What to Expect and How to Prepare for an Electrophysiology Procedure For Your Heart

Electrophysiology studies are common in cardiac care, but they’re not necessarily common to the average person. Also known as an EP, this is a detailed study that looks at the heart’s electrical activity. These studies are usually ordered by doctors when there is a problem with how a person’s heart works.

This can tell doctors what is wrong and where it’s happening so that they can assess the situation to determine a diagnosis and the appropriate treatment plan. Sometimes, an EP is performed to see how well medications or treatments are working. Essentially, the goal is to get more information.

If you’re a first-timer and curious about what to expect, read on to learn more.

How Do You Prepare a Patient for an Electrophysiology Study?

Preparing for an electrophysiology study involves a few different steps. Let’s look at each element separately to help you better prepare for electrophysiology.

The Basics of EP Preparation

Plan to have someone drive you to and from your test because you’ll have to wait 24 hours afterward until you can drive again.
If you have questions, ask your provider ahead of time.
Discuss allergies, current medications, and other concerns with your doctor, as well.
Wear comfortable clothing and nothing extra. Leave all jewelry and valuables at home. Makeup and nail polish also need to be removed.

Medication Adjustments Before Your Electrophysiology Study

Ask your doctor if you should stop taking any medications before your EP study and when you should stop before the procedure.
If you suffer from diabetes, ask your doctor about adjusting your diabetes medications and care during this time.
Don’t stop or start any medications without consulting your doctor.

Eating and Drinking

You should eat a normal meal the night before your test.
Don’t eat or drink anything, or even chew gum or mints, after midnight.
If medications are necessary, use the least amount of water possible.
Don’t swallow water or toothpaste when you brush your teeth.

Following these guidelines and your doctor’s advice will ensure that you are ready for your electrophysiology study and that you don’t have to reschedule.

How Long Does an EP Procedure Take?

An EP procedure generally takes one to four (1-4) hours. During the study, you’re given medication via IV that helps relax you and keep you drowsy so you don’t get anxious. You will lie down in a bed, and they will start an IV line in your arm that they will use to administer fluids and medications.

Then, they will shave any areas necessary and clean them with antiseptic. Sterile drapes will cover you from top to bottom, and they will likely put a strap across your arms and waist to prevent you from reaching the sterile area. Using several monitors, they can keep tabs on your vitals and heart rhythm.

The Doctor Will:

Numb the neck, groin, or arm area, and then insert several catheters into a vein in the area.
Use a fluoroscopy machine to guide the catheters into the heart.
Record the electrical activity and monitor the results.
Deliberately shock the heart with a pacemaker to increase the heart rate.
Use ablation to damage any abnormal connections that are causing irregular signals.

You may feel some pressure, but you shouldn’t feel any pain. Let them know if you’re feeling any unusual symptoms or extreme discomfort, but that’s a fairly rare occurrence.

How Long Does It Take to Recover from an EP Study?

Recovering from an EP study is about giving your heart time to recuperate from the stress it was under during the procedure. Usually, patients will stay in bed for one to three hours after the test is complete. Then, they will be sent home with a small dressing covering the incision area.

The next day, the dressing can be removed. Some patients may need to stay in the hospital if the procedure indicates serious issues. Otherwise, you should be able to take medications, eat within four to six hours, and get back to your normal routine the next day.

Final Thoughts

With electrophysiology procedures and other cardiac care, most fear comes from a lack of knowledge. Understanding a procedure before you have it done can save you a lot of stress and anxiety. As you can see, an EP study is a fairly painless, routine procedure, so it’s not really anything of great concern. Being prepared for the procedures will help you immensely.

What is Electrophysiology and Its Relation to Heart Health?

Blue Figure with Arms Outstretched and Bright Red Heart - CVRTI Electrophysiology Graphic

We all know the feeling of our heart racing or fluttering as we get excited, nervous, or stressed. But what is going on in the heart to get a heart rhythm? The heart contracts and expands to pump blood through the body using an electrical stimulus that starts in the heart’s sinoatrial node. That electrical stimulus travels through the four chambers of the heart to give the heart the ability to pump blood. Electrophysiology is the study of the electrical patterns in the heart. Electrophysiologists are doctors who specialize in the heart’s electrical patterns and most commonly treat patients with heart arrhythmias.

An Overview of Electrophysiological Research, Heart Arrhythmias, and Atrial Fibrillation

Arrhythmias are any problems with the heartbeat. Arrhythmias can feel like the heart fluttered, skipped a beat, suddenly started racing, or is beating very slow. These sensations can normally occur when experiencing different emotions. But most commonly for arrhythmia patients, this occurs because of a disruption in the heart’s electrical pathway.

When the electrical stimulus in the heart does not follow the correct electrical pathway through the heart, the heart contracts and expands either too rapidly or slowly, causing blood to flow improperly or back into the heart. The disruption in the electrical stimulus’s pathway is the cause of the arrhythmia. What can happen over time with repeated arrhythmias is that the heart cannot pump as effectively, resulting in less blood flow throughout the body. Electrophysiologists are concerned with arrhythmias when they happen unexpectedly and frequently. Not all arrhythmias are a concern, and some can be considered harmless. The earlier the diagnosis of arrhythmia, the better the outcomes for the patient. Arrhythmias can damage or weaken the heart and the heart’s ability to pump blood. Treatment options for arrhythmias can help control the occurrence of the arrhythmia or prevent damage to the heart.

Electrophysiology and Atrial Fibrillation

Specifically, electrophysiologists are concerned with patients who experience atrial fibrillation. Atrial fibrillation (also known as AFib) is an arrhythmia where the chambers of the heart begin to rapidly beat and look like they are quivering. Blood can get unexpectedly pushed into the atria of the heart. The trapped blood can lead to blood clots or strokes. Atrial fibrillation is a severe worldwide disorder and is expected to affect around 40 million people. Early diagnosis of is vital to ensure successful outcomes.

What is an Electrophysiology Study of the Heart?

Electrophysiologists conduct an electrophysiology study on patients to diagnose arrhythmias and atrial fibrillation. As part of the diagnosis, electrophysiologists will pinpoint where the electrical pattern is getting disrupted in the heart. From the study results, the electrophysiologist will be able to determine if medications, ablation therapy, or routine monitoring are needed to treat the patient. Even with electrophysiology studies, arrhythmias can be difficult to diagnose. Patients undergoing an electrophysiology study are often not experiencing constant arrhythmias. However, early diagnosis and treatment of arrhythmias are essential to ensure no further damage to the heart.

CVRTI’s Research in Electrophysiology & Abnormal Heart Rhythms

At the Nora Eccles Harrison Cardiovascular Research and Training Institute (CVRTI), researchers are committed to learning how to better understand the heart’s electrical patterns. There has been a long-standing focus on cardiac rhythm and its disorders since the foundation of the institute. The CVRTI is exploring new technologies to better diagnose and help patients who suffer from arrhythmias and other heart rhythm disorders. CVRTI researchers have changed the landscape of electrophysiology by understanding how cardiac bioelectricity creates the electrocardiographic signal, both in health and disease and deciphering how ion channels and transporters create the heartbeat and become altered. CVRTI researchers are dedicated to the study of the genomic basis of inherited arrhythmia syndromes and studying how risk factors, such as obesity , affect arrhythmia incidence and mortality. Finally, the structural basis of atrial fibrillation , the most common rhythm disorders, is being elucidated by pioneering imaging studies . In all, the CVRTI continues to lead the way in electrophysiological reasearch and understanding how rhythm disorders develop and creating tools to study and treat these in patients.

CVRTI researchers are also learning the ion channels that generate electrical signals in the heart have other roles as well. Ion channels can regulate mitochondria , which is the power center of each muscle cell, as well as cell organization . Also, the proteins that organize ion channels can be used to rescue failing heart muscle as well as help clinicians quantify the extent of heart muscle failure . The more we learn about ion channel, the better our understanding that these basic building blocks are not just important for the heart’s electrical system, but for heart function as well.