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Electrophysiology Study Electrophysiology (EP) Study Highly trained specialists perform EP studies in a specially designed EP lab outfitted with advanced technology and equipment. Why an EP study? The Value of an EP Study While electrocardiograms (ECGs An electrophysiology, or EP, study or EKGs) are important tests of the provides information that is key to heart’s electrical system, they diagnosing and treating arrhythmias. provide only a brief snapshot of Although it is more invasive than an the heart’s electrical activity. electrocardiogram (ECG) or echocar - Arrhythmias can be unpredictable diogram, and involves provoking and intermittent, which makes it arrhythmias, the test produces data unlikely that an electrocardiogram that makes it possible to : will capture the underlying electri - Normally, electricity flows through - cal pathway problem. Even tests • Diagnose the source of arrhythmia out the heart in a regular, meas - that stretch over longer time periods , symptoms such as Holter monitoring, may not ured pattern. This electrical system • Evaluate the effectiveness of capture an event. brings about coordinated heart certain medications in controlling muscle contractions. A problem During an EP study, a specially the heart rhythm disorder anywhere along the electrical trained cardiac specialist may pro - • Predict the risk of a future cardiac pathway causes an arrhythmia, voke arrhythmia events and collect event, such as Sudden Cardiac or heart rhythm disturbance. By data about the flow of electricity Death accurately diagnosing the precise during actual events. As a result, cause of an arrhythmia, it is possi - • Assess the need for an implantable EP studies can diagnose the ble to select the best possible device (a pacemaker or ICD) or cause and precise location of the treatment. treatment procedure (radiofre - arrhythmia. This detailed electrical quency catheter ablation) flow information provides valuable did you The heart does the most physical work of any muscle during a lifetime. know The power output of the heart ranges from 1-5 watts. diagnostic and, therefore, treat - electrical impulses), some of the gist, with advanced training in the ment information. very arrhythmias that are the crux diagnosis and treatment of heart of the problem. The events are rhythm problems, performs the EP EP studies most often are recom- safe, given the range of experts study. The electrophysiologist leads mended for patients with symp - and resources close at hand, and a team of specially trained health toms suggesting heart rhythm are necessary to make the correct care professionals, technicians and disorders or for people who may diagnosis and track down the pre - nurses, who assist during the pro - be at risk for Sudden Cardiac cise location of the problematic tis - cedure. The team performs the EP Death (cardiac arrest). sue causing the arrhythmia. study in an electrophysiology labo - An overview of the procedure ratory, or EP lab, a well-equipped, Once the correct diagnosis has controlled clinical environment usu - While E CGs are non-invasive, an been established, the electrophysi - ally located within a hospital. As a EP study is somewhat invasive. ologist will decide how best to treat result, the test is quite safe and The study is performed after giving the arrhythmia, by medications, complications are rare. local anesthesia and conscious se - catheter ablation (burning the dation (twilight sleep) to keep the source of arrhythmia), or by plac - patient as comfortable as possible. ing a pacemaker of implantable The procedure involves inserting cardioverter device (ICD). The Importance of the several catheters – narrow, flexible Flow of Electricity tubes – attached to electricity-mon - Throughout the EP study, the patient Each heart has its own normal itoring electrodes, into a blood ves - is sedated but awake and remains rhythm brought about by the seam - sel in the groin or neck, and still. Patients rarely report pain, less flow of electrical impulses advancing the catheters up into the more often describing what they throughout the organ. This electrical heart. The journey from entry point feel as discomfort. Some watch the flow begins in the heart’s natural to heart muscle is navigated by im - procedure on monitors and occa- “pacemaker” (also known as the ages created by a fluoroscope, an sionally ask questions. Others sinoatrial node or sinus node) in the x-ray-like machine that provides sleep. The procedure usually takes upper right heart chamber, the right continuous, “live” images of the about two hours. The patient re - atrium. The electricity flows through catheter and heart muscle. mains still for four to six hours after - the upper chambers (atria), crosses ward to ensure the blood vessel the bridge between upper and lower Once the catheter reaches the puncture sites heal properly. Once chambers (atrioventricular node) heart, electrodes at its tip gather mobile again, patients may feel stiff and travels to the lower chambers data and a variety of electrical and achy from lying still for hours. measurements are made. These (ventricles). data pinpoint the location of the Who performs the test and where? The passage of electricity culminates faulty electrical site. During this Since potentially dangerous arrhyth- in a carefully coordinated contraction “electrical mapping,” the cardiac mias are provoked during an EP of heart muscle that pumps blood arrhythmia specialist, an electro - study, it is crucial that specialized through the human body. Problems physiologist, may instigate, staff is present to handle all situa - in the precise flow of electricty are through pacing (the use of tiny tions. A physician electrophysiolo - the cause of arrhythmias..
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