What is an Electrophysiology Study?
Electrophysiologic (EP) studies are an essential tool in evaluating heart arrhythmias (problems with the heartbeat’s rhythm or rate). EP testing can be used to provoke known but infrequent arrhythmias and unmask suspected arrhythmias. More and more, the tool is being used to predict future cardiac arrhythmias in children with congenital (present at birth) heart disease.
What Happens During an EP Study?
Prior to an EP study, a doctor obtains a thorough medical history, performs a physical examination and seeks to document a child’s arrhythmia using an ECG or mobile monitoring to correlate findings of the EP study with the child’s clinical symptoms. An EP study may be performed under conscious sedation or general anesthesia, depending on the child’s age, cardiac function and peripheral vascular condition.
During this procedure, a doctor gently threads temporary electrode catheters through the peripheral veins or arteries into the heart using the guidance of a fluoroscope, which provides real-time X-rays. Next, the doctor positions the catheters in the atria, ventricles (or both), and at strategic locations along the heart’s conduction system. The catheters record cardiac electrical signals and “map” the spread of electrical impulses during each heartbeat, revealing the location of a heart block or origin of an arrhythmia.
Who is a Candidate?
Physicians determine the best way to diagnose a child’s heart arrhythmia based on:
- A child's age, overall health and medical history
- Severity of the condition
- A child's tolerance for specific medications, procedures or therapies
- Expectations for the course of the disease
- Parents’ opinions or preferences
In general, EP testing is reserved for children who are strongly suspected of having a rhythm disorder, and whose preliminary test results are normal.
What Happens After the Procedure?
After the procedure, a child will spend four to six hours in a special recovery area to allow the catheter insertion site to heal. Children typically leave the hospital within 24 hours and return to normal activities, including school, three to four days following the procedure.