• Electrophysiology

    The heart’s electrical system creates and sends electrical impulses that tell the heart’s chambers to squeeze and pump blood.

    Abnormal Heart Rhythms

    Sometimes, the heart’s electrical system does not work properly. This may result in abnormal heart rhythms, called arrhythmias. During an arrhythmia, the heart may beat too slowly, too rapidly or irregularly. An arrhythmia may be experienced as skipping or fluttering in the chest (palpitation). It may also cause light-headedness, a fainting spell, chest pain or shortness of breath. Some arrhythmias can be life-threatening, while others may go unnoticed.

    Before the Procedure

    Report any allergies you have and all medications you are taking to your doctor. Tell your doctor if you are pregnant, taking aspirin or taking blood thinners.

    Do not eat or drink anything at least 8 hours before this procedure. You may however, take your medications with sips of water after checking with your doctor. The area where the catheter is inserted will be cleaned and shaved. You will be awake for the procedure, but you may be given medication to help you relax. This procedure is done in a special area of the hospital. This area is intentionally kept cool. In this area you will see an X-ray camera and monitors that look like TV screens. These monitors let your doctor see your heart and the location of the pacing catheters as the procedure is being done. Multiple ECG pads will be placed on your chest to check your heart.

    During the Procedure

    A small tube called an introducer sheath will be placed in the vein. One or more special catheters that are long and flexible are inserted into the heart. These catheters record and send electrical signals to the heart. The signals the doctor sends may stimulate your heart to bring on the arrhythmias that produced your symptoms. An arrhythmia made during the procedure will often stop by itself. If it persists, you may faint momentarily. If this happens, the staff may deliver an electric shock to your heart to restore a normal rhythm.

    Treatment Options

    Your doctor will decide if your arrhythmia requires treatment, and if so, which option is best. These treatments may be done at the same time as your electrophysiology study.

    • Medications: These may change the electrical signals within the heart, restore a normal rhythm or prevent future arrhythmias
    • Pacemaker: A small device that is placed inside the chest to speed up the heart if it beats too slowly. This may be placed in the room your study was done, or in surgery. You would be asleep for this procedure.
    • Implantable Cardioverter Defibrillator (ICD): A small device that’s placed inside the chest to slow down the heart if it beats too quickly. This may be placed in the room your study was done, or in surgery. You would be asleep for this procedure.
    • Catheter Ablation: A technique that uses another special catheter to destroy the abnormal pathway that is causing your arrhythmia.

    After the Procedure

    The catheter and sheath will be removed. Pressure will be used to close the opening in the vein and a dressing will be placed over the insertion site. You will be taken to the recovery area or your room by cart. How soon after the procedure you may eat or drink depends upon your condition. You will need to lie on your back with your hip joint straight for about 4 hours to prevent bleeding from the insertion site. During that time, do not bend or lift the leg where the catheters were inserted. To relieve stiffness, you may move your foot or wiggle your toes. The nurse will check often to see if there is bleeding. If you notice bleeding or pain at the site, notify your nurse immediately. Depending on the results, you may be sent home several hours after the procedure, or the next day. Some patients may need to stay for more tests or procedures. When it’s time to go home you will need to have a friend or family member drive you.

    After You Go Home

    • Limit your activity during the first couple of days at home. You can move about, but do not strain or lift heavy objects.
    • A bruise or small lump under the skin at the insertion is quite common. It should disappear within 3 to 4 weeks.
    • Call your doctor or nurse if the insertion site becomes painful or warm to the touch, the bruising or swelling increases, or you develop a fever over 101.5F.
    • Ask your doctor when you can return to your normal activities, and whether there are things you should refrain from doing.

    On the Road to Recovery

    Your doctor may also suggest that you change some of your lifestyle habits to prevent a heart attack, stroke or other health problems. Some risks cannot be controlled such as age and family history. Here are some things, though, that you can do:

    • Give up tobacco;
    • Control high blood pressure (with diet, exercise and medication-if prescribed);
    • Control high blood cholesterol (with a low-fat diet, exercise and medication-if prescribed);
    • If diabetic, control blood sugar;
    • Exercise regularly;
    • Maintain a healthy weight; and
    • Learn healthy ways to manage stress.

    Being committed to making healthy lifestyle changes and taking care of yourself is the best defense against future health problems.