Electrophysiology Study - What to Expect

Heart skipping a beat? You might just need an electrophysiology study. Read on to know more about what it is, why it’s done and what to expect during the procedure.

What is an electrophysiology study?

An electrophysiology (EP) study is done to study the heart’s electrical activity. It is carried out by an electrophysiologist (cardiologist specialising in the electrical system of the heart and heart rhythm disorders).

The heart pumps blood to the rest of the body through electrical signals. This signal originates from the sinoatrial node, the heart’s natural pacemaker and is transmitted throughout the heart. This is responsible for the contractions of the heart. An EP study uses electrodes to detect these electrical signals and detect any kinds of fluctuations or abnormalities.

Why is an electrophysiology study done?

This study is done to detect any abnormalities of the heart. Your doctor can recommend this under the following conditions –

You’re experiencing symptoms such as fainting, light-headedness and weakness and your doctor suspects a cardiac cause behind it
You have an abnormally fast, slow or irregular heartbeat (arrhythmias)
You have to get a pacemaker or defibrillator
You have to undergo cardiac ablation
You’re at an increased risk of sudden cardiac death
Your doctor wants to check how well your heart medications are working to manage your condition

What is an arrhythmia?

Usually, the heart beats at 70-100 beats per minute. When the heartbeat is too fast, too slow or irregular, it is called arrhythmia. It can occur in any age group, although the risk increases with age.

What are the symptoms of arrhythmia?

Arrhythmias can present as a wide range of symptoms in both adults and children –

In adults –

Rapid or irregular heartbeat
Palpitations
Light-headedness or fainting
Sweating
Difficulty in breathing

In children –

Rapid or irregular heartbeat
Weakness
Shortness of breath
Light-headedness
Improper eating/feeding

Are arrhythmias dangerous?

Arrhythmias can lead to improper blood supply to the body. They can cause heart failure, loss of consciousness, sudden cardiac death and stroke.

What is syncope? How is it related to heart disorders?

Syncope refers to a sudden loss of consciousness or fainting. It can have many causes. In case there is a heart disorder such as an arrhythmia, blood and oxygen may not get delivered effectively to various parts of the body including the brain. When this happens it can lead to fainting.

How is an electrophysiology study done?

This study is performed in a cath lab. It is a minimally invasive test where a long, flexible, thin tube (catheter) is inserted through a blood vessel in the groin, arm or neck after local or general anaesthesia. It is then guided into the heart and the electrical activity of the heart is recorded.

Can electrophysiology study be done in children as well?

Yes, this can be performed in children as well.

What are the complications of an electrophysiology study?

Some complications include –

Bleeding or infection at the catheter site
Formation of a blood clot
Damage to the vessel through into which the catheter was inserted
Damage to the conduction system of the heart
Cardiac perforation (puncture to the wall of the heart)

How do I prepare for my electrophysiology study?

When your doctor thoroughly explains the procedure to you, you can express any concerns or questions you may have. Before the procedure, inform them about –

Any medications (including vitamins, ayurvedic, herbal and homoeopathy medicines) that you are taking, especially medicines like aspirin, warfarin etc.
Any allergies, family history or medical conditions that you have, especially about bleeding disorders
Any implants, piercings etc.

You will be asked to fast overnight before the procedure. Remove your watch, jewellery and any other metallic items that you have.

What happens during the procedure?

You’ll be asked to change into the hospital gown
The area where the catheter has to be inserted is shaved
Your doctor/nurse establishes an IV line in your arm and connects you to an ECG
You’ll receive a sedative and an anaesthetic, either a general one through a mask or at the site where the catheter is inserted
Your doctor inserts the catheter into your blood vessel and views it from a screen (fluoroscopy)
Once the catheter reaches the heart, your doctor sends minute electrical signals through the catheter to observe your heart function. This procedure, called cardiac mapping, is done to locate the area of the abnormal signals
After the procedure is completed, the catheter is removed and the entry site is tightly bandaged

What happens after the procedure?

After the procedure, your healthcare providers monitor your vital signs and observe for any abnormalities
You will receive pain medication for any kind of pain or discomfort
You will be given specific instructions regarding –

– How to take care of the site
– What medications to take
– When to return to your daily routine
– What kind of activities to avoid
– Danger signs to watch out for, such as fever, bleeding, excessive pain or redness from the wound, light-headedness, fainting, chest pain etc.

What’s my next course of action?

After the procedure, your doctor will discuss your results with you and based on this, you can be prescribed medications, or asked to undergo surgery.