How Long Does an Electrophysiology Study Take?

An electrophysiology study takes between one and four hours to complete.

An electrophysiology (EP) study is a test performed to determine the cause of abnormal heart rhythm and it usually takes about one to four hours to complete. However, it may take longer if additional treatments such as catheter ablation are performed at the same time by your heart surgeon. An EP study is usually performed by a heart specialist doctor known as  an electrophysiologist.

An electrophysiology (EP) study is a test your heart doctor/specialist/heart surgeon will order to look at your heart’s electrical activity in more detail. This test can stimulate and diagnose your abnormal heart rhythms.

This test 

• Shows the electrical activity of your heart to identify the affected location of your heart that is generating the arrhythmia (abnormal heartbeat).
• Allows your heart doctor to diagnose and treat a wide range of arrhythmias (abnormal heart rhythms).
• Allows you and your doctor to decide on further treatment plans for your heart condition, which are sometimes performed at the same time, including 
  • Insertion of a pacemaker
  • Insertion of an implantable cardioverter-defibrillator (ICD)
  • Performing cardiac catheter ablation (destroys the areas inside the heart causing an abnormal rhythm) by heat (radiofrequency ablation) or freezing (cryogenic ablation)
  • Performing a heart surgery

This test is usually performed at a hospital or clinic in a room with special equipment known as an electrophysiology (EP) laboratory or a catheterization (cath) lab by doctors (heart specialists) and nurses. You’ll be informed not to eat or drink anything for a few hours beforehand.

During the test

• An intravenous (IV) line will be inserted in your arm and sedative will be infused to make you relax.
• A nurse will clean and shave the part of your body where the doctor will be working (usually the groin, arm or neck).
• A local anesthetic solution will be given to you to make that area numb.
• Your doctor will insert a needle into the vessel and puncture it. They will insert a sheath (small straw-like tube) into your vessel (artery/vein).
• Your doctor will gently guide several flexible tubes (specialized EP catheters) into your blood vessel (vein, usually the groin) through that sheath and pass them up into your heart.
• You may feel some pressure in the area where the sheath was inserted.
• A camera on the top of the catheter will show the position of the catheters on the video screen.
• Your doctor will send small electric pulses through the catheter to make your heart beat at different speeds. You may feel palpitations (faster heartbeat). Sometimes, you may feel light-headedness or discomfort in your chest, which you should report to the doctor/nurse.
• Electrical signals produced by your heart will be tracked and recorded by a special catheter, which is known as cardiac mapping. It helps your doctor locate the area responsible for generating abnormal heartbeats.
• Your doctor will remove the catheter and the IV line.
• Your nurse will put firm pressure on the puncture site to stop the bleeding.

If the type and location of arrhythmia is identified, then your heart surgeon/specialist will decide on an appropriate therapy. Cardiac ablation or insertion of a pacemaker or ICD will be performed during or immediately after the EP study.

• You will be moved to a recovery room.
• You will be informed to rest for a few hours while keeping the arm or leg which was used for the test straight.
• Your nurse will check if there is any bleeding or swelling at the puncture site.
• Your doctor will convey the test results to you after the sedative effects wear off.

• Follow the instructions given by your nurse and doctor about medications.
• Usually, you can start eating or taking medicines within four to six hours after the test.
• Usually, you can resume your daily activities the day after the test.
• You must avoid driving for at least 24 hours.
• You may feel soreness at the puncture site for several days or have a small bruise, which is quite normal and subsides within a short span.
• If you find bleeding, lie flat and press firmly on top of it or call the doctor or electrophysiology (EP) lab.

After discharge

• You must limit your activity for the first 24 hours.
• If traveling home takes several hours, take a break every hour, stretch your legs and walk a few minutes to inhibit blood clotting.
• If you find new blood on your dressing, press firmly on the incision site for about 20 minutes. Call your doctor or visit the nearest emergency room if the bleeding continues.
• Do not lift any heavy objects that weigh more than 10 pounds for the first week.
• Remove the dressing the day after the study.
• You may see a bruise or a small lump under the skin at the insertion site, which may disappear within three to four weeks.

• Hematoma (bleeding under the skin)
• Bruising
• Damage to the heart’s normal electrical pathways (rare)