Electrophysiologic study for a slow heart rate
An electrophysiologic study (EP study) is a more detailed form of electrocardiography, which evaluates the electrical system of the heart. An electrophysiologic study is rarely needed for a slow heart rate, but it may be requested if other tests have not provided enough information about the cause of a slow heart rate. This test may also be used when symptoms indicate a very serious heartbeat irregularity that could be life-threatening.
EP studies are most helpful in determining whether people with slow rhythms need a pacemaker. Electrical heart block occurs when impulses are interrupted between the upper and lower chambers. The electrophysiologic study can identify these in certain cases so that your doctor can choose an appropriate therapy.
An EP study takes place in the cardiac catheterization or electrophysiology lab of a hospital. You receive numbing medicine (local anesthetic) along with a medicine to help you relax (sedative). Your doctor places small electrical wires (catheters) directly inside your heart. The leads are placed in the heart using a thin, flexible tube (sheath) that is threaded through a vein in your arm, groin, or neck. Your doctor uses X-rays to guide the leads into the heart.
The catheters are connected to a machine that measures and records your heart's electrical activity. This gives a detailed picture of the electrical activity in your heart. Small electrical currents may also be given to the heart during testing to trigger certain abnormal heart rhythms. In this way, the effects of the irregular rhythms can be observed and recorded. The doctor can also study the effects of certain medicines or a pacemaker on the heart in a controlled environment while you are being closely monitored.
An electrophysiologic study is not painful, and you will be awake during the procedure. You may feel your heart racing or you may feel lightheaded. It is important to keep the nurse and doctor informed of how you are feeling.
The study usually takes about 2 hours but can occasionally last longer. You need to be in bed for several hours after the test, and you may need to stay in the hospital overnight. You cannot eat or drink after midnight on the day of the test. You may not be able to take some of your regular medicines before the test. Ask your doctor whether you should take all of your usual medicines on the morning of your test.
There is a small chance of complications during electrophysiologic study testing. Complications may include bruising where the tubes (catheters) are put in, bleeding (around the heart or where the tube is inserted), blood clots, infection, or death (rare).
| Author: | Robin Parks, MS | Last Updated: July 7, 2007 |
| Medical Review: | Adam Husney, MD - Family Medicine E. Gregory Thompson, MD - Internal Medicine Laurence Epstein, MD - Cardiac Electrophysiologist | |
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