Q: What are electrophysiology studies?
Having an irregular heartbeat can be a sign of more serious heart problems. Electrical-activity based technology-called electrophysiology (EP) -studies the electrical activity of the heart to detect the presence of irregular heart rhythms in patients and helps the physician determine necessary treatment.

Q: What is an arrhythmia?
An arrhythmia is an irregular heartbeat that often results from a change or malfunction in the heart's conduction system. The conduction system is where normal electrical activity travels where normal electrical impulses travel through the heart. An arrhythmia can occur when the heart's natural pacemaker develops an abnormal rate, the normal conduction pathway is interrupted, or another part of the heart takes over as pacemaker. Arrhythmias can be unusually fast, called tachycardia, or unusually slow, called bradycardia.

Q: Should I be worried if I have an arrhythmia?
Some arrhythmias are signs of a more serious problem, while others are not. The irregular heartbeat can be brief and unnoticeable, but it also can be quite bothersome or even fatal. Because an occasional skipped heartbeat is not medically significant in the majority of cases does not mean that arrhythmias should be ignored. Notify your physician if you feel any skipped beats or feel that your heart is beating differently than normal.

Q: How is an EP study performed?
At Palmetto Health Richland's Heart Hospital, EP studies are done in the EP Lab, which is part of the Catheterization Lab. The lab is equipped with the necessary monitoring devices, video display equipment and X-ray cameras. Once the patient is made comfortable, heart and blood pressure monitoring begin and an intravenous line is inserted. The area where the thin tube-like catheter will enter the body is locally anesthetized.

A long, thin tube-like catheter is inserted in an artery or vein in the arm, neck or groin. The catheter then is guided into the heart. Small pacemaker catheters then are inserted through the catheter. The physician sends electrical impulses through these catheters to check for problems with the heart's electrical system.

Once in place, the electrode catheter performs specific, essential measurements of the heart's electrical activity and pathways. The catheter records heart sounds to assess the presence of arrhythmias.

Q: What happens if an arrhythmia is detected?
If the abnormal source of an arrhythmia is detected, the physician may use the opportunity to perform treatment such as radiofrequency ablation. Radiofrequency energy from the tip of the catheter is used to heat and destroy the heart cells that are creating the arrhythmia.

Some reasons for having an EP study include fainting, irregular heartbeat, and a very fast or slow heartbeat.

Q: How long does an EP study take?
A: An EP study that includes ablation treatment can take up to six hours.

Q: What happens after the EP study?
Once the procedure is concluded, the catheter is withdrawn, pressure is placed on the puncture point and the patient is watched for four to six hours before being released. The patient may go home the same day, or, occasionally, is watched overnight in the hospital.

Q: How quickly are results available?
Results from the study often are available to the patients at the time of the procedure.

Q: What treatments are available if the EP study shows an arrhythmia?
If the EP study reveals that an arrhythmia is being caused by abnormal electrical impulses, treatments (in addition to the catheter ablation) include a pacemaker, an implantable cardioverter defibrillator, or antiarrhythmic medications.

Q: Are arrhythmias common?
A: Approximately 4 million Americans have periodic arrhythmias. And, an estimated 2 million Americans are living with atrial fibrillation, which is the most common "serious" arrhythmia. The prevalence of arrhythmias tends to increase with age, even when there's no clear sign of heart disease.

Q: What are the symptoms of arrhythmia?
Arrhythmias occur throughout the population and their severity varies widely. Some people with arrhythmia have no symptoms, while others experience obvious discomfort. Some of the symptoms experienced by people with arrhythmia include:

  • "Galloping" or strong heartbeat,
  • Skipped heartbeat,
  • Dizziness, fatigue or fainting,
  • Chest pain, pressure or discomfort, and
  • Shortness of breath.

Q: Can an arrhythmia be fatal?
A: In severe cases, arrhythmia can result in cardiac arrest and death. If you think you may be suffering from any of these symptoms, contact your physician.

Visit the Atrial Fibrillation and Arrhythmia Center.

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