Cardiac electrophysiologic study is new medical technology to analyze the electrical conduction system of the heart.

The heart is the most important organ in transmitting blood to nourish the body and the regular contraction of a steady heartbeat of 60-80 times/minute, relies on the heart circuit. Depending on the severity and stage of the disease, disturbances of normal heart rhythm may cause irregular heart beat, seizures, lightheadedness, loss of consciousness, chest pain, weariness, heart failure and death.

Problems with the heart's electrical conduction system causes arrhythmia — an abnormal heart rhythm. Heart rhythm disorders can happen anytime with different signs for different disorders. Sometimes, the information acquired from a basic check-up is not enough to make a diagnosis. Electrophysiologic study can provide an alternative analysis.

About Cardiac Electrophysiology Studies

A cardiac electrophysiologic test is performed by placing a thin, plastic tube into the heart by way of a leg blood vessel near to the groin. Many tubes can be inserted at the same time. X-rays are used to determine the right position of insertion. The tip of each tube measures the electrical signals generated by the heart. These measurements enable the doctor to analyze whether abnormal heart rhythm has developed.

The tubes can emit weak electrical signals so the doctor can clearly see the rapid pacing of the abnormal heart rhythm. The doctor may use the electrical conduction system to adjust the heart beat via this tube so the patient’s electrical signals resume to normal, resulting in a complete cure.

A cardiac electrophysiologic study, also know as cardiac EPS, is a beneficial and safe way to analyze the symptoms of arrhythmia. However, complications can occur when the plastic tube is inserted into the veins. This may cause a rapid heart beat, pneumothorax and other problems but the risk minimal and they can be solved.

When is Cardiac Electrophysiologic Study (EPS) Warranted?

Good reasons to use EPS are to:

• Diagnose the patient’s abnormal heart rhythm if a basic check-up fails to reveal the symptoms;
• Find the reason and position of abnormal electrical conduction of the heart to determine if treatment by using a high frequency electrophysiologic machine is advisable;
• Evaluate whether the abnormal heart rhythm requires treatment with a special machine, such as one related to electrical conduction of the heart or one that emits electrical charges to detect abnormal heart rhythm; and
• Evaluate the patient’s conditions after treatment.

Preparation Before a Cardiac Electrophysiology Study

A patient should refrain from eating or drinking at lest 6 hours before check-up.

Some medications may need to be withheld before the test. This includes some medicines that regulate the heart beat, such as the powerful blood thinner coumadin, and some diabetic medicines. Ask your physician before the appointment date.

Procedures Before a Cardiac Electrophysiology Study

Several things are done before an EPS is actually performed they normally take place in the following order.

• The patient will be given a blood test to check the number of blood cells, mineral salt level & kidney function;
• His or her lungs are X-rayed;
• A heart wave check-up is done if there was no pre-check up;
• The groin area where the tube will be inserted is cleaned with soap and antiseptic;
• An intravenous line will be opened to be administer intravenous fluid and some important lung medications, if required;
• The patient is given detailed information about the test, including:
  • the reasons the test is being performed;
  • procedural techniques; and
  • potential serious test-related complications.
• The patient then signs a consent form and taken to the test room.

In the Cardiac Electrophysiology Study Test Room

The test room is clean, consisting of a bed, x-ray machine, follow-up machine and monitoring machine to detect the electrical conduction system of the heart.

• The patient lies down on the bed;
• A local anesthetic is given with a mild sedative so the procedure will be painless during the test;
• The tube is inserted into the vein near the groin; and
• Catheters measure the electrical signals generated by the heart and if treatment is possible, the abnormal electrical condition pathway will be cut using the tip of a catheter.

After the Cardiac EPS

Upon completion of the test, the catheters are removed and pressure applied to the insertion sites to seal the punctures.

The patient is monitored for approximately 4-6 hours so any serious bleeding can receive prompt attention.

The patient may feel minor pain and oral medication is provided.

After monitoring the patient overnight, if there is no complications, the patient can return home.

Patients can resume normal activities within a day or two.

For further information, please contact the Perfect Heart Institute at Piyavate Hospital International Health Care Service Provider.