An EP study

An electrophysiology (EP) study is a test performed to determine the precise origin or location in the heart of an arrhythmia. An EP study can be done just before catheter ablation or as a separate procedure. In many ways, the EP study and the catheter ablation procedure are similar since they both involve guiding catheters through veins to the heart. Of course, in an EP study this is done to diagnose the arrhythmia, while the ablation procedure is performed to treat the arrhythmia.

How the EP study is performed

During the EP study a team of medical professionals assists Dr Kerwin in the procedure and insuring the patient’s safety. The EP closely resembles an operating room where precautions are taken to sustain a sterile environment.

The patient lies flat on a surgical table, covered with surgical drapes, except for areas where the catheters are inserted. An intravenous (IV) line in the patient’s arm delivers medications when they are needed.

Sheaths, which are small hollow tubes, are inserted into blood vessels through the groin or upper leg or neck. To insert them, a small needle is used and a small puncture is made through the skin after it has been numbed with a local anesthetic. Once the sheaths are in place, thin flexible tubes called pacing catheters are guided through the sheaths to the heart.

Dr Kerwin can view the progress of catheters as he guides to the heart through a type of x-ray system called fluoroscopy. The pacing catheters serve two functions: (1) they record ECG signals from inside the heart; and (2) they can deliver small electrical impulses to the heart muscle, which is called pacing. Pacing the heart enables the electrophysiologist to analyze the heart’s conduction system.

The EP study usually takes an hour (two, at most).

During the EP study, readings are taken at the chest surface, SA node, HIS bundle, and right ventricular apex