Electrophysiologic Testing

What Is Electrophysiologic Testing?
Electrophsyiologic testing examines and studies the heart's electrical activity, pathways, and rhythm. When an electrophysiologic test is conducted, the doctor will insert a catheter through the artery and into the heart. At the end of the catheters are electrodes that will send electric signals to the heart, forcing it to beat at different speeds. The catheter then records the ECG within the heart and locates the conduction pathways being tested.

Why Is Electrophsyiologic Testing Used?
Electrophysiologic testing is done to diagnose certain types of heart disease or abnormalities. These can include:

? Arrhythmia. Arrhythmia is defined as the irregular beating of the heart and can take place in several forms, including Tachycardia, which occurs when the heart beats too quickly, usually over 100 beats per minute; Bradycardia, where the heart beats too slowly, (under 55 beats per minute in an adult), and other arrhythmia problems, which include extra heartbeats or skipped heartbeats.
? Determining a person's risk for sudden death
? Assessing the cause of such symptoms as chest pain, shortness of breath, extreme fatigue, fainting spells, or arrhythmia.
? Monitor the heart's response to a recently implanted device, like a pacemaker or defibrillator.

How Is It Done?
Electrophysiologic testing is an invasive procedure, or surgery, usually done in a hospital under local anesthesia that takes between two and four hours. Preparation for an electrophyiologic test generally includes not eating or drinking at least six hours before the test is scheduled. You may or may not be required to stop taking certain medicines, depending on the doctor's discretion.

During the procedure itself, electrodes with wires hooked up to an electrocardiogram machine will be attached to your chest. These electrodes will monitor your heart's rhythm while the test is being performed. The healthcare professional will disinfect and shave the area where the catheter will be inserted. This is most often in the thigh, neck, or under the collarbone. You will be anesthetized, so you won't feel the catheter being inserted.

Once the catheter is inserted, the doctor will thread it through the blood vessels to the larger muscles of the heart. In order to know where to position and direct the catheter, the doctor will watch a video x-ray that will help guide him to the proper location.

The electrodes located at the end of the catheter will be pointed in different directions as they induce arrhythmia in order to locate which area of the heart may be causing the abnormal beating. These shocks are too small to be felt by you, as the level of electricity is very low, and will not be painful.

Complications and Side Effects
Electrophysiologic testing is considered safe, with the risk of death being around 1 in 5,000. Some discomfort during the test may occur when the initial arrhythmia of the heart is induced. This can cause palpitations, shortness of breath, or in rarer cases, loss of consciousness. However, the medical team standing by keeps this under control, and additional anesthesia will be given if it becomes necessary to defibrillate the heart. In addition, some patients may feel anxiety while being awake during the procedure, or may have difficulty being still for a long period.

The complications that come with electrophysiologic testing are rare but can be serious. They include blood clots, low blood pressure, arrhythmia or abnormal heart rhythms, stroke or heart attack. More minor risks include a small amount of bleeding around the insertion of the catheter or bruising after it is removed.

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