Electrophysiology (EP) Study

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Electrophysiology (EP) Study

Highly trained cardiac EPs perform EP studies in a specially designed EP lab having advanced technology and equipment.

Normally, electrical impulse starts in right upper chamber of heart (SA node: Natural pacemaker of heart) and then spreads to lower chambers of heart via AV node in a regular pattern. Normal electricity of the heart is responsible for normal heart beats. A problem anywhere along the electrical pathway causes an abnormal heart rhythm (Arrhythmia). Accurate diagnosis of arrhythmia mechanism is very important for selecting best possible treatment.

Electrophysiology Study

Why an EP study?

While electrocardiogram (ECG) is important test of the heart’s electrical system, they provide limited information about heart’s electrical activity. Arrhythmias may occur intermittently, which makes it unlikely that an ECG will capture the underlying electrical problem.

During an EP study, a specially trained cardiac EP may provoke arrhythmia events and collect data about the electrical activity during actual events. As a result, EP study can diagnose the exact cause and precise location of the arrhythmia. This detail of electrical activity of heart during arrhythmia provides valuable diagnostic and, therefore, treatment information.

EP study is recommended for patients with symptoms suggesting heart rhythm disorders or for people who may be at risk for Sudden Cardiac Death.

Who performs the EP study and where?

A cardiac electrophysiologist (cardiac EP), with advanced training in the diagnosis and treatment of heart rhythm problems, performs the EP study. The electrophysiologist leads a team of specially trained health care professionals, technicians and nurses, who assist during the procedure. The team performs the EP study in an well-equipped electrophysiology laboratory (EP lab). As a result, the test is quite safe and complications are less common.

An overview of the procedure

Electrophysiology Study
Electrophysiology Study

EP study is an invasive procedure. The study is performed after giving local anaesthesia to keep the patient as comfortable as possible. The procedure involves inserting several catheters (narrow, flexible tubes) into the heart with the help of fluoroscopy (x-ray). Catheters are attached to electricity monitoring electrodes which records electrical activity of various heart chambers.

Once the catheter reaches the heart, electrodes at its tip record variety of electrical activity. These electrical data helps in finding the location of faulty electrical site. It is necessary to make the correct diagnosis and track down the precise location of the problematic tissue causing the arrhythmia.

Once the correct diagnosis has been established, the electrophysiologist will decide the best possible treatment. One of the following treatment option may be given to the patient.

  • 1. Medications
  • 2. Catheter ablation (burning the source of arrhythmia by RF ablation)
  • 3. Implantable cardioverter defibrillator device (ICD)

The Value of an EP Study

An electrophysiology study (EP study) provides information that is very important for diagnosis and treatment of arrhythmias.
  • Diagnosis of exact arrhythmia mechanism and its location in the heart
  • Predict the risk of a future cardiac event, such as Sudden Cardiac Death
  • Assess the need for an implantable device (Pacemaker or ICD)
  • Assess the need for RF catheter ablation

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