Specialized Procedures
Diagnostic Electrophysiology Studies
A diagnostic EP study tests the heart’s electrical conduction system. It evaluates the potential for changes in the normal sequence of your heart’s electrical impulses, which can cause abnormal rhythms. It can also pinpoint an arrhythmia and provide valuable information for treatment.
The most common reasons a physician orders an EP study are to evaluate loss of consciousness and to study underlying mechanisms for bradycardia, conduction disturbances and tachycardia.
During the study, electrode catheter wires will be inserted, usually through a large vein in the groin and directed to your heart. The wires allow for electrical stimulation of the heart tissue and recording of the electrical conduction properties of the heart.
Your heart will be stimulated to beat at different rates and patterns to determine if you have a tendency to experience life-threatening arrhythmias.
Most electrophysiology procedures take one to two hours but occasionally a study may last longer. You’ll remain sedated during the entire procedure, and your vital signs will be monitored continuously.
Ablation Tachyarrhythmias
Rapid rhythms of the heart (tachycardias) either originate in the ventricle (ventricular tachycardia) or from above the ventricle (supraventricular tachycardia). They typically result from reentry or ‘short-circuiting’ in the heart. Mapping and ablation of these short circuits typically result in a cure of the tachycardia.
Some forms of tachyarrhythmias, especially ventricular tachycardia, have the potential to rapidly deteriorate into more lethal arrhythmias. Such patients are candidates for ICD implantation.
Many arrhythmias lend themselves to mapping and ablation. Intracardiac mapping is a tool that allows for a higher precision in performing ablations.
ICD Implantation
Implantable cardioverter defibrillators (ICDs) are small, medical devices that are implanted in the chest below the collarbone. They continuously monitor heart rhythm through special wires inserted into the heart and are equipped to deliver electrical shocks to restore the heart’s normal rhythm and prevent sudden cardiac arrest.
Most ICDs are equipped to record the heart’s electrical patterns in order to track abnormal rhythms. Your electrophysiologist can review the recording during checkups to help plan your future care.
Cardiac Resynchronization Therapy
Many patients with heart failure remain symptomatic with shortness of breath and other conditions despite optimal medical therapy. Such patients often have enlarged hearts with out-of-sync contractions.
Resynchronization therapy involves the insertion of pacing leads into the heart and a specialized pacemaker/defibrillator (biventricular ICD) to instruct the heart to contract more synchronously.
Preparing for Your EP Test or Treatment
Most of the procedures are performed under conscious-sedation anesthesia. Your doctor will discuss in detail the type of anesthesia your procedure will require. The
electrophysiologist and nurses will monitor your heart rate, blood pressure, breathing, blood oxygen levels and heart rhythms at all times.
Your doctor will give you specific details about your particular test or treatment. It’s very important that you do not eat or drink anything after midnight the day before your EP test or treatment. Please check in with Admissions at the time given to you by your physician. Following a procedure, most EP patients stay overnight in the hospital. You should be ready to go home the next day.
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Cardiac electrophysiology (EP) is the study of the heart’s electrical system. The electrophysiologists on staff at Memorial Hermann The Woodlands are skilled cardiologists with advanced training in the diagnosis and treatment of abnormal heart rhythms. 
