Electrophysiogical Study (EPS, EP Study)
What is an electrophysiogical study (EPS, EP study)?
An electrophysiologic (EP) study is a test that maps the electrical conduction system in the heart. At Inova, a specially trained cardiologist called an electrophysiologist performs the test.
An EP can be ordered for many reasons:
- To identify the underlying cause of symptoms thought to be a heart rhythm disturbance.
- To assess abnormally fast or slow heart beats.
- To assess the effectiveness of medications that are taken to regulate a heart rhythm disturbance.
Special wires are placed in the heart to record the electrical activity of the heart.
The procedures that can be performed include:
- Inducing a heart rhythm disturbance by sending electrical signals through the catheter to stimulate the heart.
- If a heart rhythm disturbance has been induced, medications may be given through an intravenous line to test how they affect the rhythm and whether they can halt the irregularity or prevent it from happening.
- Some rhythm disturbances are stopped by using the catheter to pace the heart beat.
- Some rhythm disturbances are stopped by using an electrical shock (defibrillation) to stop the disturbance.
Are there any risks?
The risks of an EP study are low and are outweighed by the benefits of learning more about the dysrhythmia. They occur rarely and include bleeding, blood clots, perforation of the heart muscle or a blood vessel, stroke (very rare), and death (extremely rare). Click on outcome to read more about the specifics about having this procedure done at the Inova Heart Center.
Preparing for the procedure
Prior to the EP study other diagnostic studies will have been conducted, such as an EKG, a chest x-ray and an echocardiogram. The electrophysiologist may request specific blood tests to be sure the child is not anemic or has any kidney problems. The child will not be allowed to eat for a specific period of time before the procedure. Upon arrival at the hospital, some children will have an IV (intravenous needle) started. Before the procedure begins, the child will receive medicine to make him or her sleepy. This medicine can be given by mouth or through an IV.
During the procedure
The electrophysiology study usually takes 1 to 2 hours. Once in the EP Laboratory, the child will be placed on a narrow x-ray table. Monitoring equipment is attached. The area where the special IV catheter for the procedure goes, is cleaned with a special soap. The electrophysiologist will insert a catheter into the body and guide it up to the heart. The electrophysiologist will move the catheter around the heart and map the electrical conduction system in the heart. When the procedure is complete, the catheter is removed.
After the procedure
Any time an intravenous catheter is placed in a big blood vessel, there is a period of observation to watch for bleeding where the catheter was inserted. The child's heart rate, blood pressure and breathing will also be watched. Depending on a variety of circumstances (the time of day of the procedure, type of sedation used, risk for complications, child's overall health status and complexity of the case), the child may go home the day of the procedure or the next day.
