About Electrophysiological Study

An electrophysiological study is performed to try to define the reason why people experience abnormalities in their heart rhythm. These can arise from either the atrium or the ventricle.

The procedures generally are done under sedation or anaesthesia. Some arrhythmias are suppressed by anaesthesia and in these cases, only light sedation is used until the arrhythmia mechanism is elucidated.

Catheters are inserted via the femoral veins (on both sides) which allow access to the right atrium and right ventricle. Generally, three catheters are inserted into the left femoral vein and to catheters into the right femoral vein. In modern practice, access to the veins is achieved using ultrasound guidance in the majority of cases.


Various pacing manoeuvres performed and with the catheters located in different areas of the heart is possible to record the progress of these electrical stimuli through the heart. This allows identification of the mechanism of the tachycardia. Attempts are made during the procedure to induce the tachycardia and this allows confirmation of the mechanism and enhances identification of a suitable target for ablation.

Should the arrhythmia require ablation then this is generally done once the mechanism of the arrhythmia is defined. In general, this is a safe procedure with a high success rate. This is dependent on the type of arrhythmia.

In general, patient stay in the hospital for one day. After the procedure, a period of time is spent in the coronary care unit as this allows close and careful monitoring of the electrocardiogram to ensure success or any development of abnormalities.

After the procedure activity is limited due to the groin punctures. These are generally healed within three days. Occasionally bleeding occurs and this is usually controlled with direct pressure. A few patients have significant bruising and occasionally a haematoma may form.

In view of the fact that most of the work is done within the venous system and heart anticoagulation is given subcutaneously during the procedure and sometimes the day after the procedure. Usually, if ablation is performed the anticoagulation is continued for four days afterwards unless the procedure was directed towards atrial fibrillation when anticoagulation would continue for three months or longer if the person has an ongoing high risk for clot formation.

The Cardiologist - Dr Anthony Stanley Logo


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