Learn more about our variety of cardiac electrophysiology tests that can help diagnose abnormal heartbeats or arrhythmia at INTEGRIS Health.

What is Electrophysiology

An electrophysiology study (EP study) at INTEGRIS Health is the study of your heart's electrical system. Using a variety of diagnostic procedures, we can better understand the cause of your abnormal heart rhythms.

Why Would I Need an Electrophysiology Study? | Electrocardiogram (ECG) | Echocardiogram (Echo) | Holter Monitor | Event Monitor
Mobile Cardiac Monitoring | Implantable Look Recorder | Risks of an EP Study | Returning Home | What Should I Watch For? | Conditions That an EP Study Can Help Identify

Electrical impulses coordinate contractions of the different parts of the heart which helps keep blood flowing. This movement of the heart creates the heartbeat, or heart rhythm.

The electrophysiology study is done by inserting catheters and then wire electrodes which then measure the electrical activity through blood vessels that enter the heart.

Why Would I Need an Electrophysiology Study?

  • There are several reasons why your doctor or cardiology specialist may recommend an EP study for you.
  • Evaluate symptoms of dizziness, fainting, weakness, palpitations that are caused by a rhythm problem
  • EP studies can be used to help your doctor understand why your heart rhythms are too fast or too slow
  • To find the source of a heart rhythm problem with the goal to do an ablation once the source is identified
  • Also, to monitor how well medicines are working to treat a heartbeat rhythm problem
There may be other reasons why your doctor recommends a EP study but these are the most common factors.

Electrocardiogram (ECG)

An electrocardiogram is a measurement of the electrical activity of your heart. By placing electrodes at specific locations on your body (chest, arms, and legs), a graphic representation, or tracing, of the electrical activity can be made as the electrical activity is received and interpreted by an ECG machine. An ECG can show the presence of arrhythmias, damage to your heart caused by ischemia (lack of oxygen to the heart muscle), or myocardial infarction (MI, or heart attack), a problem with one or more of the heart valves or other types of heart conditions.

There are several variations of the ECG test.

Resting ECG

An ECG done while you are lying down.

Exercise ECG, Or Stress Test

You are attached to the ECG machine as described above. However, rather than lying down, you exercise by walking on a treadmill or pedaling a stationary bike while the ECG is recorded. This test is done to assess changes in the ECG during stress, such as exercise.

Signal-Averaged ECG

This procedure is done in the same manner as a resting ECG, except that your heart's electrical activity is recorded over a longer period of time, usually 15 to 20 minutes. Signal-averaged ECGs are done when arrhythmia is suspected, but not seen on a resting ECG. The signal-averaged ECG has increased sensitivity to abnormal ventricular activity called late potentials.

Echocardiogram (Echo)

This procedure evaluates the structure and function of your heart by using sound waves recorded on an electronic sensor that makes a moving picture of the heart and heart valves.

Electrophysiologic Studies (EPS)

A nonsurgical but invasive test in which a small, thin tube (catheter) is inserted into a large blood vessel in your leg or arm and advanced to your heart. This lets your doctor find the site of the arrhythmia's origin within your heart tissue to determine how to best treat it. Sometimes, your doctor can treat the arrhythmia by doing an ablation at the time of the study.

Holter Monitor

Problems with your heart's electrical system may be too brief and not seen during the shorter recording times of the resting ECG, so a Holter monitor is used to take a continuous ECG recording over 24 or more hours. Electrodes are attached to your chest and connected to a small portable ECG recorder by lead wires while you go about your daily activities.

Event Monitor

This is similar to a Holter monitor, except that you start the ECG recording only when you feel symptoms.

Mobile Cardiac Monitoring

This is similar to both a Holter and an event monitor. The ECG is monitored constantly to allow for the detection of arrhythmias, which are recorded and sent to your doctor regardless of whether you have symptoms. You can also start recording yourself when you have symptoms. These monitors can be worn for up to 30 days (about 4 and a half weeks).

Implantable Look Recorder

This is a miniature heart recording device that is implanted underneath the skin overlying your heart. It can record the heart rhythm for up to 2 years and is useful in diagnosing intermittent or rarely occurring arrhythmias.

Risks of an EP Study

Although an EP study is safe, there are some risks that you should be aware of. We recommend discussing these with your doctor before the procedure.

  • Arrhythmia: during the study, you may get abnormal heart rhythms which can lead to dizziness. If this happens, our doctor may give your heart an electric shock to bring back your heart’s regular heartbeat.
  • Heart attack or stroke
  • Heart valve damage
  • Blood clots: these can form at the tip of the catheter which can break off and block a blood vessel. Your doctor may give you medicine to prevent these.
  • Infection: bleeding and bruising at the site where the catheter went in may lead to an infection. Your doctor or nurse will help you avoid these issues if they arise during the procedure.

Returning Home

After you have been cleared to return home, follow the instructions that your caregivers gave you, including any new medications that they have prescribed to you. Most people can start eating and taking their medicine 4-6 hours after the test but confirm with your caregivers.

It is normal for the puncture site to be sore for the next several days. Additionally, expect some bruising around the area as well.

What Should I Watch For?

Call 911 if you experience the following:

  • Pain or tightness in the chest or signs of a stroke (face drooping, arm weakness, speech difficulties)
  • Sudden increase in swelling around the puncture site
  • Bleeding that does not slow down when you press hard on the puncture site

Call your doctor if you experience the following:

  • Arm or leg that was used for the catheter feels numb or tingling
  • The puncture site continues to show more bruising
  • The puncture site begins to swell, or fluids begin to leak
  • Fever
  • Shortness in breath

Conditions That an EP Study Can Help Identify

These diagnostic procedures are instrumental in narrowing down the source of your cardiac condition, and are also helpful in managing ongoing treatment and evaluating the efficacy of treatment for conditions such as:

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