Electrophysiology Study

What you should know

• An electrophysiology study (EPS) is a test to show the electrical activity in your heart. Your heart has an electrical system inside it that controls your heart's rhythm (heartbeat). A problem with your heart's electrical system may lead to abnormal heartbeats. Abnormal heartbeats include bradycardia (too slow), tachycardia (too fast), and arrhythmias (irregular heartbeats). Abnormal heartbeats may cause symptoms, such as dizziness, fainting, breathing problems, and chest pain. Abnormal heartbeats may also cause palpitations (strong heartbeats you can feel in your chest, neck, and throat). EPS helps caregivers find the area in your heart causing abnormal heartbeats. Some problems with your heart's electrical system can be fixed during the test.
  
  
• When you have abnormal heartbeats, you may need medicine to make your heart beat regularly. An EPS may be done to check how well your heart medicine is working. EPS can also be done to check if a pacemaker (device to control your heartbeat) is working correctly. During an EPS, a catheter (a long, thin, bendable tube) is put in your heart. The catheter records your heart’s electrical activity. Caregivers may also use the catheter to make your heart beat at certain times. An EPS may show the cause of your abnormal heartbeats and help your caregiver plan your treatment. An EPS may correct your abnormal heartbeats and relieve your symptoms, such as dizziness and trouble breathing.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

• You may have an allergic reaction to the anesthesia medicine used during your procedure. After your procedure, you may have lower back and leg pain. You may have irregular heartbeats that make you dizzy or faint (pass out). You may bleed, have swelling or bruising, or get an infection where the catheter was put in. The catheter may cause nerve damage, or damage to your heart valves.
  
  
• The catheter may cause a fistula (abnormal tissue opening) to your esophagus (food pipe). A fistula can be life-threatening if not fixed right away. You may get an infection in the lining of your heart. Fluid or blood may build up around your heart, making it hard for your heart to beat. You may get blood clots or air in your blood vessels. If a blood clot travels to your lungs, you may have trouble breathing. Blood clots may also travel to your brain and cause a stroke. You could have a heart attack, and you may die.
  
  
• If you do not have an EPS, you may not learn the cause of your abnormal heartbeats. You may not get proper treatment. Your symptoms, such as chest pain and trouble breathing may get worse. You may become weak, have dizziness, and you may faint often. You may get a blood clot in your heart that could travel to your lungs or brain. Abnormal heartbeats can cause your heart to stop, and you could die. Talk with your caregiver if you have questions or concerns about your procedure or care.

Getting Ready

Before your procedure:

• Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
  
  
• Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
  
  
• Tell your caregiver if you have any medical conditions, such as diabetes, and how long you have had them. Tell your caregiver if you have any devices in your heart, such as a pacemaker.
  
  
• You may need blood tests before your EPS. You may also need an EKG or an echocardiogram (echo) to check your heart and how it beats. Ask your caregiver for more information about these and other tests you may need. Write down the date, time, and location of each test.

The night before your procedure:

• Ask caregivers about directions for eating and drinking.
  
  
• If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your procedure. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before the procedure. You may need to check your blood sugar more often before and after having your procedure.

The day of your procedure:

• Write down the correct date, time, and location of your procedure.
  
  
• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
  
  
• Ask your caregiver before taking any medicine on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring a list of all the medicines you take, or your pill bottles, with you to the hospital.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your procedure or surgery. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.

Treatment

What will happen:

• You will be taken to the room where the EPS will be done. You may be given medicine to help you relax or make you drowsy. General anesthesia medicine may be given to keep you asleep during the procedure. Local anesthesia may be given as a shot to numb the area where the catheter is put in. A catheter with leads (wires) will be put into an artery or vein (blood vessels) in your groin or chest. The groin is the area between your abdomen (stomach) and the top of your leg. The catheter will be moved through your blood vessel into your heart. The leads will be placed in certain areas of your heart.
  
  
• The catheter will record the electrical activity of your heart. Caregivers may send electrical signals through the catheter to make abnormal heartbeats. Caregivers may use the catheter to destroy heart tissue that is causing the abnormal heartbeats. This is called ablation. Once caregivers record enough information from your heart, the catheter is removed. A bandage will cover the area where the catheter was put in to hold pressure and stop any bleeding.

After your procedure:

You will be taken to a room to rest until you are fully awake. Do not get out of bed until your caregiver says it is okay. You need to lie still with your leg straight for about two hours. Caregivers will check your blood pressure, pulse (heartbeat count), and respirations (breath count) often. You may need an EKG to check if your heart is beating normally. Caregivers will check for bleeding in the area the catheter was put in. When caregivers see that you are not having any problems, you may be able to go home. If you are staying in the hospital, you may be taken back to your room.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot make it to your procedure.
  
  
• You have a fever.
  
  
• You feel dizzy or light-headed.
  
  
• You feel new or more palpitations in your chest, neck, or throat.

Seek Care Immediately if

• You faint.
  
  
• You fall suddenly for no known reason. You may feel like your leg muscles cannot hold you up.
  
  
• You have signs or symptoms of a heart attack:
  
  
  • Chest pain or discomfort that spreads to your arms, jaw, or back.
    
    
  • New, sudden back pain.
    
    
  • Nausea (feeling sick to your stomach).
    
    
  • Trouble breathing at rest or with activity.
    
    
  • Sweating.
    
    
  • Lips or nailbeds that turn blue or white in color.
    
    
  • This is an emergency. Call 911 or 0 (operator) for an ambulance to get to the nearest hospital or clinic. Do not drive yourself!
  
  
• You have signs of a stroke: The following signs are an emergency. Call 911 immediately if you have any of the following:
  
  
  • Weakness or numbness in your arm, leg, or face (may be on only one side of your body)
    
    
  • Confusion and problems speaking or understanding speech
    
    
  • A very bad headache that may feel like the worst headache of your life
    
    
  • Not being able to see out of one or both of your eyes
    
    
  • Feeling too dizzy to stand

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.