More than six million Americans live with an abnormal heartbeat called an arrhythmia. These irregularities are caused by problems with the electrical signals that control muscle contractions in the heart. Electrophysiologists (cardiologists with training in heart rhythm disorders) use electrophysiology studies to gain insight into the underlying cause of abnormal heart rhythms and how best to treat them.
At NewYork-Presbyterian, our experts use the latest electrophysiology tests, heart imaging techniques, and other exams to identify the cause and location of your arrhythmia with precision. This knowledge enables us to put together a customized plan of care designed just for you.
What is Electrophysiology?
Electrophysiology is the area of medicine that focuses on electrical activity in the body, including the pumping action of the heart. Individuals with an abnormally rapid or slow heartbeat (arrhythmia) and/or related symptoms, such as fainting or dizziness, may be advised to undergo an electrophysiology study. These tests help determine the problem’s specific nature and provide treatment guidance.
How is an Electrophysiology Study Performed?
During an electrophysiology study, following the administration of a local anesthetic, your physician guides wire electrodes via a catheter through a small incision (usually in the groin) and threads them up into specific areas in the heart to monitor electric impulses. Movement of the catheters through the body is closely monitored with fluoroscopy (a kind of x-ray) to minimize the chance of any injury. Blood pressure and oxygen levels are carefully observed throughout.
To gather as much information as possible, your doctor may also do the following:
- Initiate an electrical signal that slows or speeds up the heartbeat
- Administer medication that affects the speed of the heartbeat
- Record electrical activity in different parts of the heart
In some instances, a procedure called cardiac ablation is also performed during the study. This treatment involves creating scar tissue to pinpoint areas in the heart to address the arrhythmia and restore a normal heartbeat.
Electrophysiology studies typically take between one to four hours to complete. They are not painful but may produce some discomfort when medications or electrical signals are administered to slow or speed up the heartbeat. A sedative is often given to help patients remain relaxed during the procedure.
Once the study is complete and the catheters have been removed, the insertion area is bandaged tightly to prevent bleeding, and you will be transferred to a recovery area for observation.
Risks to Consider
Electrophysiology studies are conducted in a hospital setting and are considered very safe. However, some risks related to the procedure include:
- Infection, bleeding, or bruising in the groin or other insertion point where the catheter enters the body
- Injury to the blood vessels where the catheter is inserted
- Blood clots in the legs or lungs
- Bleeding and other damage (perforation) of the heart tissue
Preparing for an Electrophysiology Study
If you are scheduled for an electrophysiology study, you can help prepare by:
- Reviewing all medications and supplements taken regularly; your doctor will advise you on whether you need to temporarily stop before undergoing the study
- Not eating or drinking anything after midnight on the day of your appointment
- Informing your doctor of any allergies to medications, including local and general anesthetics, as well as to iodine, latex, or tape
- Disclosing any possibility that you may be pregnant
- Reviewing any history of bleeding disorders or use of medication to prevent blood clots
What to Expect After an Electrophysiology Study?
After the cardiologist has completed the electrophysiology study, you will need to rest quietly for four to six hours while your heartbeat and blood pressure are monitored. Because you will be sedated during the procedure, you should plan to have someone accompany you home when you are released.
Your cardiologist will share the results of your study and discuss any treatment recommendations based on his or her findings.
Before you leave the hospital, you will receive specific directions for self-care and guidelines for returning to daily activities. You will also be given instructions regarding symptoms that should prompt a call to your cardiologist, which include bleeding, fever, chest pain, dizziness, and tingling or other neurologic symptoms in the leg closest to the catheter insertion site.
NewYork-Presbyterian’s electrophysiology laboratories offer state-of-the-art assessments of key elements of cardiac function. Contact us for an appointment at one of our convenient NewYork-Presbyterian locations in New York City or Westchester.