Invasive | Electrophysiologic Study

To enable successful elimination of an abnormal heart rhythm we must be able to deduce where it is coming from. In order to do this we must bring on the palpitation or at least be able to map where the source is. Therefore in most cases palpitation must fulfill two main criteria if they are to be treated. They must be sustained (however in some cases one beat can be enough) and it must be tolerated by the patient for long enough to allow enough time for us to find the source.

What Should I Expect?

By the time that you arrive at the catheter laboratory you will have already seen the consent form (this is a written agreement by you to undergo the procedure) but a doctor will go through the procedure with you again and make sure you have asked all the questions you want. The text contained in the consent forms contains specific information about the risks of the procedures. After further checks you will be taken through to the catheter lab and positioned on the X-ray table.Your skin will be cleaned at the sites where we will introduce the tubes and covered with sterile towels to avoid infection. Local anaesthetic will then be infused around the sites of introduction of the tubes, usually a patch about 1cm2 at the tops of both legs).

The anaesthetic will sting as it first goes in but after this you should feel pushing and pulling only and no pain. We are also happy to give you sedation as and when you need it but sedation very slightly increases the risks of the procedure and reduces our chances of bringing on your abnormal rhythm thus making treatment impossible. We will then introduce wires (electrode catheters) to the heart using X-ray to guide us. These wires allow us to both record the electrical activity of the heart and stimulate the heart using very small electrical currents.

When the wires are in position we then study the hearts electrical system including an attempt to bring on your symptoms of palpitation. We do this by recording the signals collected by the catheters and by stimulating the heart with pacing. Many patients worry about us starting the palpitations they find their symptoms very distressing, but remember that we are monitoring you carefully throughout and can stop any abnormal rhythm whenever we have to.

London bridge hospital