Electrophysiology Studies (EPS) are diagnostic procedures used to pinpoint the origin of abnormal heart rhythms (arrhythmias).
During an EPS, thin tubes (catheters) are guided through blood vessels to reach the heart. These catheters contain electrodes that both deliver and record electrical signals within the heart.
The primary objectives of an EPS include:
- Identifying the source of an arrhythmia.
- Evaluating the effectiveness of medications in controlling the arrhythmia.
- Determining the feasibility of catheter ablation, a procedure that destroys the heart tissue responsible for the abnormal electrical signals.
- Assessing the potential benefit of a pacemaker or implantable cardioverter defibrillator (ICD) in managing the arrhythmia.
- Evaluating the risk of serious heart problems, such as fainting or sudden cardiac death, due to cardiac arrest.
What are the risks of an EP study?
While generally safe, potential risks associated with Electrophysiology Studies (EPS) include:
- Transient arrhythmias: During the procedure, you may experience abnormal heart rhythms that can cause dizziness. In such cases, your healthcare provider may administer a brief electrical shock to restore a normal heartbeat.
- Serious complications: Although rare, there is a slight risk of heart attack, stroke, heart valve damage, and blood clots.
- Local complications: Infection, bleeding, and bruising may occur at the catheter insertion site (typically in the groin, arm, or neck). Your healthcare team will take precautions to minimize these risks.
It's crucial to discuss these potential risks and any concerns you may have with your healthcare professional. They can provide you with more detailed information specific to your individual situation.
How should I prepare for an EP study?
Before your Electrophysiology Study (EPS), please follow these guidelines:
- Fasting: Do not eat or drink for six to eight hours prior to the procedure.
- Medication: Inform your healthcare provider about all medications you are currently taking, including over-the-counter drugs, herbs, and vitamins. 1 They may advise you to temporarily withhold certain medications before the test. Do not stop any medication without consulting your healthcare provider.
- Transportation: Arrange for someone to drive you to and from your appointment.
- Hearing aids and glasses: If you use hearing aids or wear glasses, please bring them with you to the procedure.
What occurs during an EP study?
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During an Electrophysiology Study (EPS), the procedure typically takes place in a specialized room equipped for such tests, often referred to as the electrophysiology laboratory (EP lab) or catheterization laboratory (cath lab).
Key steps involved in the procedure include:
- Preparation:
- An intravenous (IV) line is inserted.
- You may receive medication to help you relax during the procedure.
- The insertion site (usually in the groin, but sometimes in the arm or neck) is prepared with cleaning and shaving.
- Catheter Insertion:
- Local anesthesia is administered to numb the insertion site.
- A thin tube (sheath) is inserted into a blood vessel.
- Specialized catheters are then guided through the sheath to reach your heart.
- Real-time imaging (using a video screen) helps guide the catheters to the appropriate location.
- Electrical Stimulation and Recording:
- Small electrical pulses are delivered through the catheters to stimulate your heart.
- The catheters record the electrical activity of your heart, allowing your doctor to pinpoint the source of any arrhythmias (cardiac mapping).
- Completion:
- The catheters are carefully removed.
- Pressure is applied to the insertion site to control any bleeding.
- The IV line is removed.
The duration of the EPS typically ranges from one to four hours.
Following the EPS:
- If the source of the arrhythmia is identified and appropriate treatment is determined, further procedures such as cardiac ablation, pacemaker implantation, or ICD implantation may be performed immediately or shortly after the EPS.
What occurs after an EP study?
Following the Electrophysiology Study (EPS), you will be transferred to a recovery room for observation, typically for one to three hours.
During this time:
- Remain still: As instructed by your nurse, minimize movement and keep the limb used for the procedure (arm or leg) straight.
- Monitoring: Your nurse will closely monitor the puncture site for any signs of bleeding or swelling.
- Post-procedure instructions: Before your discharge, your nurse will provide you with specific post-procedure care instructions to follow at home.
What happens when I arrive home after an EP study?
Post-Electrophysiology Study (EPS) Care:
- Follow Instructions: Adhere strictly to all post-procedure instructions provided by your healthcare professional, including any prescribed medications.
- Resumption of Activities:
- Most individuals can resume eating and drinking within four to six hours after the procedure.
- Normal daily activities can usually be resumed the following day.
- Refrain from driving for at least 24 hours.
- Managing the Puncture Site:
- Some soreness at the puncture site is expected for several days.
- Minor bruising is also common.
- If bleeding occurs:
- Lie flat.
- Apply firm pressure to the bleeding site.
- Contact your healthcare provider or the EP lab immediately.
What should I watch for after an EP study?
Call 911 immediately if you experience:
- Chest pain or tightness: This could indicate a heart attack.
- Signs of stroke: These include facial drooping, arm weakness, and difficulty speaking.
Contact your healthcare provider immediately if you notice:
- Numbness or tingling: In the arm or leg used for the catheter insertion.
- Coldness or color changes: In the hand or foot of the affected limb.
- Worsening bruising: At the puncture site.
- Swelling or drainage: At the puncture site.
- Fever: Any elevation in body temperature.
- Shortness of breath: Difficulty breathing.
When will I get my results?
Following your Electrophysiology Study (EPS), your healthcare provider will typically schedule a follow-up appointment to review the test results. During this consultation, you will discuss the findings and explore the most appropriate treatment options based on your individual case.