Electrophysiology
What is Electrophysiology?
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 methods of evaluating your heart rhythms and can help your physician determine an appropriate treatment option for you.
How Does Electricity Work in my Heart?
The body naturally produces electricity that travels 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 of the right atrium of the heart. This area is located in the upper right chamber of your heart and is called the sinoatrial 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 heart beat 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.
An electrophysiology study can help your physician determine an appropriate treatment for you by showing where the arrhythmias are occurring.
How Do I Prepare for My Electrophysiology Study?
If you are currently taking medications to control your heart rhythms, you may 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 the 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-ray table and an IV will be started for administration of medications and the dye that will be used. 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.
A fluoroscopic x-ray allows your doctor to watch as the catheter is carefully guided to various locations in the heart. You will not feel the catheter being inserted into your heart because there are no sensory nerves inside veins and arteries. Recordings are made from the catheters, from which your physician can diagnose the type of arrhythmia you have and determine an appropriate treatment.