Electrophysiologic Study in India: What to Know?

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Electrophysiologic Study: What is it?

An electrophysiologic study (EPS) is one of a number of tests of the electrical conduction system of the heart performed by a cardiac electrophysiologist, a specialist in the electrical conduction system of the heart. These tests are performed using catheters situated within the heart.

There are a number of different tests that fall under the heading of an electrophysiologic study (EP study). If the heart is electrically stimulated via the intracardiac catheter it is known as programmed electrical stimulation (PES). PES is used to help diagnose and risk stratify individuals with a number of rhythm disturbances of the heart. Other studies that do not require extrinsic stimulation of the heart include conduction studies to determine if the individual’s heart block is at risk of progressing to complete heart block. EP studies also allow the ablation of ectopic electrical foci causing supraventricular arrhythmias.

Why it is done?

Your doctor may recommend an EP study when other tests like the stress test, standard EKG, echo or angiogram cannot provide enough information to thoroughly evaluate your abnormal heart rhythm.

Who are NOT candidates for this test?

The following people are not the candidates for electrophysiologic study:

• Pregnant women.
• Patients with extreme anxiety that causes high blood pressure and irregular heartbeats.
• People who take warfarin and have problems keeping a safe level of the medicine in your blood.
• An individual who is not being able to lie flat.
• People with kidney or liver failure.
• People having bleeding problems or infection.

What preparations are needed before the procedure?

Your doctor will explain the procedure to you and you can also ask any questions you have regarding the procedure. You will asked to sign a consent form that gives your permission to do the test. It is advised, to read the form carefully and ask the questions if something isn’t clear to you. Inform your doctor if you are sensitive to or are allergic to any medications or the anesthetic agents. You will be asked to fast for a certain period of time before the procedure.

You will lie in a bed and your nurse will start an IV in a vein in your hand or arm. This IV is used to deliver the medications and the fluids during the procedure.

Method:

In order to perform an EP study, one or more catheters must be placed within the heart. The catheters are typically placed in the right atrium and/or right ventricle via one or more incisions made in the central venous system. The incisions are typically made in either the internal jugular vein, subclavian vein, or common femoral vein.

Catheters placed via the venous system enter the heart via the right atrium. The advantage of this is that the right atrium is where the SA node is located. The right atrium is also the location of most of the common re-entrant pathways associated with atrial flutter. If a catheter is placed with the distal tip in the right ventricle, it may be possible to measure conduction through the bundle of His, which is useful to determine the level of heart block. If the catheter is placed in the coronary sinus, it is possible to measure electrical activity in both the left atrium and the left ventricle without entering the high pressure arterial system associated with the left side of the heart.

Additional advantages of using these veins are that they are all a part of the central venous system and do not have the valves that peripheral veins contain. The advantage of approaching the heart via the venous system as opposed to via the arterial system is that the risk of stroke is dramatically less if the arterial system is not used. Also, since the venous system is lower pressure, complications such as hematomas are typically easier to manage.

FAQ’s

• • Who performs an EP Study?
    • This type of study is performed by an electrophysiologist and using a single or multiple catheters situated within the heart through a vein or artery.

• • Where is the electrophysiologic study performed?
    • This procedure is performed in a Cath lab, which is a specially equipped operating room.

• • Is the procedure painful?
    • Most patients who have had this procedure reported that they do not experience any pain.

• • How long will I have to stay in the hospital?
    • Most people recover quickly from the procedure and feel well enough to go home later on the same day. However, your doctor may want to initiate further treatment while you are in hospital depending on the findings of your study. This will be discussed with you after your procedure.

• • When can I resume my normal daily activities?
    • You should be able to carry on with normal activities the following day, but avoid heavy lifting for about two weeks afterwards.

What to expect after the procedure?

You will be taken to an observation room after the completion of this procedure. The nurses will monitor your heart rate, temperature and blood pressure as well as check for the signs of bleeding. They will also watch the pulse, color and temperature of the arm or leg where the catheter was placed. If you have an EP study only, then you will most probably go home the same day. Most people can return back to their normal activities in one to two days.

You will receive the results of the preliminary test after the completion of the procedure. Based on these results, your doctor will determine if you need to stay in the hospital or you are able to go back home.

Why Consider India for this procedure?

India offers the Electrophysiologic Study at affordable rates compared to the US, UK and other western countries. Indian surgeons and physicians are renowned for their highly efficient skills and expertise in providing quality medical treatment and care for the patients seeking medical treatments. The Indian hospitals have state of the art facility, world class infrastructure, latest technology and medical equipments, thereby ensures quality medical facilities and treatments for the foreign patients seeking treatment in India.