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The Cleveland Clinic

Heart Disease: Diagnosing Heart Disease: Electrophysiology Testing Getting Support

An EP study is a test that records the electrical activity and measures the electrical pathways of your heart. This test is used to determine the cause of your heart rhythm disturbance and the best treatment for you. During the test, your doctor will safely reproduce your abnormal heart rhythm and then give you different medications to see which one controls it best.

Why Do I Need an EP Test?

  • To determine the cause of an abnormal heart rhythm.
  • To locate the site of origin of an abnormal heart rhythm.
  • To decide the best treatment for an abnormal heart rhythm.
  • To monitor the effectiveness of antiarrhythmic treatment.

Sometimes an EP study is conducted before implantable cardioverter/defibrillator placement to determine which device is best and afterwards to monitor treatment success.

How Should I Prepare for the EP Study?

  • Ask your doctor what medications you are allowed to take. Your doctor may ask you to stop certain medications one to five days before your test (for example, aspirin products). If you are diabetic, ask your doctor how you should adjust your diabetic medications.
  • Do not eat or drink anything after midnight the evening before the test. If you must take medications, drink only a sip of water.
  • When you come to the hospital, wear comfortable clothes. You will change into a hospital gown for the procedure. Leave all jewelry or valuables at home.
  • Your doctor will tell you if you can go home or must stay in the hospital. If you are able to go home, bring a companion to drive you home.

What Can I Expect During the Test?

  • You will lie on a bed and the nurse will start an intravenous (IV) line into your arm or hand. This is so you can receive medications and fluids during the procedure. You will be given a medication through your IV to relax you and make you drowsy, but it will not put you to sleep.
  • The nurse will connect you to several monitors.
  • Your groin will be shaved and cleansed with an antiseptic solution. Sterile drapes are used to cover you, from your neck to your feet. A strap will be placed across your waist and arms to prevent your hands from coming in contact with the sterile field.
  • The doctor will numb your groin with medication and then insert several catheters into the vein in your groin. Guided by the fluoroscopy machine, the catheters are threaded to your heart. The catheters sense the electrical activity in your heart and are used to evaluate your heart's conduction system. The doctor will use a pacemaker to increase your heart rate. You may feel your heart beating faster or stronger. Your nurses and doctor will want to know about any symptoms you are feeling. If your arrhythmia occurs, your doctor may give you medications through your IV to test their effectiveness in controlling it. If necessary, a small amount of energy may be delivered by the patches on your chest to bring back a normal heart rhythm.

The EP study takes about two to four hours to perform. However, it can take longer if additional treatments such as catheter ablation are performed at the same time.



Next: What happens after the electrophysiology test? »

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Electrophysiology Test

What causes an arrhythmia?

Arrhythmias may be caused by many different factors, including:

  • Coronary artery disease
  • Electrolyte imbalances in your blood (such as sodium or potassium).
  • Changes in your heart muscle.
  • Injury from a heart attack
  • Healing process after heart surgery.

Irregular heart rhythms can also occur in "normal, healthy" hearts.

What are the types of arrhythmias?

  • Premature atrial contractions. These are early extra beats that originate in the atria (upper chambers of the heart). They are harmless and do not require treatment.
  • Premature ventricular contractions (PVCs). These are among the most common arrhythmias and occur in people with and without heart disease. This is the skipped heartbeat we all occasionally experience. In some people, it can be related to stress, too much caffeine or nicotine, or too...

Read the Arrhythmia (Irregular Heartbeat) article »










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