Intracardiac electrophysiology study (EPS)

Intracardiac Electrophysiology Study (EPS)

An Intracardiac Electrophysiology Study (EPS) is an assessment of the heart's electrical system. This type of study helps to diagnose and treat disturbances in the heart rhythm. EPS gives the physician detailed information about the type of arrhythmia, the speed at which it operates, how it is affected by medications, and how well certain treatments work for the patient.

Preparation for EPS

Prior to having an EPS, the patient's doctor will need to review the patient's medical history, perform a physical exam, and request diagnostic testing such as an electrocardiogram (EKG). The doctor may also recommend blood tests and other testing to rule out underlying health issues that may be contributing to the arrhythmia.

EPS Procedure

EPS is performed in a laboratory or hospital that is specifically designed for this type of diagnostic test. The procedure typically involves a nurse or using a mild sedative to keep the patient relaxed and comfortable during the procedure. The patient will also be connected to monitoring equipment to measure his or her heart rate and rhythm. The doctor will then insert catheters into the patient's veins, which will be guided into the heart. The catheters will be used to send electrical impulses to help map the heart's electrical pathways.

Types of EPS

  • Electrophysiologic Mapping: This is done to identify areas of tissue in the heart with abnormalities
  • Programmed Stimulation Test: This is used to identify certain arrhythmias
  • Autonomic Nerve Stimulation: This is used to measure how autonomic nerve pathways respond to various stimuli
  • Defibrillator Testing: This is used to test the effectiveness of implanted pacemakers and defibrillators

Risks of EPS

Although EPS is generally a safe procedure, there are potential risks and side effects. These include bleeding at the insertion site, bruising at the insertion site, infection, cardiac perforation, and damage to blood vessels. Other risks are more rare but possible, including blood clots, air bubbles in the veins, and higher than normal heart rate. The doctor will discuss these risks with the patient before the procedure.

When to Perform EPS

EPS is usually used to diagnose and treat arrhythmias, such as atrial fibrillation, atrial flutter, ventricular tachycardia, and other arrhythmias that cannot be corrected with medication. It may also be used to diagnose or manage the following conditions: heart failure, pacemaker or implantable cardioverter-defibrillator problems, persistent chest pain or dizziness, unexplained fainting, and salutatory tachycardia.

Why Perform EPS?

EPS helps doctors diagnose and treat abnormal heart rhythms more accurately and effectively. It also helps to identify areas of abnormality in the heart’s electrical system and to monitor the effectiveness of treatments, such as pacemakers, medications, or ablation. Additionally, EPS is a safe and painless procedure that helps doctors offer better care and treatment options to their patients.