Intracardiac electrophysiology study (EPS) is a test to look at how well the heart’s electrical signals are working. It is used to check for abnormal heartbeats or heart rhythms.
Electrophysiology study - intracardiac; EPS - intracardiac
How the test is performed
Wire electrodes are placed in the heart to do this test. These electrodes measure electrical activity in the heart.
The procedure is done in a hospital laboratory. The staff will include a cardiologist, technicians, and nurses.
To have this study:
Your groin area will be cleaned and numbing medicine (anesthetic) will be applied to the skin.
The cardiologist will then place several IVs (called sheaths) into the groin or neck area. Once these IVs are in place, wires or electrodes can be passed through the sheaths into your body.
The doctor uses moving x-ray images to guide the catheter into the heart and place the electrodes in the right places.
The electrodes pick up the heart's electrical signals.
Electrical signals from the electrodes may be used to make the heart skip beats or produce an abnormal heart rhythm. This can help the doctor understand more about what is causing the abnormal heart rhythm or where in the heart it is starting.
You may also be given medicines may also be used for the same purpose.
Other procedures that may also be done during the test:
Procedure to destroy small areas in your heart that may be causing your heart rhythm problems (called catheter ablation)
How to prepare for the test
You will be told not to eat or drink for 6 - 8 hours before the test.
You will wear a hospital gown. You must sign a consent form for the procedure.
Your health care provider will tell you ahead of time if you need to make changes to the medicines you regularly take. Do not stop taking or change any medicines without first talking to your health care provider.
In most cases, you will be given medicine to help you feel calm before the procedure. The study can last from 1 hour up to several hours. You may not be able to drive home afterward so you should plan for someone to drive you.
How the test will feel
You will be awake during the test. You may feel some discomfort when the IV is placed into your arm. You may also feel some pressure at the site when the catheter is inserted. You may feel your heart skipping beats or racing at times.
Why the test is performed
Your doctor may order this test if you have signs of an abnormal heart rhythm (arrhythmia).
You may need to have other tests before this study is done.
An EPS may be done to:
Test the function of your heart's electrical system
Pinpoint a known abnormal heart rhythm (arrhythmia) that is starting in the heart, and help decide the best therapy for it
Determine whether you are at risk for future heart events, especially sudden cardiac death
See if medicine is controlling an abnormal heart rhythm
Miller JM, Zipes DP. Diagnosis of cardiac arrhythmias. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 36.
Olgin JE. Approach to the patient with suspected arrhythmia. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 62.
Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.