154:
332:
419:
requiring removal using a needle under the breast bone (pericardiocentesis); hematoma at the site(s) of the puncture(s); induction of a dangerous cardiac rhythm requiring an external shock(s); a clot may be dislodged, which may travel to a distant organ and impede blood flow or cause a stroke; myocardial infarction; unanticipated reactions to the medications used during the procedure; damage to the conduction system, requiring a permanent pacemaker; death.
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small pinch at the insertion site. After a short period of general rest, the patient may resume some minor activity such as gentle, short, slow walks after the first 24 hours. If stairs must be climbed, they should be taken one step at a time and very slowly. All vigorous activity must be postponed until approved by a physician.
384:
When the necessary procedures are complete, the catheter is removed. Firm pressure is applied to the site to prevent bleeding. This may be done by hand or with a mechanical device. Other closure techniques include an internal suture and plug. If the femoral artery was used, the patient will probably
343:
The next step is pacing the heart, this means he/she will speed up or slow down the heart by placing the electrode at certain points along the conductive pathways of the heart and control the depolarization rate of the heart. The doctor will pace each chamber of the heart one by one, looking for any
409:
As with any surgical procedure, cardiac catheterizations come with a generic list of possible complications. One of the complications that are sometimes reported involves some temporary nerve involvement. Sometimes a small amount of swelling occurs that can put pressure on nerves in the area of the
418:
More severe but relatively rare complications include: damage or trauma to a blood vessel, which could require repair; infection from the skin puncture or from the catheter itself; cardiac perforation, causing blood to leak into the sac around the heart and compromising the heart's pumping action,
414:
is the most common complication with an incidence ranging between 0.5 and 2.5%. There have been reports of patients feeling like they have hot fluid like blood or urine running down their leg for up to a month or two after the incision has healed. This usually passes with time, but patients should
396:
For patients who had a catheterization at the femoral artery or vein (and even some of those with a radial insertion site), in general recovery is fairly quick, as the only damage is at the insertion site. The patient will probably feel fine within 8 to 12 hours after the procedure, but may feel a
244:
It is important for patients not to eat or drink for up to 12 hours before the procedure. This is to prevent vomiting, which can result in aspiration, and also cause severe bleeding from the insertion site of the catheter. Failure to follow this simple preparation may result in dangerous
327:
Once the catheter is in and all preparations are complete elsewhere in the lab, the EP study begins. The X-ray machine will give the doctor a live view of the heart and the position of the electrodes. He will guide the (steerable) electrodes to the correct position inside the heart. The
344:
abnormalities. Then the electrophysiologist tries to provoke arrhythmias and reproduce any conditions that have resulted in the patient's placement in the study. This is done by injecting electric current into the conductive pathways and into the
352:) to induce arrhythmia (inducibility of VT/VF). If the arrhythmia is reproduced by the drugs (inducible), the electrophysiologist will search out the source of the abnormal electrical activity. The entire procedure can take several hours.
400:
It is also important to note that unless directed by a doctor, some patients should avoid taking blood thinners and foods that contain salicylates, such as cranberry-containing products until the clot has healed (1–2 weeks).
245:
consequences. In general, small amounts of water can be consumed up to 2 hours before the exam. Patients should try to schedule the exam at a time when they will be having symptoms and will not need to drive for 2 to 3 days.
153:
372:) to effectively heat up the abnormal cells, to form scar tissue. This can be painful with pain felt in the heart itself, the neck and shoulder areas. A more recent method of ablation is
328:
electrophysiologist begins by moving the electrodes along the conduction pathways and along the inner walls of the heart, measuring the electrical activity along the way.
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that can be induced. EP studies are used to investigate the cause, location of origin, and best treatment for various abnormal heart rhythms, and are often followed by a
53:
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to destroy abnormal tissue. A 3D navigation system that tracks and records the catheter position and associated electrical signals may also be used.
516:
Karen.E.Thomas and Peter J. Zimetbaum (2011). "Electrophysiology study: Indications and interpretations". In Gan-Xin Yan; Peter R. Kowey (eds.).
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261:), equipment to record electrical signals from the heart, a stimulator to electrically excite the heart and control the heart rate, and
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114:
257:. These are specially equipped operating rooms that usually contain an X-ray machine capable of acquiring live X-ray video images (a
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If at any step during the EP study the electrophysiologist finds the source of the abnormal electrical activity, they may try to
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An access site that will allow catheters to be passed to the heart via an artery or vein is shaved and cleaned, usually in the
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Handbook of cardiac electrophysiology : a practical guide to invasive EP studies and catheter ablation
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224:) to assess the conduction system of the heart and to look for additional electrical connections (
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Peter W. Macfarlane; Adriaan van
Oosterom; P. Kligfield; Michiel Janse; J. Camm, eds. (2010).
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315:) are punctured before a guidewire and plastic sheath are inserted into the vessel using the
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be asked to lie flat for several hours (3 to 6) to prevent bleeding or the development of a
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has formed. The patient will be moved to a recovery area where he/she will be monitored.
30:
This article is about the medical procedure performed on the heart. For other uses, see
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Josephson's clinical cardiac electrophysiology : techniques and interpretations
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389:. Trying to sit up or even lift the head is strongly discouraged until an adequate
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at various places. Last, the electrophysiologist may administer various drugs (
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Electrophysiological
Disorders of the Heart: Expert Consult – Online and Print
525:
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220:. This electrical activity is recorded when the heart is in a normal rhythm (
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553:
520:. Contemporary cardiology. Vol. 34. Hanumana Press. pp. 123–140.
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if you can. Unsourced or poorly sourced material may be challenged and
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473:. Preceded by: Josephson, Mark E. (Fifth ed.). Baltimore, MD.
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tell their doctor if they have these symptoms and if they last.
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209:
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is generally inserted to allow medication to be given such as
36:
364:
the cells that are misfiring. This is done using high-energy
335:
Doctors conduct an electrophysiology study in the hospital's
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to measure the oxygen saturation of the blood. A peripheral
27:
Medical test to record electrical activity within the heart
276:. Monitoring equipment is attached including an automated
650:"Cryoablation for the Treatment of Atrial Fibrillation"
68:
579:. Murgatroyd, Francis D. London: ReMEDICA Pub. 2002.
622:
Saksena, Sanjeev; Camm, A. John (12 December 2011).
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376:, which is considered less risky and less painful.
253:An EP study is typically performed in an EP lab or
178:
170:
160:
146:
303:. The blood vessels used to reach the heart (the
216:to record electrical activity from within the
67:Please review the contents of the article and
707:
8:
571:
569:
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565:
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268:The procedure may be performed awake under
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749:Cardiology diagnostic tests and procedures
714:
700:
692:
501:: CS1 maint: location missing publisher (
152:
845:Transcatheter pulmonary valve replacement
543:
435:Electrical conduction system of the heart
888:shunt from heart chamber to blood vessel
674:(2nd ed.). Springer. p. 1146.
330:
988:shunt from blood vessel to blood vessel
461:
600:
494:
143:
1118:Valve-sparing aortic root replacement
857:enlargement of existing septal defect
7:
852:production of septal defect in heart
182:Electrical activity within the heart
166:Electrophysiological study, EP study
949:transposition of the great vessels
874:creation of septal defect in heart
25:
1249:Cardiac resynchronization therapy
518:Management of Cardiac Arrhythmias
469:Josephson, Mark E. (2015-08-10).
18:Programmed electrical stimulation
1473:
1472:
133:
41:
1256:Left atrial appendage occlusion
672:Comprehensive Electrocardiology
174:Diagnose abnormal heart rhythms
69:add the appropriate references
1:
1378:Radionuclide ventriculography
1363:Myocardial perfusion imaging
628:. Elsevier Health Sciences.
202:minimally invasive procedure
236:during the same procedure.
54:reliable medical references
1533:
970:for univentricular defect
29:
1497:Cardiac electrophysiology
1470:
1310:Implantable loop recorder
954:Arterial switch operation
744:Interventional cardiology
734:
638:– via Google Books.
526:10.1007/978-1-60761-161-5
323:EP Study and inducibility
190:cardiac electrophysiology
151:
83:"Electrophysiology study"
60:or relies too heavily on
1389:Coronary catheterization
879:Blalock–Hanlon procedure
840:Mitral valve replacement
823:Aortic valve replacement
1385:Cardiac catheterization
1327:Electrophysiology study
1227:Radiofrequency ablation
1192:Alcohol septal ablation
440:Ventricular tachycardia
337:cardiac catheterization
147:Electrophysiology study
1431:Impedance cardiography
1053:Coronary artery bypass
607:: CS1 maint: others (
340:
230:abnormal heart rhythms
1462:Transcutaneous pacing
1266:Heart transplantation
1187:Ventricular reduction
1003:Blalock–Taussig shunt
450:Antiarrhythmic agents
334:
208:introduced through a
1436:Ballistocardiography
993:systemic circulation
350:proarrhythmic agents
311:, and sometimes the
1315:Cardiac stress test
1293:Electrocardiography
1232:Pacemaker insertion
979:Kawashima procedure
943:compound procedures
818:Aortic valve repair
791:Mitral valve repair
317:Seldinger technique
278:blood pressure cuff
274:general anaesthetic
1502:Cardiac procedures
1368:Cardiovascular MRI
1298:Vectorcardiography
1153:Pericardial window
1148:Pericardiocentesis
1089:Drug-eluting stent
918:Rastelli procedure
867:Balloon septostomy
341:
263:ablation equipment
228:), and during any
226:accessory pathways
1512:Electrophysiology
1484:
1483:
1341:Angiocardiography
1287:Electrophysiology
1274:
1273:
1217:Catheter ablation
1200:Conduction system
1125:LeCompte maneuver
1113:Bentall procedure
974:Norwood procedure
964:Senning procedure
959:Mustard procedure
862:Atrial septostomy
813:Valve replacement
681:978-1-84882-047-0
535:978-1-60761-160-8
429:Electrocardiogram
412:Venous thrombosis
366:radio frequencies
270:local anaesthetic
234:catheter ablation
186:
185:
142:
141:
118:
32:Electrophysiology
16:(Redirected from
1524:
1517:Electrodiagnosis
1476:
1475:
1441:Cardiotocography
1409:
1373:Ventriculography
1346:Echocardiography
1337:
1289:
1205:Maze procedure (
1202:
1168:
1144:
1097:
1096:Obstacle removal
1084:Bare-metal stent
1080:
1040:
997:pulmonary artery
989:
944:
929:pulmonary artery
902:Fontan procedure
897:pulmonary artery
889:
853:
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716:
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309:subclavian veins
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37:
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1413:Phonocardiogram
1405:
1335:Cardiac imaging
1333:
1285:
1270:
1198:
1182:Septal myectomy
1172:Cardiomyoplasty
1164:
1158:Pericardiectomy
1140:
1129:
1095:
1076:
1036:
1030:Cardiac vessels
1025:
1019:Glenn procedure
987:
942:
925:right ventricle
887:
851:
773:
758:
754:Cardiac imaging
739:Cardiac surgery
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1078:Coronary stent
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1245:implantation
1239:implantation
1222:Cryoablation
1063:Off-pump CAB
873:
856:
781:Valve repair
771:Heart valves
671:
665:
653:. Retrieved
644:
624:
617:
576:
517:
511:
470:
464:
431:(ECG or EKG)
417:
408:
399:
395:
383:
374:cryoablation
368:(similar to
359:
342:
326:
298:
296:, or drugs.
267:
252:
243:
222:sinus rhythm
197:
193:
187:
179:Test of
124:January 2022
121:
111:
104:
97:
90:
78:
58:verification
51:
1399:Cardiac PET
1142:Pericardium
1106:Atherectomy
1044:Angioplasty
786:Valvulotomy
346:endocardium
272:, or under
259:fluoroscope
240:Preparation
52:needs more
1491:Categories
1394:Cardiac CT
1261:Cardiotomy
1166:Myocardium
934:Sano shunt
724:procedures
722:Tests and
456:References
445:Arrhythmia
410:incision.
370:microwaves
339:laboratory
294:anesthesia
94:newspapers
1507:Catheters
774:and septa
603:cite book
497:cite book
489:938434294
290:sedatives
249:Procedure
206:catheters
1478:Category
1211:minimaze
1207:Cox maze
595:48363139
554:21253086
423:See also
387:hematoma
380:Recovery
356:Ablation
255:cath lab
198:EP study
162:Synonyms
763:Surgery
655:May 23,
545:2218957
305:femoral
200:) is a
194:EP test
192:study (
171:Purpose
108:scholar
73:removed
1450:Pacing
1058:MIDCAB
1049:Bypass
999:shunt
893:atrium
806:mitral
801:aortic
678:
632:
593:
583:
552:
542:
532:
487:
477:
362:ablate
280:and a
214:artery
204:using
110:
103:
96:
89:
81:
1407:sound
1279:Tests
1237:S-ICD
1134:Other
1068:TECAB
913:aorta
728:heart
301:groin
218:heart
115:JSTOR
101:books
1209:and
947:for
676:ISBN
657:2015
630:ISBN
609:link
591:OCLC
581:ISBN
550:PMID
530:ISBN
503:link
485:OCLC
475:ISBN
391:clot
210:vein
87:news
56:for
1356:TEE
1351:TTE
1243:ICD
1038:CHD
1010:SVC
995:to
927:to
911:to
895:to
540:PMC
522:doi
307:or
212:or
196:or
1493::
1014:PA
605:}}
601:{{
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562:^
548:.
538:.
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499:}}
495:{{
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319:.
292:,
188:A
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1387:/
1213:)
1051:/
715:e
708:t
701:v
684:.
659:.
611:)
597:.
556:.
524::
505:)
491:.
126:)
122:(
112:·
105:·
98:·
91:·
65:.
34:.
20:)
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