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Diagnostic Tests in Cardiovascular Diseases

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10. Electrophysiology Study

An electrophysiology study is performed on patients who have rhythm disturbances. This is a routine procedure during which the nature of your heart rhythm disturbance will be studied and the location of any ‘short circuits’ identified.

This procedure will be performed under the direction of one of the physicians from the arrhythmia team.

How is the study done?

There will be a number of physicians, nurses, and other hospital personnel assisting in your procedure – many of whom you will meet when you are admitted to the hospital. It will take place in the cardiac electrophysiology laboratory.

As part of your study, wires with electrodes are positioned inside your heart to record electrical signals and stimulate your heart. These wires are inserted through intravenous tubes inserted in the vein via the groin and the neck, and sometimes an artery in the groin. The entire duration of the electrophysiology study ranges between one to four hours.

What type of anesthetic will be used?

You will be given an intravenous sedative medication upon arrival to the laboratory and more if needed during the procedure. A local anesthetic(freezing) will be injected in the areas where the wires are inserted.

How will I feel during the study?

In rare cases, during the study you may be aware of extra beats or feelings of your heart racing. It may be necessary to put you to sleep, briefly, in order to shock your heart beat back to a more normal rhythm. Let the doctor or nurse know if you are feeling any discomfort. Very rarely, you may pass out (lose consciousness) during rapid heart rhythms.

Possible side effects/risks

Your doctor will explain these in more detail as the actual risks depend to a degree on the exact type of procedure contemplated. The most common risks are 1-2% for serious complications (heart block requiring a pacemaker, or cardiac perforation requiring needle drainage) and slightly higher for less serious complications like bleeding or bruising.

Please Note: You must fast from midnight the night prior to the test – nothing to eat or drink, including water and gum/candy.

Make sure you arrange for someone to drive or pick you up. Do not drive yourself at least for the rest of the day.

When can I go home?

You can anticipate being discharged the same day of your procedure, possibly with a short resting period at home for a few days afterwards.

(Adapted from a document prepared by the St. Michael’s Cardiac Arrhythmia Service)