Medical Encyclopedia

 

Medical Encyclopedia

Other encyclopedia topics:  A-Ag  Ah-Ap  Aq-Az  B-Bk  Bl-Bz  C-Cg  Ch-Co  Cp-Cz  D-Di  Dj-Dz  E-Ep  Eq-Ez  F  G  H-Hf  Hg-Hz  I-In  Io-Iz  J  K  L-Ln  Lo-Lz  M-Mf  Mg-Mz  N  O  P-Pl  Pm-Pz  Q  R  S-Sh  Si-Sp  Sq-Sz  T-Tn  To-Tz  U  V  W  X  Y  Z  0-9 

Intracardiac electrophysiology study (EPS)

Contents of this page:

Illustrations

Heart, front view
Heart, front view
Conduction system of the heart
Conduction system of the heart

Alternative Names    Return to top

Electrophysiology study - intracardiac; EPS - intracardiac

Definition    Return to top

Intracardiac electrophysiology study (EPS) is an invasive test that allows doctors to determine the details of abnormal heartbeats, or arrhythmias.

See also: Cardiac ablation procedures

How the Test is Performed    Return to top

The study involves placing wire electrodes in the heart to measure electrical activity along the heart's conduction system and in heart muscle cells themselves.

The procedure is done in a hospital laboratory by a trained staff that includes cardiologists, technicians, and nurses. The environment is safe and controlled to minimize any danger or risk to the patient.

A health care provider will clean your groin area and apply a numbing medication (anesthetic). The cardiologist will then place several IVs into the groin area. Once these IVs are in place, tubes (catheters) can be passed through the IVs into the body.

The doctor uses moving x-ray images to carefully guide the catheter up into the heart and place the electrodes into the proper areas.

The electrodes detect the heart's electrical activity and map out any abnormal heartbeats. This helps the doctor see the type of arrhythmia you have and where the problem starts in your heart.

Abnormal electrical activity can occur anywhere along this heart's conduction system ("the heart's wiring"). Normally, the heart's electrical signals move through the the two chambers on the top of the heart (the atria), to the atrioventricular (AV) node, and then to the lower chambers of the heart (the ventricles).

How to Prepare for the Test    Return to top

Test preparations are similar to those for a cardiac catheterization. Food and fluid will be restricted for 6 - 8 hours before the test. The procedure will take place in a hospital, and you will wear hospital clothing. You must sign a consent form for the procedure.

Your health care provider will give you instructions regarding any changes to your normal medications. Do not stop taking or change any medications without consulting your health care provider.

A mild sedative is usually given 30 minutes before the procedure. You may not be able to drive home yourself if you are discharged the same day.

How the Test Will Feel    Return to top

During the test, you will be awake and able to follow instructions.

A simple EPS generally lasts from 20 minutes to 1 hour. It may take longer if other procedures are involved.

Why the Test is Performed    Return to top

Your doctor may order this test if you have signs of an abnormal heart rhythm (arrhythmia). Information from this study helps your doctor determine the severity of the arrhythmia as well as the best treatment. Before this test is done, your cardiologist may have tried other, less invasive tests such as ambulatory cardiac monitoring.

An EPS may be done to:

What Abnormal Results Mean    Return to top

Abnormal results may be related to slow or fast abnormal heart rhythms. Some examples are:

This list may not be all-inclusive.

The health care provider must determine the exact location and type of the arrhythmia so that specific treatment can be given. The arrhythmia may start from any area of the heart's electrical conduction system.

Risks    Return to top

The procedure is generally very safe. Possible risks include:

Considerations    Return to top

A catheter ablation may be done during EPS to treat the arrhythmia.

References    Return to top

Miller JM. Diagnosis of Cardiac Arrhythmias. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 8th ed. St. Louis, Mo: WB Saunders; 2007: chap. 32.

Update Date: 4/23/2009

Updated by: Steven Kang, MD, Division of Cardiac Pacing and Electrophysiology, East Bay Arrhythmia, Cardiovascular Consultants Medical Group, Oakland, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M. Logo

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 1997-2009, A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.