An electrophysiology study (EP Study) examines your heart’s electrical activity. Normal electrical activity typically follows a regular, organized path. It controls the timing of heartbeats. An EP study can look at how electrical signals move through the heart. This helps determine the cause of irregular heart rhythms (arrhythmias). An EP study helps to diagnose and decide on treatment for abnormal heart rhythms (arrhythmias).
From an EP study, we can get information such as:
What kind of arrhythmia you have
What part of your heart is causing the issue
Where the abnormal heart rhythm in your heart is coming from
What is causing your abnormal heart rhythm
Why you may be feeling, dizzy and/or why you fainted
If you are at risk for sudden cardiac death
During the EP Study
The length of the procedure varies. It depends on the amount of time needed to study your heart’s electrical system. Results help determine whether an ablation is performed. You may have an EP study and ablation on the same day.
We will go over a sedation (anesthesia) plan to make sure you are comfortable. Sterile drapes will cover you from underneath your chin to over your feet. Only the surgical site(s) are exposed.
One or more thin, flexible tubes (called catheters), go into a blood vessel and then are placed in the heart. Once inside the heart, your heart’s electrical activity is studied. Sensors on the catheter send electrical signals and we then record the heart’s electrical activity.
Sometimes the abnormal or irregular rhythm may be reproduced. This is done by using the catheter and/or medicine(s). If an abnormal electrical signal(s) is seen, the area(s) it is coming from may be located. Then ablation may be performed.
Ablation
If ablation is performed, a 3D picture, or map of your heart is made. This shows areas of normal and abnormal tissue in the heart.
Ablation creates tiny scars on the heart to block, stop, or reduce the irregular or abnormal heart signals. There are different types of ablations.
Radiofrequency: This type of ablation uses heat or burning to create tiny scars in the heart.
Cryotherapy: This type of ablation uses cooling or freezing to scar the heart. For certain patients, freezing may be safer than heat. In some situations, a multiple energy types may be used.
Ablation can be performed by delivering short bursts of very strong (high-voltage) electrical energy pulses called pulse field ablation (or PFA).
You may be exposed to some Xray during the procedure.
What to Expect
You will rest in the recovery area for a few hours after the ablation. Depending on your recovery, you may go home or stay at the hospital.
After your procedure, you may have:
Soreness or tenderness at the puncture sites that may last 1 week.
Bruising at the site that may take 2-3 weeks to go away.
A small lump (dime to quarter size) at the site which may last up to 6 weeks.
Pain Control
You may take a mild pain reliever such as acetaminophen (Tylenol), ibuprofen (Motrin) or other NSAID medicines. NSAIDs can increase your risk of bleeding, especially if you are on a blood thinner. Talk with your care team if these medicines are safe for you to take after the procedure.
You may place an ice pack or warm pack over the site for 20 minutes every 2 hours. Gently wipe the puncture site after you remove the pack if it is wet.
Care of the Puncture Site(s)
It is important that you take care of your sites to prevent an infection. Keep the sites clean and dry for 24 hours. You may remove the dressing(s) and shower after 24 hours. Remove the dressing over the site before taking a shower.
To care for the puncture site:
Gently clean the site for 3 days with soap and water. Pat dry and leave open to air.
Keep the site dry.
Inspect the site daily for redness, swelling, or drainage.
You may feel a small lump (dime to quarter size) under the skin. Most of the time, this goes away within 6 weeks. In some cases, it can persist if scar tissue forms.
Please let us know if you have any new or increasing pain at the site.
Activity
Avoid strenuous activity. Do not lift anything heavier than 10 pounds for 7 days.
Do not soak in a bathtub, hot tub, or go into a swimming pool, lake, or river until the site is healed.
After 7 days, you may resume normal activity.
Going Home
You may go home the same day or stay in the hospital overnight. We will review discharge instructions with you. If you go home the same day, someone should drive you home and stay with you overnight.
Do not drive for 24 hours, unless instructed otherwise.
Do not make any important decisions until the next day.
Heart Healthy Diet
Include heart healthy foods in your diet, such as: vegetables, fruits, nuts, beans, lean meat, fish, and whole grains. Limit sodium, alcohol, and sugar.
Lifestyle Changes
Do not smoke.
Be active. Try for at least 30 minutes of activity on most days of the week. Talk to your care team about what type of level of exercise is safe for you.
Maintain a healthy weight. Lose weight if you need to.
Manage health problems such as high blood pressure, sleep apnea, high cholesterol, and diabetes.
Medicines
You will receive instructions and directions about medicines after your procedure. If you take or are prescribed a blood thinner, take this and do not skip any doses. If you take Coumadin (warfarin), you will need to have a PT/INR level checked. You may need the dosage adjusted. This will be done within 3-5 days of discharge.
Follow Up Visits
Follow up visits will be arranged after your procedure.
After the ablation, you may be asked to wear a heart monitor. This is to look at your heart rhythm.
Return to Work
Talk to your clinician about when it is safe to return to work.
When to Get Emergency Help
Call 911 or go to the nearest emergency room if you have:
Trouble swallowing, or you are coughing up or vomiting blood
Severe swelling
New numbness, weakness or coldness in your arms, hands, fingers, legs, feet or toes
Skin that turns blue
Sudden bleeding or swelling at the groin puncture site. If this occurs, apply direct pressure. If the bleeding does not stop after 10 minutes of placing constant pressure on the site, call 911. Keep pressure on the site until help arrives.
Signs of stroke:
Sudden face drooping, arm or leg numbness weakness, confusion
Trouble seeing, trouble speaking, trouble walking, or severe headache.
When to Call
Call if you have:
Chest pain or new back pain.
Increased shortness of breath.
Signs of infection around the puncture site, such as:
Redness
Warmth
Swelling
Drainage
A fever over 101.5°F
Trouble urinating
A sudden increase in weight overnight (more than 3 pounds), or over a few days, as this could be a sign of fluid buildup.
Been prescribed a blood thinner and have questions or concerns about stopping this.
Who to Call
UW Health Heart and Vascular Clinic Monday-Friday, 8:00 am – 4:30 pm
(608) 915-0200.
After hours, nights, weekends, and holidays, this number will give you the paging operator. Ask for the cardiology fellow on call. Give your full name and phone number with the area code. A clinician will call you back.