Sahyadri Hospital
blog post

Electrophysiology

What is an Electrophysiology (EP) Study?

Electrophysiology study is a powerful test to diagnose arrhythmia’s accurately and help treating them effectively.

Unlike many diseases of the heart, arrhythmia’s are normally hidden or be dormant. They come out and strike only when conditions are favorable for them.

EP study uses advanced computerized technology to bring the arrhythmia out of its dormancy and shows how to get rid of it.

It is something like charming a dangerous snake out of its hole and getting rid of it so that there is no chance of it doing harm at all.

Why do I need an electrophysiology study?

An electrophysiology study is a procedure conducted by a specialist in heart rhythm disorders (EP) in hospital. It enables your doctor to precisely determine the cause of the abnormal heart rhythms and assist him in making decisions in relation to treatment.

Patients have an electrophysiological study as a day case or an overnight stay. EP doctors place recording wires in the heart via the veins in the groins. These specially designed recording wires with the help of advanced computers analyze the function of the heart’s electrical system, and diagnose abnormal heart rhythms.

Can I not take medication and treat my arrhythmia, why do I need a Procedure?

Medicines are not powerful enough to stop arrhythmia’s completely and reliably. They are only partially helpful in reducing symptom burden. Since many arrhythmia’s are potentially dangerous, it is not worth taking the risk.

On the other hand, Radiofrequency Ablation (RFA) is a safe and reliable way of clearing abnormal electrical circuits. Many patients do not need medicines for arrhythmia after having RFA. It is very popular treatment among arrhythmia patients worldwide.

Who is an Electrophysiologist?

An Electrophysiologist (EP) is a cardiologist who has had special experience in diagnosing and managing arrhythmia’s

Who is an Electrophysiologist?

Before the study is performed, you may be asked to stop taking some of your medications for up to 2 weeks prior to the procedure. Your doctor/nurse should give you specific advice about this.

You will also have some routine tests such as blood sampling and a physical examination.

Your doctor/nurse will visit you, or see you ahead of the procedure, to discuss details of the procedure. Feel free to ask any questions.

Your electrophysiology study will be performed in a cardiac catheter laboratory; a room equipped with X-rays, sophisticated computers and monitoring equipment and is a very safe and secure place. There will be a team of people present, some of whom you may have met before.

The doctor, or electrophysiologist, will carry out the procedure with the help of a physiologist, who gives technical support, nurses, who will look after you and assist the doctor and a radiographer who will assist with the X-ray equipment.

An electrophysiology study is an invasive procedure, which is usually performed using local anesthetic. You may also be given some sedation, which makes you feel relaxed and sleepy while the doctor is performing the study.

During the study you will be required to lie flat and the local anesthetic will be administered to your right groin. Some fine tubes will then be inserted into the vein where the local anesthetic has been applied. Fine wires or electrical recording catheters are then passed through the tubes and positioned within the heart. You will not feel any pain.

If you are a woman of child-bearing age, it is important that you tell your nurse/ doctor before the procedure if you think you may be pregnant.

Once the wires are positioned within the heart the doctor is able to record electrical activity from specific areas of your heart. Extra beats are also delivered which may bring on your palpitations.

This is necessary to see where the heart rhythm is coming from. It is possible to put the heart back into normal rhythm within a few seconds, by delivering some extra beats.

The procedure should enable the doctor to detect any abnormalities in the electrical system of your heart. The procedure normally takes approximately 45-60 minutes.

Once the procedure is over, the wires and tubes will be removed and the nurse/doctor will apply some light pressure over these areas for a few minutes to stop any bleeding. You will then be transferred back to the ward/recovery where you will be asked to rest in bed for 2-4 hours.

It is usual however, for your Electrophysiologist to proceed with a catheter ablation treatment immediately after the electrophysiology study is completed, you come out of the catheter laboratory after receiving full and definitive treatment to your problem in one sitting so that you do not have to go through similar procedure again.

There is further information on radiofrequency catheter ablation available in another patient leaflet.

What are the risks associated with the electrophysiology study?

Electrophysiology study is a very safe procedure with minimal 1% risk of complications. The main benefit of having an electrophysiology study is to clearly know the cause of your the abnormal heart rhythm and to give you an opportunity to be completely free of it by definitive treatment. Because of its safety and success, it is a very popular treatment choice among patients all over the world.

How long will I have to stay in hospital?

Most people recover quickly from the procedure and feel well enough to go home in a day or two.

You should be able to carry on with normal activities the following day; you should avoid heavy lifting for about 2 weeks afterwards.

Following the study, it is quite common to be aware of your own heartbeat, even in normal rhythm. Some people are aware of extra or “missed beats”. Try not to worry too much about these symptoms, which usually settle down with the passage of time.