Electrophysiology Study

An Electrophysiology Study (EP study) is a test utilized to assess the heart’s electrical framework and check for abnormal heart rhythms. The natural electrical impulses coordinate the contractions of different parts of the heart. This helps maintain normal blood circulation. This movement of the heart produces the heartbeat. This is done so the heart can be evaluated and its damaging causes can be found. It may also be done to help evaluate how your body responds to some medicines.

During an EP study, a heart rhythm specialist or an electrophysiologist can also map the propagation of electrical impulses from the heart with each beat. This may be done to help find the source of the irregular heartbeat.

Procedure of EP Study

After we have learned what electrophysiology study is, let’s now move on to the procedure. The EP study is done in a hospital electrophysiology lab, where you will be placed on an X-ray table. A camera and television screen, heart rate monitor and various instruments will be nearby. Electrodes will be placed on your chest and back to connect you to a monitoring device. A blood pressure cuff will be placed on your upper arm to monitor your blood pressure.

To prevent infection, the nurse will shave and clean the groin and possibly the neck area where the catheter is placed. The area will be cleaned with a disinfectant.
Find a comfortable position where you can lie still during the procedure.
Depending on the type of study you’re going through, you may be given an injection into a vein, an injection into your arm to calm you down, or make you drowsy. These medications help reduce your anxiety and ease your discomfort. Your doctor will let you know if sedation is appropriate.
A local anesthetic will be used with a fine needle to numb the area where the catheter is inserted.
One or more catheters, which are thin, long, flexible wires, will be inserted into a large vein in your groin or neck. The catheter will be guided to your heart. The position of the catheters inside your heart will be monitored on the monitor.

Benefits of EP Study

The aims of conducting EP studies are to gain insight into the function of each component of the conduction system, to identify the mechanism and precise focus of arrhythmia, to perform risk stratification, and to perform ablation of the impaired circuit. to determine the need for treatment or therapy. This article provides an overview of anatomy and physiology, common cardiac indications, and the clinical importance of EP research. On average, the electrophysiology study cost of a basic EP study without ablation could range from ₹50,000 to ₹1,50,000 or more. If ablation or other interventions are required, the cost would increase significantly.

Why is of EP Study done?

Your Cardiologist may advise an Electrophysiology study for several reasons so as to evaluate symptoms such as dizziness, fainting, weakness, palpitations, or other symptoms to see if they could be caused by a rhythm problem. This may be done when other tests aren’t clear and your doctor suspects you have a heart rhythm problem. EP studies can also be used to get information about an abnormally fast or slow heart rate. EP studies are sometimes done to find the source of the heart rhythm problem for the purpose of ablation after the source is identified and to see the medications used to treat the heart rhythm problem how well it is working.

What are the risks involved in EP Study?

In most cases, this procedure is quite safe. Potential risks may include things such as arrhythmia. An arrhythmia may occur during the EP examination and cause dizziness. In this case, your doctor may give your heart an electric shock to get it back to normal. A heart attack (myocardial infarction), stroke, or damage to a heart valve can also be fatal. In some cases, a blood clot forms at the tip of the catheter and breaks off, blocking the blood vessel. Your doctor may prescribe drugs to prevent blood clots. Infection, bleeding, and bruising at the catheter insertion site (groin, arm, or neck) may also occur. Doctors and nurses can help avoid these problems.

What happens during an Electrophysiological Study?

In hospitals and clinics, doctors and nurses perform EP tests in rooms with special testing equipment. This room may be called the “Electrophysiology Laboratory” or the “EP Laboratory” or some call it a catheterization lab. During testing:

A nurse will plug her IV (infusion line) into your arm. You will be given drugs to help you relax (sedatives). However, during the test I am awake and able to follow instructions.
It usually occurs in the groin, but can also occur in the arms and neck.
An injection of local anesthetic is given to numb the area. A doctor inserts a needle through the skin and into a blood vessel.
Your doctor sends small electrical pulses through the catheter to make your heart beat at different rates. You may feel your heart beat faster and faster.
Electrical signals produced by the heart are picked up and recorded by a special catheter. This is called cardiac mapping and allows doctors to pinpoint the cause of an abnormal heart rhythm.
Your doctor will remove the catheter and IV line. The nurse will apply pressure to the injection site to stop the bleeding. The test usually lasts 1-4 hours.
If the type and location of the arrhythmia have been identified and appropriate therapy determined, cardiac ablation or insertion of a cardiac pacemaker or his ICD can be performed during or shortly after the EP study.

Key Parts of Electrophysiology Study

An electrophysiology (EP) study involves several key parts that help doctors understand and manage heart rhythm issues:

Catheter Insertion
Thin, flexible tubes called catheters are carefully inserted into blood vessels, typically in the groin or neck area, and guided to the heart.

Mapping and Recording
Catheters record the heart’s electrical signals, creating a map that helps locate abnormal areas or irregular heart rhythms.

Provocation Techniques
Using the catheters, doctors can trigger or provoke abnormal heart rhythms to understand how and where they originate.

What happen after the Procedure EP Study?

You will be moved to the recovery room for 1 to 3 hours. In this time:

Lie still for as long as the nurse tells you to. Be sure to keep the arm or leg used for the test straight.
Your nurse will check for bleeding or swelling at the puncture site.
Before you leave, you will be told what to do at home. Follow the instructions your nurse or doctor has given you, including taking any new medicines that have been prescribed for you. Most people can start eating and taking medicine within 4 to 6 hours after the test. Most are able to do their usual daily activities the day after the test. Do not drive for at least 24 hours.
The needle puncture site may be painful for several days. A small bruise at the puncture site is normal. If the site begins to bleed, lie flat and press firmly on it. Have someone call your doctor or EP lab.

Till date patients of Nagpur were referred to metropolitan cities like Mumbai or Hyderabad for this treatment or senior EP specialists used to visit Nagpur to treat patients. With full time accessibility of Dr. Chetan Rathi at Nagpur, 1st EP specialist of not only Nagpur but whole Vidarbha locale, patients can indeed profit from this facility at Nagpur.

FAQ's for Electrophysiology Study Test in Nagpur

Is an EP test painful?

An EP test might cause mild discomfort, but it’s not usually considered painful. Local anesthesia is used to numb the area, and patients might feel pressure or a sensation when catheters are inserted into blood vessels.

Is electrophysiology safe?

Electrophysiology procedures are generally safe when performed by experienced professionals. However, like any medical procedure, there are potential risks and complications, such as bleeding, infection, or arrhythmia induction.

Is electrophysiology a surgery?

Electrophysiology procedures are not classified as surgeries in the traditional sense. They are minimally invasive, involving the insertion of catheters through blood vessels, usually without the need for major incisions.

What is the recovery time for electrophysiology ?

Recovery time after electrophysiology depends on the specific procedure and the patient’s condition. Generally, patients can resume light activities within a day or two, but complete recovery might take a week or more.

Can you walk after EP study?