Electrophysiology Study of the Heart

________________________________________________________________________

KEY POINTS

• An electrophysiology study is a procedure done to find what is causing an abnormal heart rhythm.
• Ask your provider how long it will take to recover and how to take care of your child at home.
• Make sure you know what symptoms or problems you should watch for and what to do if your child has them.

________________________________________________________________________

What is an electrophysiology study?

An electrophysiology (EP) study is a procedure that may be done to find what is causing an abnormal heart rhythm.

An electrical signal in the heart starts each heartbeat, causing the heart muscle to squeeze (contract). Normally, this signal starts in the upper right chamber of the heart (the right atrium) at a place called the sinus node. The signal then follows pathways to the upper left atrium and to the lower chambers of the heart (the ventricles). Your child may have an abnormal heart rhythm if the electrical signals don’t follow the normal pathways or the nerve cells that make the electrical signals don’t work right.

An EP study uses small tubes called catheters inserted into a blood vessel and up into your child’s heart to check the electrical signals and pathways in the heart. This test can find if the problem is where the electrical signal starts or if the problem is the pathway that the signal takes. It can help your child’s provider find the right treatment for the problem.

When is it used?

An EP study may be done if the healthcare provider thinks there may be a problem with your child’s heart rhythm. For example, your child’s heart may beat faster or more slowly than normal, or it may skip beats or have abnormal beats.

An EP study can also predict the risk abnormal heart rhythm if your child was born with a heart defect.

How do I prepare my child for this procedure?

• Your child may or may not need to take regular medicines the day of the procedure. Tell the healthcare provider about all medicines and supplements that your child takes. Some products may increase your child’s risk of side effects. Ask the healthcare provider if your child needs to avoid taking any medicine or supplements before the procedure.
• Tell your provider if your child has any food, medicine, or other allergies such as latex.
• Your child’s provider will tell you when your child should stop eating and drinking before the procedure. This helps to keep your child from vomiting during the procedure.
• Follow any instructions your child’s healthcare provider may give you.
• Ask any questions you have before the procedure. You should understand what the healthcare provider is going to do. You have the right to make decisions about your child’s healthcare and to give permission for any tests or procedures.

What happens during the procedure?

This procedure is usually done at the hospital.

Your child will be given medicine called anesthesia to keep your child from feeling pain during the procedure.

• Local anesthesia numbs part of the body where your child will have the wires put in.
• General anesthesia relaxes the muscles and puts your child into a deep sleep. A breathing tube is usually put in your child’s throat during general anesthesia.

The healthcare provider will put 1 or more thin, flexible wires through a blood vessel in your child’s groin or neck and into the heart. X-rays will be used to position the catheters in the right place. The wires will check the electrical impulses inside the heart. With the wires, your provider can find the heart's electrical pathways and check their condition.

The procedure may last an hour or more.

What happens after the procedure?

After the procedure your child may stay in an observation area for at least a few hours. Depending on your child’s condition, your child may need to stay in the hospital for 1 or more days.

Your child may have a bruise near the puncture site and be uncomfortable for a few days.

Follow your healthcare provider's instructions. Ask your healthcare provider:

• How and when you will get your child’s test results
• How long it will take to recover
• If there are activities your child should avoid and when it’s okay to normal activities
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.

What are the risks of this procedure?

Every procedure or treatment has risks. Some possible risks of this procedure include:

• Your child may have problems with anesthesia.
• Your child may have infection or bleeding.
• Blood clots may get into one or both of your lungs.
• The wires might hurt the blood vessels or heart muscle or damage the heart’s electrical system.
• The wires might break during the procedure and need to be removed with surgery
• Blood clots may cause a heart attack or stroke.
• A heart rhythm problem that starts during the test may need treatment with an electric shock across the chest.

Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.