Intracardiac electrophysiology study (EPS) is a test to look at the heart's electrical function. It allows doctors to check for abnormal heartbeats or heart rhythms.
The study involves placing wire electrodes in the heart. These electrodes measure electrical activity in the heart and its muscle cells.
The procedure is done in a hospital laboratory by trained staff that includes a cardiologist, technicians, and nurses.
A health care provider will clean your groin area and apply a numbing medicine (anesthetic). The cardiologist will then place several IVs (called sheaths) into the groin or neck area. Once these IVs are in place, wires or electrodes can be passed through the sheaths into your body.
The doctor uses moving x-ray images to carefully guide the catheter up into the heart and place the electrodes into the proper areas.
The electrodes detect the heart's electrical activity and are used to check the heart's electrical system.
Other procedures that may also be done during the test:
You will have to avoid eating or drinking for 6 - 8 hours before the test.
The procedure will take place in a hospital, and you will wear hospital clothing. You must sign a consent form for the procedure.
Your health care provider will instruct you about any changes you must make to your normal medications. Do not stop taking or change any medications without first talking to your health care provider.
You will usually get a mild sedative 30 minutes before the procedure. The procedure may last from 1 hour to several hours. You may not be able to drive home yourself, even if you are released the same day.
You will be awake during the test. You may feel some discomfort when the IV is placed into your arm. You may also feel some pressure at the site when the catheter is inserted. You may feel your heart skipping beats or racing at times.
Your doctor may order this test if you have signs of an abnormal heart rhythm (arrhythmia). Information from this study helps your doctor learn how severe the arrhythmia is, and the best treatment for it. Before this test is done, your cardiologist may have recommended that you have other tests.
An EPS may be done to:
Abnormal results may be due to slow or fast abnormal heart rhythms, such as:
This list does not include all causes of abnormal heart rhythms.
The health care provider must find the exact location and type of arrhythmia so that you can get the right treatment. The arrhythmia may start from any area of the heart's electrical system.
The procedure is generally very safe. Possible risks include:
Electrophysiology study - intracardiac; EPS - intracardiac
Miller JM, Zipes DP. Diagnosis of cardiac arrhythmias. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 36.
Olgin JE. Approach to the patient with suspected arrhythmia. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 62.
Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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