Intracardiac electrophysiology study (EPS)

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Conduction system of the heart

Heart, front view

Intracardiac electrophysiology study (EPS) involves placing wire electrodes within the heart to determine the characteristics of heart arrhythmias.

Electrophysiology study - intracardiac; EPS - intracardiac

The study is performed in a hospital laboratory by a trained staff that includes cardiologists, technicians, and nurses. The environment is safe and controlled to minimize any danger or risk to the patient.

The cardiologist inserts a catheter into a vein through a small incision in the groin after cleansing the are and numbing it with a local anesthetic. This catheter is equipped with an electrode connected to electrocardiographic monitors.

The catheter is then carefully threaded into the heart using an x-ray imaging technique called fluoroscopy to guide the insertion. Electrodes are placed in the heart to measure electrical activity along the heart's conduction system and within heart muscle cells themselves.

Normal electrical activity is signaled from the heart's natural pacemaker known as the sinoatrial (SA) node. It then travels through the atria (the two chambers on the top of the heart), the atrioventricular (AV) node (connecting the atria to the ventricles), and the ventricles (the lower chambers of the heart).

Abnormal electrical activity can occur anywhere along this conduction system, including in the muscle cells of the atria or ventricles. The electrodes inserted during EPS will map the type of arrhythmia you have and where the problem arises in your heart. This information will allow your cardiologist to determine the severity of the problem (including whether you are at risk for sudden cardiac death) as well as appropriate treatment.

Test preparations are similar to those for a cardiac catheterization. Food and fluid will be restricted 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.