If a patient has unknown fainting and/or severe heart palpitation that remain unknown, a Long Island Heart physician will order an electrophysiology study. An electrophysiology (EP) study is a particular type of catheterization test that helps determine the cardiac electrical system. The electrical system is significant because it controls the heart rhythm.
How is the Electrophysiology study performed?
If you have an EP study, you will be brought into a specialized catheterization lab called the electrophysiology laboratory. The patient will be given a medical gown to dress into before they are asked to lie down on an examination table. Local anesthesia and possibly a mild sedative are given before the physician inserts the electrode catheters into one or more blood vessels. Using flouroscopy (similar to an x-ray), the catheters are moved through the blood vessels and into certain areas of the heart.
Once they are properly positioned, the electrode catheters are used to do two main tasks: record the electrical signals generated by the heart and to pace the heart. Cardiac arrhythmias can be fully studied by recording and pacing from strategic locations within the heart. Once the procedure is completed, the catheter(s) are removed and the small incisions are taken care of.
After your study
Your physician will evaluate your heart during the study; they will determine what is causing your palpitations and/or fainting and proceed from there. After confirming your results, your physicians will treat the heart with one of the three procedures:
Radiofrequency ablation is often the treatment of choice if supraventricular tachycardia (SVT) or and some forms of ventricular tachycardia (VT) are found. The ablation procedure is usually carried out during the same procedure at the EP study. The ablation itself is done by transmitting some form of energy through the catheter. The energy that could be used is heat, freezing, or microwave energy in order to damage the tissue at the tip of the catheter.
If the EP study confirms a slow heart rate or bradycardia, a pacemaker will be inserted during the same procedure. A pacemaker is a small, sophisticated electronic device that is implanted under the skin to help regulate the heart beat. Pacemakers are used to help coordinate the beating of heart and preventing the heart rate becoming too slow. The pacemaker is a permanent device that will help regulate the heart beat, while the heart still does all its own work.
Iplantable defibrillator is the treatment of choice if rapid forms of ventricular tachycardia (VT) and/or ventricular fibrillation (VF) are identified during the EP study. This device can now be inserted in the EP laboratory, immediately following the EP study. The defibrillator is a small electronic device that is implanted under the skin and attached by wires to the heart in order to monitor and regulate a patient’s heartbeat. When it detects an abnormality, such as a fast or erratic heart rate, the ICD sends electrical impulses to the heart in order to correct the rhythm.