An electrophysiological study is an invasive Cardiology test that aims to diagnose certain cardiac rhythm disorders (tachyarrhythmias and bradyarrhythmias) using catheters in order to provide the most appropriate treatment to patients who suffer from them.
What is it indicated for?
The electrophysiological study makes it possible to determine the origin of a tachyarrhythmia or bradyarrhythmia previously documented in an ECG with a view to planning the most appropriate treatment and, on other occasions, to determine whether the patient’s symptoms (palpitations, dizziness, syncope, dyspnea) may be due to tachy or bradyarrhythmias. It is therefore indicated in patients with certain documented arrhythmias as well as in patients with symptoms highly suggestive of the presence of these arrhythmias intermittently and that have not been documented in ECG or Holter.
How is the electrophysiological study performed?
It is performed in an electrophysiology room while the patient is fasting, lying down, conscious but sedated for greater comfort. Local anesthesia is applied to the area where the puncture will be performed (usually the groin) so that it is not painful, and from this point, through the local veins or arteries, several catheters (thin, long, flexible wires) are introduced which are directed to the heart by means of X-ray control. With these catheters, the electrical activity of the heart is recorded from the inside and we can even stimulate to try to induce the arrhythmias or electrical disturbances we are looking for. It may be necessary during the test to administer a drug to clarify the diagnosis of the arrhythmia. During the test you may experience palpitations, either caused by the catheters or by the medication administered, always in a controlled environment and in a reversible manner. Once the diagnosis has been made, in most cases the best treatment is applied in the same procedure. The duration of the study varies depending on the arrhythmias in question, and the patient must remain in bed and rest for several hours afterwards.
What are the risks of this test?
Electrophysiological studies are very safe procedures. Most of the time you will only notice a slight discomfort at the puncture site, or the appearance of a small hematoma at the puncture site that will almost always be reabsorbed spontaneously. The presence of serious complications related to the procedure is fortunately exceptional (cases of phlebitis, arteriovenous complications, hemorrhage, cardiac perforation, embolism, etc., are described in the literature). In any case, the personnel involved in these procedures have the necessary experience and training to recognize possible complications early and provide the appropriate treatment as soon as possible.