Electrophysiology Study (EP)

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What is Electrophysiology Study (EP)

Electrophysiology study is a heart test in which thin, flexible tubes (catheters) are placed in a large vein in your groin, arm, neck, or chest.

This test is done to evaluate the electrical conduction system of your heart. You may need this test if you have:

  • Dizziness or fainting.
  • A fast heartbeat (tachycardia).
  • A slow heartbeat (bradycardia).
  • An irregular heartbeat (arrhythmia), such as atrial fibrillation.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.
  • Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Tachycardia that does not go away.
  • Bleeding or bruising around the insertion sites.
  • Infection.
  • Temporary or permanent heart rhythm abnormalities.
  • Temporary changes in blood pressure.
  • Puncture(perforation)of the heart wall or a blood vessel. This can cause bleeding between the heart and the sac that surrounds it (cardiac tamponade).
  • Possible cardiac arrest or fatal heart arrhythmia.
  • Allergic reactions to medicines or dyes.
  • Damage to other structures or organs.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

  • Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

  • 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
  • 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
  • 6 hours before the procedure – stop drinking milk or drinks that contain milk.
  • 2 hours before the procedure – stop drinking clear liquids.

Medicines

  • Ask your health care provider about:
    • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
    • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do nottake these medicines before your procedure if your health care provider instructs you not to.
  • You may be given antibiotic medicine to help prevent infection.

General instructions

  • Plan to have someone take you home from the hospital or clinic.
  • If you will be going home right after the procedure, plan to have someone with you for 24 hours.
  • Ask your health care provider how your surgical site will be marked or identified.

What happens during the procedure?

  • To lower your risk of infection:
    • Your health care team will wash or sanitize their hands.
    • Your skin will be washed with soap.
    • Hair may be removed from the surgical area.
  • An IV tube will be inserted into one of your veins.
  • You will be given one or more of the following:
    • A medicine to help you relax (sedative).
    • A medicine to numb the area (local anesthetic).
    • A medicine to make you fall asleep (general anesthetic).
  • Catheters with an electrode tip will be inserted into a large vein. These electrode tips can measure the heart’s electrical activity. They can also use electrical signals to change the heart rhythm.
  • The catheters will be guided to the heart using a type of X-ray machine (fluoroscopy). Once the catheters are in the heart, they will evaluate the electrical activity of your heart.
  • If you are awake during the EP study, you may feel dizzy or light-headed. Your heart rate may temporarily increase or you may feel your heart beating hard. Tell your health care provider if you experience these things during the EP study:
    • You feel dizzy or nauseous.
    • You have chest pain or pressure.
  • The catheters will be removed.
  • Firm pressure will be applied to the insertion sites to prevent bleeding.
  • A bandage (dressing) may be applied over the insertion sites.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Do not drive for 24 hours if you were given a sedative.
  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.

You will need to lie flat for a few hours or as told by your health care provider. Keep your legs straight. Do not bend or cross your legs.

Care After Electrophysiology Study

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

  • Tenderness and bruising at the sites where the thin, flexible tubes (catheters) were inserted.
  • A feeling that your heartbeat is irregular or faster than normal (palpitations).

Follow these instructions at home:

Insertion site care

  • Follow instructions from your health care provider about how to take care of your insertion site. Make sure you:
    • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
    • Change your dressing as told by your health care provider.
    • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do notremove adhesive strips completely unless your health care provider tells you to do that.
  • Check your insertion site every day for signs of infection. Check for:
    • More redness, swelling, or pain.
    • More fluid or blood.
    • Warmth.
    • Pus or a bad smell.

Do nottake baths, swim, or use a hot tub until your health care provider approves.

General instructions

  • Do notdrive for 24 hours if you were given a medicine to help you relax (sedative).
  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have more redness, swelling, or pain around your insertion site.
  • You have more fluid or blood coming from your insertion site.
  • Your insertion site feels warm to the touch.
  • You have pus or a bad smell coming from your insertion site.
  • You have a fever.
  • You develop a hard spot bigger than a walnut at the insertion site. This could be a blood clot.
  • You have a large amount of bruising that expands from the insertion site.
  • You feel light-headed.
  • You feel nauseous.
  • You feel dizzy.

Get help right away if:

  • You have heavy bleeding from the catheter insertion site.
  • The limb, such as an arm or leg, that was used for the insertion site tingles, becomes numb, feels cold, or changes color.
  • You have chest pain or a heavy feeling in your chest.
  • You vomit repeatedly.
  • You faint.
  • You have trouble speaking, understanding speech, or both.
  • You have weakness on one side of your body.
  • You have a sudden change in vision.

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