Archive for April, 2010

 

Electrophysiology Study (EP study)

 

How is an EP study performed ?

If you have an EP study, you will be brought to the electrophysiology laboratory (a specialized catheterization laboratory) and you will lie down on an examination table. You will be given local anesthesia, and possibly a mild sedative, and then electrode catheters will be inserted in to one or more blood vessels. (Catheters are inserted either through a small incision or by means of a needle-stick, usually in the arm, groin or neck. Most often two or three catheters are used, and they may be inserted from more than one site. ) Using flouroscopy (similar to an x-ray), the catheters are advanced through the blood vessels and in to specific areas within the heart.

Once they are appropriately positioned, the electrode catheters are used to do two main tasks: to record the electrical signals generated by the heart and to pace the heart. (Pacing is accomplished by sending tiny electrical signals through the electrode catheter. ) By recording and pacing from strategic locations within the heart, most kinds of cardiac arrhythmias can be fully studied.

Once the procedure is completed, the catheter(s) are removed. Bleeding is controlled by placing pressure on the catheterization site for 30 to 60 minutes.

 

How does the EP study help to direct treatment of arrhythmias ?

Insertion of a pacemaker : If the EP study confirms the presence of significant bradycardia, a permanent pacemaker can often be inserted immediately, during the same procedure.

 

Ablation : If supraventricular tachycardia (SVT) — and some forms of ventricular tachycardia (VT) — are found, radiofrequency ablation is often the treatment of choice. The ablation procedure is usually carried out during the same procedure, immediately following the EP study.

 

Implantable defibrillators : If rapid forms of VT and/or ventricular fibrillation (VF) are identified during the EP study, most commonly an implantable defibrillator is the treatment of choice. This device can now often be inserted in the EP laboratory, immediately following the EP study. In earlier years, the EP study was used to identify the “best” anti-arrhythmic drug for patients with VT or VF, but today it is known that no anti-arrhythmic drug is as effective as the implantable defibrillator in preventing sudden death from these arrhythmias.

 

An EP study may be performed for the following reasons : –

 

How common is this procedure ?

Radiofrequency ablation is widely used. It’s the preferred treatment for many types of rapid heartbeats. It has a success rate of over 90 percent and a low risk of complications. Patients who have this done can resume normal activities in a few days. It causes little or no discomfort and is done under mild sedation with local anesthesia.

 

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