Electrophysiological study

Electrophysiological Study

An electrophysiological study (EPS) is a test that examines the electrical activity of the heart to diagnose abnormal heart rhythms, known as arrhythmias. This procedure is typically performed by a specialized cardiologist known as an electrophysiologist.

Indications

EPS is indicated for patients who have experienced symptoms such as palpitations, dizziness, syncope, or unexplained cardiac arrest. It is also used to evaluate the effectiveness of antiarrhythmic medications and to assess the need for implantable devices such as pacemakers or defibrillators.

Procedure

The procedure is performed in a specialized laboratory called an electrophysiology lab. The patient is usually sedated but remains conscious. Local anesthesia is applied to the insertion site, typically in the groin area.

Catheter Insertion

Thin, flexible wires called catheters are inserted through a vein and guided to the heart using fluoroscopy. These catheters have electrodes that can record electrical signals from the heart.

Electrical Mapping

The electrophysiologist uses the catheters to map the electrical activity of the heart. This mapping helps identify the location of abnormal electrical pathways that may be causing arrhythmias.

Inducing Arrhythmias

In some cases, the electrophysiologist may induce arrhythmias by delivering small electrical impulses to the heart. This helps in diagnosing the type and location of the arrhythmia.

Risks

While EPS is generally safe, it carries some risks, including bleeding, infection, and damage to the heart or blood vessels. Rarely, it can cause a serious arrhythmia that requires emergency treatment.

Treatment Options

If an arrhythmia is identified, the electrophysiologist may perform an ablation during the same procedure. Ablation involves destroying the abnormal tissue causing the arrhythmia using radiofrequency energy or cryotherapy.

Recovery

After the procedure, patients are monitored for a few hours. Most can return home the same day, but they should avoid strenuous activities for a few days.

See Also

• Cardiac electrophysiology
• Arrhythmia
• Pacemaker
• Implantable cardioverter-defibrillator

References

• Zipes, D. P., & Jalife, J. (2013). Cardiac Electrophysiology: From Cell to Bedside. Elsevier Health Sciences.
• Josephson, M. E. (2008). Clinical Cardiac Electrophysiology: Techniques and Interpretations. Lippincott Williams & Wilkins.