Electrophysiological Studies

What to Expect

During the Procedure

• Description of the room, monitoring devices, positions, and equipment that will be used - From the holding area, you will be taken to the room where the procedure will actually take place. The room will feel cool. You will lie on a firm but padded x-ray table and you will be connected to equipment that will monitor your heart rhythm, blood pressure, and oxygen levels. A nurse will accompany you at all times. Please feel free to ask questions at any time.
  
  You will lie flat on your back during the entire procedure. There will be several monitor screens in the room, showing your vital signs (EKG, heart rate, blood pressure, breathing rate, and oxygen level), the images of the catheter being moved through the body into the heart, and the structures of the heart as the dye is injected.
  
  The cath lab is a sterile area, so everyone in the room will wear gowns, masks, and caps. The physician and assistants actually performing the procedure will wear sterile gloves. A large x-ray camera will be above the table to make pictures of the procedure.
  
  
• Anesthesia - You will be given a sedative medication in your IV prior to the procedure to help you relax. However, you will remain awake during the procedure.
  
  
• Basic description of the procedure:
  
  
  • The cath site (groin or arm) will be cleansed again with antiseptic soap.
    
    
  • Sterile towels and a sheet will be placed around this area.
    
    
  • A numbing medication (lidocaine or xylocaine) will be injected into the skin at the cath site. You may feel slight stinging at the site for a few seconds after the numbing medication is injected.
    
    
  • Once the numbing medication has taken effect, a sheath, or introducer, is inserted into the blood vessel. This is a plastic tube through which the catheter will be inserted into the blood vessel and advanced into the heart. If the arm is used, a small incision (cut) is made to expose the blood vessel for insertion of the sheath.
    
    
  • It will be very important for you to remain still during the procedure so that the catheter placement is not disturbed and to keep from causing damage to the insertion site.
    
    
  • The catheter is inserted through the introducer into the blood vessel. The physician advances the catheter through the blood vessels into the heart. This is done by watching the catheter on the monitor and guiding it into the proper structures. The room will be dim, so that the monitors can be seen better by the physician and the staff.
    
    
  • Once the physician has the catheter placed properly, the electrical testing will begin by giving very small electrical shocks to certain areas within the heart. If a dysrhythmia is induced, you may begin to feel lightheaded or dizzy. Medication will be given in your IV to treat the dysrhythmia.
    
    
  • If a certain spot of tissue is found that is causing a dysrhythmia, the physician may perform an ablation to eliminate the tissue. This is done with radio waves (radiofrequency ablation). The radio waves are delivered through the catheter to the tissue.
    
    
  • If you notice any discomfort or pain, such as chest pain, neck or jaw pain, back pain, arm pain, shortness of breath, or breathing difficulty, let the physician know.
    
    
  • Once the procedure has been completed, the catheter will be removed from the insertion site.
    
    
  • The physician or an assistant will hold pressure on the insertion site for about 15 minutes so that the blood can begin to form a clot at the site and stop the bleeding. Once the physician or assistant is satisfied that the bleeding has stopped, a very tight bandage will be placed on the site. A sandbag may be placed on top of the bandage for additional pressure on the site, especially if the site is the groin.
    
    
  • You will be assisted to slide from the table onto a stretcher so that you can be taken to the recovery area. NOTE: You will not be allowed to bend your leg nearest the insertion site, if the insertion was done in the groin, for several hours. To help you remember to keep your leg straight, the knee of the affected leg will be covered with a sheet and the ends will be tucked under the mattress on both sides of the bed to form a type of loose restraint.
    
    
• Procedure time - The procedure itself will last about two to four hours, depending on what is found during the procedure. If an ablation is done, the procedure may last an hour or so longer.
  

page four