Programmed electrical stimulation

A cardiac electrophysiology study (EP test or EP study) is a minimally invasive procedure that tests the electrical conduction system of the heart to assess the electrical activity and conduction pathways of the heart. During EPS, sinus rhythm as well as supraventricular and ventricular arrhythmias of baseline cardiac intervals is recorded. The study is indicated to investigate the cause, location of origin, and best treatment for various abnormal heart rhythms. This type of study is performed by an electrophysiologist and using a single or multiple catheters situated within the heart through a vein or artery.

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 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.

An EP study is typically performed in an EP lab or cath lab. These are specially equipped operating rooms that usually contain a Flouroscope, Recording System, Cardiac Stimulator, Ablation Equipment, a Cardiac Mapping System and the necessary cables, catheters and sheaths.

An IV tube is generally inserted to keep the patient hydrated and to allow for the administration of sedatives, anesthesia, or drugs.

In order to reach the heart with a catheter, a site will be prepared that will allow access to the heart via an artery or vein, usually in the wrist or groin. This site is then described as the insertion point.

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