Electrophysiology Study (EPS)

An Electrophysiology Study (EP) study is an invasive but nonsurgical procedure done by a cardiac electrophysiologist (a doctor who specializes in heart rhythm evaluation and treatment). EP studies test the electrical activity of your heart to find where an arrhythmia (abnormal heartbeat) is coming from.

The EP study can be used to evaluate your heart's electrical system, screen for abnormal heart beats (arrhythmias), guide treatment for arrhythmias, and evaluate your risk for arrhythmia formation in certain heart conditions.

Before the procedure

• Tell your doctor which medicines you take, including over the counter medications, herbs and vitamins. Ask if you should stop taking any of them before the procedure, especially blood thinners or medicines that can affect your heart rate or rhythm.
• Have any routine tests that your doctor recommends, such as blood tests.
• Do not eat or drink anything after midnight the night before the procedure, or at least 8 hours before the procedure or as directed by your healthcare provider.
• Arrange to have a responsible adult bring you home from the procedure.

During the procedure

• The procedure can take 1 to 4 hours to complete.
• You will be given medicine through an intravenous (IV) line to help you relax.
• The skin in your groin area will be numbed with a local anesthetic. This may be on the right groin, the left groin, or both.
• Your doctor will insert one or multiple IV lines into your femoral vein through a puncture wound in your groin area.
• The doctor will then put a small straw-sized tube (called a sheath) into the femoral vein in your groin area in one or both groins. He/she will use this sheath and pulsed x-ray (fluoroscopy) to gently guide catheters (long thin tubes) into your heart and place them in specific locations to record your heart’s electrical activity.
• Your doctor will send small electric pulses through the catheters to make your heart beat at different speeds. You may feel your heart beat stronger or faster during this time.
• Electrical signals produced by your heart will be picked up by the special catheters and recorded. This is called cardiac mapping and allows the doctor to locate where arrhythmias are coming from and/or may come from.
• During the procedure, medicines that stimulate the heart beat and rhythm may also be used to help induce an abnormal heart rhythm.
• Once your doctor gets the needed information, the wires will be removed from the body.   
• The IV lines will be removed from the groin.
• Pressure will be applied to the insertion site to prevent any bleeding and a gauze dressing will be applied to the puncture wound. 

After the procedure

• You will need to lie flat and keep the leg that had the catheters in place, straight for at least 4 hours after the procedure in order to prevent bleeding and swelling at the puncture wound site.
• A nurse will check the insertion site and monitor your heart rate, heart rhythm, and blood pressure and other vital signs while you are lying flat.
• After the study, you may stay overnight, or you may go home the same day. This will depend on the results of the study as well as the indication for the procedure. 

Home care

Before you leave the hospital, your nurse or doctor will give you written instructions made especially for you about what to do at home. The following are some general recommendations for care at home: 

• You will not be able to drive yourself home because you had medicine to relax you (sedation)
• You will need to make arrangements for a ride. Your healthcare provider may tell you not to drive for 24 hours after the procedure.
• You should be able to go back to your normal daily activities in the next 1 to 2 days. These include walking, climbing stairs, and doing household chores.
• Do not do any heavy physical activity for several days after the procedure. This will allow your body to heal.
• Ask your healthcare provider when you can return to work.
• Take your temperature and check your incision for signs of infection every day for a week. Signs of infection include redness, swelling, drainage, or warmth at the puncture wound site. It is normal to have a small bruise or lump where the catheter was inserted.
• Take your medicines exactly as directed. Do not skip doses. You may need to make some changes in your medicines after the procedure. Be sure to go over your medicine instructions with your healthcare provider before you are discharged.
• Learn to take your own pulse. Keep a record of your results. Ask your healthcare provider which readings mean that you need medical attention.
• Do not lift objects heavier than 10 pounds for at least one week after the procedure.   

Follow-up care

Make a follow-up appointment as directed by your healthcare provider.