Electrophysiology Lab

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Electrophysiology relates specifically to the diagnosis and treatment of the heart's electrical system, which controls the heart rhythm

Each day, the heart pumps approximately 2,000 gallons of blood throughout the body and beats about 100,000 times. The heart is located in the center of the chest, but because the bottom of the heart tips to the left, more of the heartbeat is felt on that side of your body. Normally, electricity flows through the heart and produces the familiar thump-bump pattern that can be heard through a stethoscope.

If you have a problem with irregular heart rhythms (arrhythmia), your heart may beat too fast, too slowly or erratically. This causes a dangerous disruption of blood flow and can result in stroke, organ damage or organ failure. It's clear that a prompt and thorough examination is called for.

At the electrophysiology lab at Baylor Scott & White Heart and Vascular Hospital – Dallas, both diagnostic and therapeutic services are conducted. We have earned national recognition as a leader in the treatment of heart and vascular disease, and our electrophysiology lab is no exception. Under the direction of experienced electrophysiologists and cardiologists, our EP lab is equipped to care for all types of problems affecting the heart's electrical system.

Two doctors in full scrubs work in an electrophysiology lab

Electrophysiology specialists may perform a variety of studies to diagnose heart rhythm problems (arrhythmias)

Most heart rhythm studies are simple and non-invasive, while others may involve catheterization lab procedures for a more in-depth check of the heart's electrical signals:

Physical exam and patient history
Electrocardiogram (ECG or EKG)
Stress tests
Tilt table tests that check for the source of lightheadedness and fainting
Electrophysiology study
Coronary angiography

Electrophysiology (EP) studies

Electrophysiology studies are commonly performed to identify the area in the heart that is causing the arrhythmia and to develop the best course of treatment. Information generated during these studies also may be used to:

Predict a future cardiac event
Evaluate the effectiveness of certain medications to control the irregular heartbeat
Decide if certain procedures or implants are necessary, such as a catheter ablation procedure, an implantable defibrillator or a pacemaker

Heart rhythm devices

Depending on which kind of heart rhythm problem you experience, your heart doctor may recommend one of the following arrhythmia treatment options:

Pacemaker (heart beats too slow)
Defibrillator (heart beats too fast)
Heart failure device (for dyssynchronous ventricles)
Implantable loop recorder

What to expect at your electrophysiology procedure

Pre-considerations

Before treatment options can be determined, several factors must be considered, including:

Age
Personal and family medical history
Current medications
Any existing diseases or conditions
Signs and symptoms of the current arrhythmia

Night before the procedure

If you are scheduled to undergo an electrophysiology test, you should not eat or drink anything after midnight the night before the procedure. Check with your heart doctor about continuing any medications. If you have diabetes, talk to your doctor about food and insulin intake, which can affect blood sugar levels.

Prior to procedure

After arriving at the hospital and changing into a hospital gown, an intravenous line is started. You will be given a sedative to make you feel drowsy. Once you are in the cardiac catheterization laboratory (sometimes shorted to "cardiac cath lab") where the procedure will take place, electrodes are placed on your chest. An area in your groin is numbed, and access is gained using a small puncture where a special catheter is inserted into a vein and then threaded to your heart using fluoroscopy, which provides continuous, real-time X-ray images of the moving heart.

During the procedure

The catheter can detect electrical activity in the heart and doctors can administer small electrical impulses to make the heart beat at different speeds. The heart's electrical signals normally move from the two top chambers of the heart (the atria), through the atrioventricular node and to the ventricles of the heart, or lower chambers.

After the procedure

An electrophysiology test typically lasts between two and four hours, but it may take longer if additional treatments are performed at the same time. After the procedure is completed, the catheter is removed, and firm pressure is applied to the incision site to prevent bleeding. Most people go home the same day.

Results

Abnormal results from an electrophysiology test can identify numerous conditions, such as ventricular tachycardia (rapid heartbeats that start in the ventricles) and supraventricular tachycardia, which includes atrial fibrillation (abnormal electrical discharges in the heart that cause an irregular heartbeat) and Wolff-Parkinson-White syndrome (where there is an extra electrical pathway in the heart).

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Baylor Scott & White Heart and Vascular Hospital - Dallas

Electrophysiology relates specifically to the diagnosis and treatment of the heart's electrical system, which controls the heart rhythm

Electrophysiology specialists may perform a variety of studies to diagnose heart rhythm problems (arrhythmias)

Electrophysiology (EP) studies

Heart rhythm devices