Abnormal Heart Rhythm |
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Electrophysiology Study and Catheter Ablation
An electrophysiology study and catheter ablation are procedures performed in a special laboratory in the hospital and may require an overnight stay.
Before the Procedure
You and your child will talk with one of the doctors on our team. The doctor will review your child's history. At this time, the doctor will review the procedure in detail, its benefits and potential risks. He or she also will discuss with you what kind of sedation is likely needed for your child. On occasion, we may decide to use general anesthesia. If necessary, we will discuss this with you. You and your child will meet with an anesthesiologist before the procedure.
Be sure to ask any questions you may have. You will be asked for your written consent.
It is standard hospital policy to perform a pregnancy test on all females over the age of 12 years before exposing them to X-rays.
No blood will be given to your child during this procedure. Blood donations by friends or family are not needed.
Aspirin and Medications
Please give your child aspirin every day, beginning three days before the ablation. Aspirin prevents blood from clotting too easily, making the ablation a safer procedure. Tylenol does not have this effect and can't be used in place of aspirin.
The dosage varies depending on your child's weight:
- Children weighing less than 20 pounds should get half of a baby aspirin tablet daily. Each whole tablet contains 80 milligrams. Give half of that, or 40 milligrams. Any brand is fine, including the flavored, chewable type.
- 20 to 40 pounds - Your child should get one baby aspirin per day, or 80 milligrams.
- More than 40 pounds but less than 80 pounds - Your child should get two baby aspirins, each 80 milligrams, daily for a total daily dose of 160 milligrams.
- 80 pounds or more - Your child should get one adult aspirin, 325 milligrams, per day. It's OK to crush the pill and mix it with food. Some brands are coated to make them easier to swallow.
If your child is allergic to aspirin or appears to have a cold, the flu or chicken pox, do not give aspirin. Instead, please call us and speak with the doctor.
If your child is currently on medications for the heart rhythm, we will ask you to stop giving your child these medications three to five days before the procedure. Please discuss this with your doctor.
Fasting
Make sure that your child's stomach is empty at the time of the study. Your child should not eat or drink anything for six to eight hours before the procedure. This usually means that your child should not eat or drink anything after midnight the night before the procedure.
During the Procedure
The procedure is performed in a room called an electrophysiology (EP) lab or catheterization (cath) lab. The lab is equipped with computers and monitors to record heart rate, blood pressure and oxygen levels. We use X-ray equipment to help us guide the catheters, which are thin flexible tubes, into the heart. The amount of X-ray exposure is usually very small.
Typically, the staff includes one or two doctors, one or two nurses and a technician.
The day of the procedure, you and your child will either be sent to a hospital room or a waiting area before coming to the lab. During the procedure, we will provide you with a pager, in case we have any questions or we need to reach you.
At the start of the test, we may give your child sedation orally, to help your child relax. In addition, the doctor or nurse will insert a small tube, an intravenous or IV line, into your child's arm. We will use this IV to give sedation before and throughout the procedure to make sure your child is comfortable.
Once the monitors are applied and the sedation is effective, your child will lie comfortably on his or her back. The nurse will clean and, if necessary, shave the area where the catheters will be inserted. Catheters are most commonly inserted in the veins in the groin area and the neck. Catheters are the thin tubes that record electrical signals and help us to study the heart's electrical system and the abnormal heart rhythm.
Your child will be covered with a sterile sheet from chin to toe.
During the test, we will stimulate your child's heart to create the abnormal heart rhythm. With the use of catheters, we will locate the extra pathway or focus. This is called mapping. After a map has been completed, we are ready to perform an ablation.
During the ablation, we deliver radiofrequency (RF) energy through a catheter that is in contact with the extra pathway or focus. The tip of the catheter heats up and destroys the small area of extra electrical tissue.
After the Procedure
The EP study and ablation will take several hours. We will page you when we are finished. The doctor will then meet with you and discuss all the details. Your child will be transported to his or her room. Bed rest for four to six hours after the procedure will be needed to allow the groin area to heal.
Many children are hungry after the procedure. When they are fully awake, they are allowed to drink some liquids if they aren't nauseous. If liquid is tolerated, they may then eat.
Your child may notice some tenderness in his or her groin or neck once the local anesthetic has worn off. This can be treated with Tylenol or Motrin. There may be some bruising in the area, which will fade over the next few weeks.
Returning Home
Typically, your child will leave the hospital within 24 hours. Once home, most children return to full activity, including school, three to four days following the procedure.
Please call your child's doctor or nurse if you notice anything unusual after you return home. Please call immediately if your child experiences any of the following:
- Dizziness or near-fainting
- Rapid heartbeat. If this occurs, help your child to a relaxed lying position
- Blood leaking from the groin or neck where catheters were placed. Apply very firm, steady pressure with the heel of your hand to the groin or with your fingertips to the neck
We don't expect any of these problems. But if they do occur, please call so they may be handled quickly.
Contact Us
If you have any questions about this information, please feel free to contact the doctors and nurses on our team at the UCSF Pediatric Heart Center at (415) 353-2008.
More Information:
Reviewed by health care specialists at UCSF Children's Hospital.
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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