What is an Electrophysiology Study?
An electrophysiology study or EPS is a diagnostic procedure to look more closely at the electrical function of your heart. It is the most accurate and reliable method of evaluating your heart rhythms and will help your physician determine the treatment option that is most appropriate for you.
Who is an Electrophysiologist?
Electrophysiologists are cardiologists who have additional education and training in the diagnosis and treatment of abnormal heart rhythms.
How does Electricity Work in my Heart?
The heart has a natural pacemaker that produces the electrical impulses that travel over the heart muscle and stimulates the heart to contract or beat. The electrical signal that tells your heart to beat comes from a small area at the right upper chamber of the heart, called the sino-atrial node or SA node.
When a signal is given by the SA node, a small electrical impulse runs through your heart and stimulates the heart muscle to contract. The contraction of the heart muscle produces a heartbeat and forces blood out of your heart to the rest of your body.
Certain conditions can cause the electrical system to make the heartbeat too slowly, too fast, or in an uncoordinated manner. These irregular patterns are called arrhythmias and they can occur in any of the four chambers of the heart.
What is SCA Sudden Cardiac Arrest?
In SCA, the heart abruptly and unexpectedly ceases to function (cardiac arrest). It is an "electrical problem caused by a heart rhythm disorder called Ventricular Fibrillation NF). In SCA, the heart is no longer able to pump blood to the rest of the body.
Is SCA and Heart Attack the same?
SCA is NOT a heart attack. Heart attack is a condition technically known as a myocardial infarction IMII. MI is a .plumbing pr.., in which a blockage in a blood vessel interrupts the flow of blood to the heart causing an “infarct, an area of the dead heart muscle. SCA may, however, occur in association with a heart attack. Patients with a history of heart attack or with decreased heart function may also at risk of SCA
Why must I see an Electrophysiologist?
Electrophysiologist determines whether an individual is in a group that is at high risk for SCA or other cardiovascular diseases.
A number of tests may be performed to determine this:
- Echocardiogram. In this painless, invasive test, a device called a transducer is placed on the chest and sound waves are bounced off the heart. This provides a moving picture of the heart.
- Hotter monitors are external devices that are carom by an individual who may be at risk for heart disease. The monitor automatically records a continuous electrocardiogram (Ecg) of the heart’s electrical activity. It is usually worn for 24 to 48 hours.
- An electrophysiology study (EPS) is a test that can help predict if an individual is at high risk for sudden cardiac arrest. Signals are administered to the heart muscle in patterns to see if they will stimulate ventricular tachycardia. The test is performed in a safe and controlled electrophysiology laboratory in a hospital or clinic and the patient is in no danger.
What does the EP study help to identify?
An electrophysiology study can
- Identify which patients who have had a prior heart attack or MI, are at risk for serious ventricular arrhythmias
- Help determine which patients may require aggressive treatment to prevent sudden cardiac arrest.
- Identify individuals whose hearts cannot be induced into dangerous arrhythmias. They appear at lower risk for developing spontaneous, sustained VT that can lead to ventricular fibrillation and sudden cardiac arrest.
What is Ejection Fraction?
The ejection fraction (EF) is a measure of the proportion for fraction) of blood that is expelled by the ventricle with each contraction or heartbeat. The heart pumps out 55 percent or more of the blood in the left ventricle with each beat. If the ejection fraction falls below 55 percent, it is an indication that the heart muscle is weakened.
How do I prepare for my Electrophysiology Study?
If you are currently taking medications to control your heart rhythms, you will be asked to stop taking them prior to the study. Your physician will give you specific instructions regarding other medications you may be taking. You will be asked not to eat or drink anything for eight hours prior to your EPS. On the day of your study, you will be admitted to the hospital where you will have blood tests, an ECG and a chest X-Ray done.
How is an Electrophysiology Study done?
An EPS is performed in an electrophysiology lab that will be darkened to make it easier to see the cardiac monitors. You will lie flat on a padded X, table and an Neill be started for administration of medications and the dye that will be us. Your groin will be shaved and cleaned with an antiseptic solution and an area on the neck may also be cleaned, depending on the type of arrhythmia you have. A local anesthetic will be used to numb the skin and a small tube (called a sheath) will be placed into a blood vessel in the groin. Once the sheath has been placed, small plastic catheters [pacing wires’ are guided up to the heart. Recordings are made from the catheters, from which your physician can diagnose the type of arrhythmia you have and determine the best treatment. It can be done as a daycare procedure and the patient needs to be in bed post-procedure for 3 -4 hours.
During the study, the arrhythmia can be induced by pacing [stimulating) the heart with or without medications. Once the arrhythmia is induced, the source can be identified and the treatment can be planned accordingly. During this time, the patient may feel his/her heart racing. Induced arrhythmia is usual, terminated by pacing the heart again or by administering medications and rarely by electrical cardioversion. When the entire study has been completed, the catheters and sheath will be removed. Firm pressure must be applied to the groin area for approximately 15 minutes to prevent bleeding from the insertion site. Once the bleeding has stopped, you will be moved to a patient room to recover. The entire EPS usually, takes about 2-3 hours from start to finish.
What is Ablation Therapy?
Ablation therapy is a technique .designed to treat tachycardias (fast heart rhythms) and eliminate the need for medications. After the area of the heart causing the arrhythmia is pinpointed, the electrophysiologist treats the problem by applying radiofrequency energy thigh frequency alternating current) through the catheter which destroys (ablates) the arrhythmic tissue.
What happens next after the Ablation Therapy?
You will be required to be flat for 4 to 6 hours following your study. Your blood pressure, heart rate and areas where the catheters were inserted will be checked frequently.
What are the risks associated with this procedure?
It is quite a safe procedure. The complication rate is usually, less than 1 – (Discuss with your electrophysiologist the details of the procedure and risks involved with the procedure).
When can I resume normal activities after the procedure?
You can resume your normal activities within a day or two after your discharge from the hospital. Following, a complex arrhythmia procedure, sometimes, may be required to limit your physical activities a little longer.