What is an Electrophysiology (EP) Study? Its Importance in Diagnosing Heart Diseases

Cardiology | by Dr. Rakesh Sarkar | Published on 27/09/2024

An Electrophysiology Study, popularly known as EP Study or Cardiac Electrophysiology Test, is a series of tests that examine the heart’s electrical activity.

An EP Study can find the cause of irregular heart rhythms (arrhythmias). The heart specialists can also perform this test to predict the risk of sudden cardiac death.

The heart’s electrical system releases signals that control the timing of the heartbeats. During EP Study, an electrophysiologist can create a detailed map of how these signals move between each heartbeat. If you are recommended an EP study, please reach out to our top cardiologists at BM Birla Heart Hospital in Kolkata for expert care and guidance.

Importance of EP Study in Diagnosing Heart Diseases

When other tests such as a standard EKG, Holter monitor, event recorder, stress test, echocardiogram, or angiogram fail to provide enough information to the cardiologist about your abnormal heart rhythm, an EP Study is done.

A cardiologist can have detailed information about your abnormal heart rhythm with the help of an EP Study. This test can help in understanding:

• The type of arrhythmia you have
• The causes of abnormal heart rhythm
• Which part of the heart causes the problem
• What has been making you feel dizzy or fainting
• How well are ongoing medications working for you
• Which treatment options would be best for your problem
• Will you be at risk for a sudden cardiac death in the future

Looking at your condition, the cardiologist can use the information from the EP Study to treat your problem with a catheter immediately. The doctor can do this through the catheter already placed in your heart for the EP Study test. 

How Does an EP Study Work?

cThen, the cardiologist uses this information to decide whether to use medications to treat the problem or perform an ablation. Precisely, an EP Study test can:

• Evaluate its symptoms
• Find the causes of arrhythmia
• Determine the need for treatment
• Assess the effectiveness of the medications
• Predict the risk of future like sudden cardiac death

An EP Study can also help the cardiologist decide if a pacemaker or implantable cardioverter defibrillator is needed for you.

How is an EP Study Done?

An EP Study test is done in a hospital set-up. An intravenous line is inserted in your hand or arm, and sticky patches with sensors on them (electrodes) are placed on your chest to monitor the heartbeat during the test.

The groin area is shaved from where the catheter will be placed for surgery. Before the surgery starts, the anaesthetist gives you general anaesthesia to relax you.

When you are under the influence of anaesthesia, catheters are placed in three or more areas of your heart. Then the doctor inserts a tube into a blood vessel and guides it to the heart using moving X-ray images.

The sensor on the tip of the catheter sends electrical signals to your heart and records its action. Other tests can be done during the EP Study Test, depending on your symptoms and overall health. 

The EP Study trained cardiologist can do the following while performing an EP Study:

1. Measure electric signals in the different parts of the heart.
2. Send signals that increase or decrease your heartbeat.
3. Give you certain medicines to check how they affect your heartbeat.
4. Map the heart to determine the best area to do cardiac ablation to treat an irregular heartbeat.

An EP Study is a painless procedure, but you may feel uneasiness and discomfort as your heartbeat speeds up and slows down during the test. Tell your doctor if you feel any pain.

The entire process takes around 1-4 hours. In case of cardiac ablation, it may last longer. After the test, you are shifted to the recovery room where you rest for 5-6 hours, while the doctor monitors your heartbeat and blood pressure to check for complications. If everything is normal, you will be discharged within a few hours. 

Patients are usually advised to relax for a day and avoid driving or engaging in physical activity.

Usually, the result is shared with you at a follow-up appointment with the doctor. Then treatment is recommended to you based on your test results.

Treatment Options After an EP Study

Based on the results, your doctor may recommend specific treatment options such as catheter ablation, medications, surgery or Implantable Cardiovascular Defibrillator (ICD) or a pacemaker, whichever suits you the best.

Finding a trained EP Study specialist is tough. There are very few cardiologists who specialise in this. However at the BM Birla Heart Research Centre we don’t leave any treatment option unexplored when it comes to caring for your heart. With the latest infrastructure to support the findings we have the skills and expertise of one of the best EP Study specialists in India, at our hospital in Kolkata. To set up a consultation feel free to reach out to us.

FAQ

Is an EP study painful?

An EP Study test is a painless procedure, done under the influence of general anaesthesia. However, you may feel uneasiness and discomfort.

What are the risks associated with an EP study?

Just like any other test, an EP Study test may have some risks, including bleeding or infection, damage to the valves or blood vessels, blood clots in the legs or lungs, heart attack, stroke and death in rare cases.

What is the cost of an EP study?

The cost of an EP Study in India ranges between 70,000 to 1,50,000. However, various factors affect the overall cost such as the hospital’s location, doctor’s experience, and the complexity of the procedure.