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Electrophysiology

Latoya Linton-Frazier, MD, and John Lobban, MD, specialize in the Cardiac Electrophysiology field at Mon General Hospital. Cardiac electrophysiology is the science of elucidating, diagnosing and treating the electrical activities of the heart. Cardiac electrophysiologists are trained to perform interventional cardiac electrophysiology studies (EPS) as well as surgical device implantation.


Our Electrophysiology tests and treatments include:


What is an electrophysiological study?


An electrophysiological study (EP study) is a procedure used to evaluate abnormal heartbeats.

Natural electrical impulses coordinate contractions of the different parts of the heart. This helps keep blood flowing the way it should. This movement of the heart creates the heartbeat, or heart rhythm.

During an EP study, small, thin wire electrodes are put into a vein in the groin (or neck, in some cases). The wire electrodes are threaded through the vein and into the heart, using a special type of X-ray “movie,” called fluoroscopy. Once in the heart, the heart’s electrical signals are picked up by the electrodes and measured. Electrical signals are also sent through the electrodes to stimulate the heart tissue to try to cause the abnormal heart rhythm so that it can be evaluated and its cause can be found, or to help evaluate how well a drug is working.

During the EP study, doctors may also map the spread of the heart’s electrical impulses during each beat. This may be done to help locate the source of an abnormal heart beat. If a location is found, the tissue can be destroyed.

The results of the EP study may also help the doctor decide whether more treatment is needed and which treatment would be best. You may need a pacemaker or implantable defibrillator, adding or changing medications, doing more ablation procedures, or providing other treatments.

 


Why might I need an electrophysiological study?

An electrophysiological study (EP study) may be done for the following reasons:
  1. To evaluate symptoms such as dizziness, fainting, weakness, palpitation, or others to see if they might be caused by a rhythm problem when other tests have not been clear
  2. To locate the source of a heart rhythm problem
  3. To see how well medication(s) given to treat a rhythm problem are working
  4. To treat a heart rhythm problem
  5. There may be other reasons for your doctor to recommend an EP study.

What are the risks of an electrophysiological study?


Possible risks of an electrophysiological study (EP study) include:

  • Severe rhythm problems
  • Bleeding and bruising at the site where the catheter(s) is put into a vein
  • Damage to the vessel that the catheter is put into
  • Formation of blood clots at the end of the catheter(s) that break off and travel into a blood vessel
  • Rarely, infection of the catheter site(s)
  • Rarely, perforation (a hole) of the heart

You may want to ask your doctor about the amount of radiation used during fluoroscopy and the risks related to your situation. It is a good idea to keep a record of your radiation exposure, such as previous scans and other types of X-rays, so that you can inform your doctor. Risks associated with radiation exposure may be related to the cumulative number of X-rays and/or treatments over time.

For some people, having to lie still on the procedure table for the length of the study may be uncomfortable or painful.

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.


How do I get ready for an electrophysiological study?

  • Your doctor will explain the procedure to you and give you a chance to ask questions.
  • You will be asked to sign a consent form that gives your permission to do the test. Read the form carefully and ask questions if anything is not clear.
  • Tell your doctor if you are sensitive to or are allergic to any medications, iodine, latex, tape, or anesthetic agents (local and general).
  • You will need to fast (not eat or drink anything) for a certain period prior to the procedure. Your doctor will tell you how long to fast, usually overnight.
  • If you are pregnant or think you may be, tell your doctor.
  • Tell your doctor if you have any body piercing on your chest and/or abdomen (belly).
  • Be sure your doctor knows about all medications (prescription and over-the-counter), vitamins, herbs, and supplements that you are taking.
  • Tell your doctor if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting.
  • You may need to stop some of these medications prior to the procedure.