Arrhythmia |
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The Electrophysiology Procedure
Please read the following to learn more about what to expect and how to prepare for an electrophysiology (EP) study:
Once you are at the hospital there are a couple final preparations for the procedure:
- For your comfort, empty your bladder as completely as possible before the study starts. A bedpan or urinal will be available during the procedure.
- A small intravenous (IV) needle will be inserted into a vein in your arm, for drugs to be injected if necessary.
The EP study is performed in the electrophysiology laboratory of the hospital, where you will be placed on an X-ray table. A camera and television screens will be close by, as will heart monitors and various instruments. You will be connected to monitors with electrodes and gelatin patches. A blood pressure cuff will be put onto your upper arm so that we may monitor your blood pressure frequently.
A nurse will shave and cleanse the area where the catheters will be inserted, including the groin and/or neck, to protect against infection. The area will be cleansed with an orange-brown, sticky antiseptic. Sterile sheets will he draped over your body. It is important that you find a comfortable position so that once the study begins, you will be able to stay still and not touch the sterile working area.
During the study you may be given some sedative medications to make you sleepy, which will be given through the intravenous (IV) line in your arm. These medications will help reduce your anxiety and relieve your discomfort. In addition, a local anesthetic will be given with a tiny needle to numb the area where the catheters are placed. You will feel a pinprick and possibly a stinging sensation from the anesthetic for just a few seconds.
One or more catheters, which are thin, long flexible wires, will be inserted into a large vein in your groin and/or neck. The catheters will then be guided to your heart. The positioning of catheters inside your heart will be monitored on a screen. You may feel pressure when the catheters are inserted but no other discomfort. The incision site is less than a quarter of an inch and should not leave a scar after it heals.
There are two parts to the EP study:
- Recording the heart's electrical signals to assess the electrical function
- Pacing the heart to bring on certain abnormal rhythms for observation under controlled conditions
Medications are sometimes used to stimulate your arrhythmia, so you may feel your heart racing or pounding. This may make you anxious, but you needn't be alarmed. The doctors want to induce the abnormal rhythm causing your problem, so that they can treat the arrhythmia. If you have any uncomfortable symptoms -- such as chest pain, dizziness, shortness of breath, nausea and pain -- tell your nurse or doctor.
Your Role During the Study
The EP study should not cause you any pain. It is important that you stay calm and relaxed, and not move your arms or legs in the sterile working area. If you feel any discomfort, let your doctors or nurses know immediately, so that they can help you get comfortable.
In the controlled condition of the EP laboratory, induced arrhythmias are handled by well-trained personnel with state-of-the-art equipment. This is an important tool that allows your doctor to gain information about your arrhythmia that will help prevent future occurrences.
Recovery
Once the EP study is over:
- The catheters will be removed and pressure will be applied to the groin and/or neck to prevent bleeding.
- You will lie still in bed for four to six hours to allow the site of the catheter to seal. You must not move or bend your leg.
- You will be checked frequently, but if you feel sudden pain or see bleeding at the site, call the nurse immediately.
- You may be able to discuss some of the preliminary findings with your doctor after the test.
- You may be able to eat or drink if you feel well enough.
Before being discharged, your doctor or arrhythmia nurse coordinator will instruct you about any restrictions on your normal activities, medications and follow-up care.
At Home
After you are discharged from the hospital and return home, it is important that you take care of yourself.
Limit your activity for the first 24 hours. Don't strain or lift heavy objects more than 10 pounds for the first week. If traveling home takes a long time, stop every hour and stretch your legs -- walk a few minutes to prevent formation of blood clots in your legs. If you notice new blood on the dressing, press firmly on the incision site for about 20 minutes. If bleeding continues, call your doctor or go to the nearest emergency room while still applying pressure. Leave the dressing on until the day after the study; your nurse will show you how to remove it.
Don't worry if you see a bruise or small lump under the skin at the insertion site. It will disappear within three to four weeks.
Call your doctor or the arrhythmia nurse coordinator if:
- The site becomes painful or warm to the touch
- You have chest pain, palpitations, shortness of breath, lightheadedness or fever
More Information:
Reviewed by health care specialists at UCSF Medical Center.
Last updated May 8, 2007
This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.
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