assure your safety. Besides Dr. Peykar, there will be specially trained healthcare technicians and nurses to assist and monitor your condition.

EP studies are carried out in our specially equipped lab that resembles an operating room. The same precautions for maintaining a sterile environment will be followed.

The EP lab features a lot of equipment — including a type of x-ray system called fluoroscopy.

You will lie flat on the table, covered with surgical drapes, except for the area where the catheter will be inserted. You will have an IV in your arm to deliver medications as needed. You will be given a local anesthetic at the point where the catheter will be inserted. There will be a small amount of bleeding at the site, but it will be controlled and there is no danger to you.

Patients seldom complain of pain, although you may have a somewhat unpleasant sensation in your chest.

The EP study usually takes 1-2 hours. If other procedures are done immediately, such as a catheter ablation, your time in the EP lab will be longer — up to 6 hours in some cases.

After the EP study

  • If the results of the EP study lead to the conclusion that catheter ablation is the right treatment option, the procedure is usually done immediately.
  • Whether or not you undergo another procedure, you need to remain still for 4-6 hours afterward. This should help the area where the catheter was inserted to start healing properly. It is normal to have a small lump (about the size of a walnut) at the site.
  • Once you can get up and move around, you may feel stiff from lying still for so long.
  • Some procedures are done as an outpatient and others have an overnight stay. If you are discharged from the hospital the same day, you should arrange for someone else to drive you home.