You might be surprised to learn that your heart has its very own electrical system. It controls the rate and rhythm of your heartbeat and keeps blood pumping through your body at a smooth, even pace. If that electrical system doesn’t work correctly, you may develop arrhythmia (irregular heart rhythm).
An electrophysiology study is a test to examine your heart’s electrical system and diagnose problems with your heart rhythm. Here’s a look at who needs an electrophysiology of the heart and what happens during this test.
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What Is an Electrophysiology Study?
With each heartbeat, electrical signals travel from the top of your heart to the bottom. The signals conduct impulses that force your heart to contract and relax in a regular rhythm and pump blood through your heart.
Cardiologists specially trained in heart rhythm disorders perform an electrophysiology study (also called EP study) to check your heart’s electrical system. To do the test, they guide wire electrodes through a blood vessel and to your heart.
The electrodes send signals to your heart and collect information about your heart’s electrical activity on a computer. During the EP study, doctors create a detailed map of how the signals move between heartbeats. Sometimes, doctors can also fix heartbeat problems during the EP study.
“EP Studies are the backbone of cardiac electrophysiology,” said Brett Roberts, MD, electrophysiologist, UPMC Heart and Vascular Institute in Central Pa., “They enable us on a very granular level to detect electrical abnormalities in the heart that may result in a patient’s ailment.”
Who Needs an Electrophysiology Study?
Your doctor might recommend having an EP study to check your heart’s electrical impulses if:
- You have an irregular or abnormally fast or slow heartbeat, and they want to determine the best way to treat it.
- You have unexplained dizziness or fainting.
- You take medicine to regulate your heart rhythm, and they want to check how well it’s working.
- Your doctor needs to check your heart before implanting an ICD (implantable cardioverter-defibrillator). This device stays in your chest, monitors your heart rhythm, and delivers a shock when it senses an abnormal rhythm.
- They plan to do a cardiac ablation to fix your heart rhythm. This is when your doctor uses a catheter to apply heat or cold to certain areas of your heart. That creates scar tissue that blocks irregular electrical signals and restores a normal heart rhythm.
What to Expect During an Electrophysiology Procedure
Your health care provider will review any special instructions about preparing for your EP study. This will include instructions about eating, drinking, and taking any medicines before your electrophysiology procedure.
Before the electrophysiology study
Before the test, they’ll connect you to an ECG to monitor your heart using small electrodes that stick to your skin. You’ll also get an IV in your arm with medicine to make you feel relaxed and sleepy. You might fall asleep during the study, but if you don’t, you’ll be very relaxed and won’t feel any pain.
During the electrophysiology study
During the EP study, the doctor will make a tiny incision into a vessel in your groin, neck, or arm. Then, they’ll insert one or several catheters into the vessel. They’ll thread the catheters through the vessel all the way to your heart, using a special x-ray to guide them.
Once the catheters are in place, the doctor will send tiny electrical impulses through them to different parts of your heart. You might feel your heart beating faster or harder when they do this, or you might feel dizzy. They try to recreate your arrhythmia this way.
If your doctor discovers an area in your heart that’s causing an arrhythmia, they may treat it with cardiac ablation. An EP study takes between two to four hours, but it might be longer with an ablation.
After the electrophysiology study
Once they complete the study and remove the catheter, you’ll go to the recovery room. Nurses will watch you for any bleeding and monitor your heart and blood pressure.
If you had an ablation, you might stay overnight in the hospital. But with an EP study only, most people go home the same day. The area where they inserted the catheter may feel bruised, sore, or tender for a few days after the test.
Your doctor will review your EP study results with you afterward, usually at a follow-up appointment.
An EP study takes more time and is more invasive than many other heart tests. But the results provide valuable information and help guide your doctor in treating your heart rhythm problem.
Editor's Note: This article was originally published on , and was last reviewed on .
The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine. We strive to provide the most advanced, cutting-edge care for our patients, treating both common and complex conditions. We also offer services that seek to improve the health of our communities, including heart screenings, free clinics, and heart health education. Find an expert near you.