EP Studies
Electrophysiology Study and Catheter Ablation: Before Your Procedure
What is an electrophysiology study and catheter ablation?
An electrophysiology study, also called an EPS, is a test to see if there is a problem with your heartbeat (heart rhythm) and to find out how to fix it. Sometimes a procedure called catheter ablation is done during an EPS. This procedure destroys (ablates) small areas of your heart that are causing your heart rhythm problem.
The doctor puts plastic tubes called catheters into blood vessels in your groin, arm, or neck. He or she then uses an X-ray machine to guide long, flexible wires called catheters through the tubes and to your heart. Your doctor uses the catheters to record your heart's electrical signals.
If the doctor thinks your problem can be fixed with ablation, he or she can destroy a small part of your heart tissue. This is usually done with radio waves.
You will probably be awake during the procedure. The doctor will give you medicines to help you feel relaxed and to numb the areas where the catheters go in. You may feel a little uncomfortable, but you should not feel pain.
An EPS takes 1 to 3 hours. Catheter ablation usually takes 2 to 6 hours. In rare cases, it can take longer. If you have EPS only and you do not need more treatment, you may go home the same day. But if you also have ablation, you may stay overnight in the hospital. How long you stay in the hospital depends on the type of ablation you have. Most people can go back to work and their normal routine in 1 or 2 days.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
What happens before the procedure?
Having a procedure can be stressful. This information will help you understand what you can expect and how to safely prepare for your procedure.
Preparing for the procedure
- Bring a list of questions to ask your doctors. It is important that you understand exactly what procedure is planned, the risks, benefits, and other options before your procedure.
- Tell your doctors ALL the medicines, vitamins, supplements, and herbal remedies you take. Some of these can increase the risk of bleeding or interact with anesthesia. Your doctor will tell you which medicines to take or stop before your procedure.
- If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your procedure. Make sure that you understand exactly what your doctor wants you to do.
- You may need to stop taking certain medicines a week or more before your procedure, so talk to your doctor as soon as you can.
Taking care of yourself before the procedure
- Build healthy habits into your life. Changes are best made several weeks before the procedure, since your body may react to sudden changes in your habits.
- Stay as active as you can.
- Eat a healthy diet.
- Cut back or quit alcohol and tobacco.
- If you have an advance directive—which may include a living will and a durable power of attorney for health care—let your doctor know. If you do not have one, you may want to prepare one so your doctor and loved ones know your health care wishes. Doctors recommend that everyone prepare these papers before a procedure, regardless of the type of procedure or condition.
What happens on the day of the procedure?
- Follow the instructions exactly about when to stop eating and drinking, or your procedure may be canceled. If your doctor has instructed you to take your medicines on the day of the procedure, please do so using only a sip of water.
- Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
- Remove all jewelry, piercings, and contact lenses.
- Leave your valuables at home.
At the hospital or surgery center
- Bring a picture ID.
- A small tube (IV) may be placed in a vein, to give you fluids and medicine to help you relax.
- You will lie down on a table. The doctor or nurse may place small electrode patches on your skin. You will also have a cuff around your arm that will regularly squeeze your arm and check your blood pressure.
- You will get oxygen through a mask on your face or a tube through your nose.
- You will have a small device on your finger or ear to check how much oxygen is in your blood.
- EPS by itself may take 1 to 3 hours. But if you also have ablation, the whole procedure may take 2 to 6 hours.
- In the recovery room, the nurse will check to be sure you are stable and comfortable. It is important for you to tell your doctor and nurse how you feel and ask questions about any concerns you may have.
- A nurse will apply pressure to the areas where the catheters were put in to help stop bleeding. After the bleeding stops, the doctor or nurse will put bandages on those areas.
- You will have to lie flat in bed for 4 to 6 hours. Do not bend your legs. This allows your blood vessels to heal.
Going home
- You may go home after 4 to 6 hours in the recovery room. If you had an EPS and an ablation, you may stay in the hospital longer.
- You will need someone to drive you home.
- You will be given more specific instructions about recovering from your procedure, including activity and when you may return to work.
When should you call your doctor?
- You have questions or concerns.
- You don’t understand how to prepare for your procedure.
- You become ill before the procedure (such as fever, flu, or a cold).
- You need to reschedule or have changed your mind about having the procedure.
Electrophysiology Study and Catheter Ablation: What to Expect at Home
Your Recovery
You had an electrophysiology study for a problem with your heartbeat. You may also have had a catheter ablation to try to correct the problem. You may have swelling, bruising, or a small lump around the site where the catheters went into your body. These should go away in 3 to 4 weeks.
Do not exercise hard or lift anything heavy for a week. You will probably be able to go back to work and to your normal routine in 1 or 2 days.
This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.
How can you care for yourself at home?
Activity
- For 1 week, do not lift anything that would make you strain. This may include heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, a vacuum cleaner, or a child.
- For 1 week, do not exercise hard or do any activity that could strain your blood vessels or groin.
- Ask your doctor when it is okay to have sex.
- You may shower. But do not swim or take a bath until the catheter sites heal, or until your doctor tells you it is okay.
Diet
- You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
- Drink plenty of fluids (unless your doctor tells you not to).
Medicines
- Ask your doctor if you can take acetaminophen (Tylenol) for pain. Do not take aspirin for 3 days, unless your doctor says it is okay.
- Check with your doctor before you take aspirin or anti-inflammatory medicines to reduce pain and swelling. These include ibuprofen (Advil, Motrin) and naproxen (Aleve).
- Make sure you know which heart medicines to continue and which ones to stop. Ask your doctor if you are not sure.
- If you get medicines to keep blood clots from forming (blood thinners), take them exactly as directed.
Catheter site care
- You can remove your bandages the day after the procedure.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.
When should you call for help?
Call 911 anytime you think you may need emergency care. For example, call if:
- You passed out (lost consciousness).
- You have severe trouble breathing.
- You have sudden chest pain and shortness of breath, or you cough up blood.
- You have a lot of bleeding from your catheter site.
Call your doctor now or seek immediate medical care if:
- You have a fever over 100°F.
- You are bleeding from one of the areas where a catheter was put in.
- You have painful swelling, or bruising larger than a credit card where a catheter was put in.
- You have signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the catheter site.
- Pus draining from the catheter site.
- Swollen lymph nodes in your neck, armpits, or groin.
- A fever.
- Your arm or leg is numb or hurts.
- Your feet are very cold.
- Your heart rhythm problem comes back.
- You are dizzy or lightheaded, or you feel like you may faint.
Watch closely for any changes in your health, and be sure to contact your doctor if:
- You have questions about the results of your procedure or your treatment plan.