We perform electrophysiology (EP) studies every day, but if you’re due to have one, you’re probably nervous and wondering what to expect. Following is a breakdown of what will happen at every stage of the procedure.
What You Should Know Before the Procedure
- Don’t eat or drink anything starting at midnight before the test.
- Tell us about all medicines you take, including over-the-counter medicines, herbs and vitamins. We may ask you not to take them before EPS, but you shouldn’t stop taking your medicine until we ask you to.
- Have someone drive you to your appointment and bring you home.
- If you usually wear a hearing aid, wear it during your procedure. If you wear glasses, bring them to your appointment.
What You Should Know the Day of the Procedure
These studies are performed at The Valley Hospital and take place in a room with specialized equipment called an electrophysiology (EP) laboratory.
In preparation for the procedure
- A nurse will put an intravenous (IV) line in your arm, through which you’ll get a sedative that will help you relax
- Your nurse will clean and shave the groin areas where the venous access will be obtained for catheters (wires) insertion
During the procedure
- You’ll be given sleeping medication through the vein and an injection of local anesthetic to make the groin area numb. After that, we will make a needle puncture through your skin and into your blood vessels (the veins), and then insert a small straw-like tubes called sheaths into your veins. We will then guide several specialized electrophysiology catheters into your blood vessel through the sheath and advance them to your heart
- A video screen will show us the position of the catheters in your body with the help of fluoroscopy (a video X-ray). You may feel some pressure in the area where the sheath was inserted, but you shouldn’t feel any pain
- A specialized electrode catheter designed for EP studies lets us send electrical signals to your heart and record its electrical activity. During an EP study, about 3 to 5 electrically sensitive catheters are placed inside your heart to record electrical activity
- We’ll then send small electric pulses through the catheters to make your heart beat at different speeds in order to evaluate the integrity of its electrical system or to reproduce arrhythmias. You may feel your heart beat stronger or faster
- At the end of the procedure, we’ll remove the catheters and put pressure at the site of insertion to stop the bleeding. Your body forms a cap that stops the bleeding from the puncture sites in 10-15 min, but it takes 3-4 hours for it to become strong enough to prevent bleeding when you move
- EP studies usually last 1 to 2 hours
- If we identify the type and location of your arrhythmia and decide on an appropriate therapy, catheter ablation, insertion of a pacemaker, or insertion of an implantable cardioverter defibrillator (ICD) may be performed during or immediately after the EPS
After the Procedure
You’ll be moved to a recovery room where you will rest for 3-4 hours.
- You’ll be lying down and should not move or bend your legs for 3-4 hours to prevent groin bleeding
- Your nurse will check on you often to see if there is bleeding or swelling at the puncture sites
- After the sedative wears off, your doctor will talk to you about your test results and review your home care regimen
What You Should Know When You go Home:
- Follow the instructions we gave you, including taking any new medicines. Most people can start eating food and taking their medicines within 4 to 6 hours after the test
- We ask you to take it easy for 3-4 days, including no driving, exercising or lifting weights (walking and climbing stairs is fine,) then gradually increase activity. Most people can resume their usual daily activities within a week
- The puncture site may be sore for several days, and it’s normal to develop a small bruise there as well
- If the site starts to bleed, however, lie flat and press firmly on top of it. Have someone call the doctor or the office right away
- We would also want to be informed about any excessive chest pain or shortness of breath, dizziness, syncope or pre-syncope, fever, chills, or swallowing problems
Even though we’ll have talked to you about your test results on the day of the EP study, we usually also ask you to make an appointment to discuss the results of your test in greater detail at a later date.
At that appointment, you’ll get a chance to discuss your treatment plan (if therapeutic actions weren’t taken during the EP study). You’ll discuss whatever treatment options are available to you, and their risks vs. benefits, at that appointment.