Electrophysiology study
An electrophysiology study (EP test or EP Study) is a minimally invasive procedure which test the electrical conduction system of the heart to assess the electrical activity and conduction pathways of the heart. This test is used to investigate and locate the source of irregular heart rhythms and then find the best treatment for the various abnormal heat rhythms. A specialist or an Electrophysiologist is the only person who can administer this procedure. This procedure is done by using a single or multiple catheters tat goes within the heart through a vein or an artery. People or patients who need to prepare or have an electrophysiology study , or an EP test study done is usually when the doctor or specialist believes that they are at high risk for further complications.
For patients who need to receive an electrophysiology study , it is extremely importat that the patient to not eat or drink for up to 12 hours before the actual procedure is give. The 12 hour time frame needed for the electrophsiology study is to prevent vomiting, which possibly can result in aspiration and may even cause a severe bleed from the site of the insertion of the catheter used for the procedure. The only substance possibly allowed up to 2 hours before the exam is small amounts of water. Patients who are scheduled to receive the electrophysiology study should closely adhere to these simple instructions. Failure to comply with the preperations may result in dangerous consequences. The doctors and specialist administering this procedure also highly recommend that the patient should try to schedule the exam at a time when they will be hving symptoms and will not need to rive for 2 to 3 days.
When performing the electrophysiology study , this particular procedure is performed in a cath lab. The cath lab is a specially equipped operating room. They also contain video x-ray machines and large magnets for manipulating the electrodes. Also, there are other important necessary equipment machines needed to perform the electrophysiology study . Once the patient is at a point of relaxation, a IV tube is generally inserted to keep the patient hydrated and to also allow for the possible administration of sedatives, anesthesia, or drugs to prevent pain and uncomfortness. To make it possible to reach the heart with a catheter, a site is prepared that will allow access to the heart by vein or artery, which is usually the wrist or the groin. This site is known as the insertion point.
Durng the electrophysiology study , a metal plate is placed underneath the patient between the shoulder blades directly under the heart. Following is an automated blood pressure cuff that is placed on the arm which periodically measures the patients blood pressure. An oximeter is also placed on one of the patients finger which steadily monitors the patients pulse and oxygen saturation of the blood. When the specialist gets the insertion point for the electrophysiology study , the area is thoroughly cleaned and sterilized. Ocal anesthesia is also injected into the skin to numb the point of insertion.
Following, a small puncture is made with a needle in either the femoral vein in the groin, or the radial vein in the wrist, before a guide wire is inserted into the venous puncture. A plastic sheath with a stiffer plastic introducer inside is then threaded over the wire and pushed in the vein. The wire is removed while the side port is aspirated to allow and ensure blood flows back. It is then flushed with saline.
Once the electrophysiolgy stud is conducted, the 2 large magnets are brought in on either side of the patient. The x-ray machine will give the doctor a view of the heart and the position of the electrodes and magnets will allow the doctor to guide the electrodes through the heart. The doctor paces the heart, by speeding up or slowing down the heart by placing the electrodes at certain points along the conductive pathways of the heart and literally controlling the deploration rate of the heart. The procedure can take up to several hours. If the doctor finds the surce of the abnormal electrical activity during the electrophysiologist study, he may try to ablate the cells that are misfiring. It is done using high energy radio frequencies to effectively "cook" the abnormal cells.
After the electrophysiology study is completed, the catheter is removed. Pressure is aplied at the site to prevent bleedin. The patient is required to lie flat for several hours, about 3 to 6 hours to prevent bleeding or a hematoma. An adequate clot is needed before any type of movement can be done. The patient needs to be approved by the doctor to resume normal activity. For patients needng the eletrophysiology study, they need to make sure they are properly and promptly prepared for any and all possible risks and complications followng the electrophysiology study.
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