143:
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requiring removal using a needle under the breast bone (pericardiocentesis); hematoma at the site(s) of the puncture(s); induction of a dangerous cardiac rhythm requiring an external shock(s); a clot may be dislodged, which may travel to a distant organ and impede blood flow or cause a stroke; myocardial infarction; unanticipated reactions to the medications used during the procedure; damage to the conduction system, requiring a permanent pacemaker; death.
32:
124:
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small pinch at the insertion site. After a short period of general rest, the patient may resume some minor activity such as gentle, short, slow walks after the first 24 hours. If stairs must be climbed, they should be taken one step at a time and very slowly. All vigorous activity must be postponed until approved by a physician.
373:
When the necessary procedures are complete, the catheter is removed. Firm pressure is applied to the site to prevent bleeding. This may be done by hand or with a mechanical device. Other closure techniques include an internal suture and plug. If the femoral artery was used, the patient will probably
332:
The next step is pacing the heart, this means he/she will speed up or slow down the heart by placing the electrode at certain points along the conductive pathways of the heart and control the depolarization rate of the heart. The doctor will pace each chamber of the heart one by one, looking for any
398:
As with any surgical procedure, cardiac catheterizations come with a generic list of possible complications. One of the complications that are sometimes reported involves some temporary nerve involvement. Sometimes a small amount of swelling occurs that can put pressure on nerves in the area of the
407:
More severe but relatively rare complications include: damage or trauma to a blood vessel, which could require repair; infection from the skin puncture or from the catheter itself; cardiac perforation, causing blood to leak into the sac around the heart and compromising the heart's pumping action,
403:
is the most common complication with an incidence ranging between 0.5 and 2.5%. There have been reports of patients feeling like they have hot fluid like blood or urine running down their leg for up to a month or two after the incision has healed. This usually passes with time, but patients should
385:
For patients who had a catheterization at the femoral artery or vein (and even some of those with a radial insertion site), in general recovery is fairly quick, as the only damage is at the insertion site. The patient will probably feel fine within 8 to 12 hours after the procedure, but may feel a
233:
It is important for patients not to eat or drink for up to 12 hours before the procedure. This is to prevent vomiting, which can result in aspiration, and also cause severe bleeding from the insertion site of the catheter. Failure to follow this simple preparation may result in dangerous
316:
Once the catheter is in and all preparations are complete elsewhere in the lab, the EP study begins. The X-ray machine will give the doctor a live view of the heart and the position of the electrodes. He will guide the (steerable) electrodes to the correct position inside the heart. The
333:
abnormalities. Then the electrophysiologist tries to provoke arrhythmias and reproduce any conditions that have resulted in the patient's placement in the study. This is done by injecting electric current into the conductive pathways and into the
341:) to induce arrhythmia (inducibility of VT/VF). If the arrhythmia is reproduced by the drugs (inducible), the electrophysiologist will search out the source of the abnormal electrical activity. The entire procedure can take several hours.
389:
It is also important to note that unless directed by a doctor, some patients should avoid taking blood thinners and foods that contain salicylates, such as cranberry-containing products until the clot has healed (1–2 weeks).
234:
consequences. In general, small amounts of water can be consumed up to 2 hours before the exam. Patients should try to schedule the exam at a time when they will be having symptoms and will not need to drive for 2 to 3 days.
361:) to effectively heat up the abnormal cells, to form scar tissue. This can be painful with pain felt in the heart itself, the neck and shoulder areas. A more recent method of ablation is
317:
electrophysiologist begins by moving the electrodes along the conduction pathways and along the inner walls of the heart, measuring the electrical activity along the way.
221:
that can be induced. EP studies are used to investigate the cause, location of origin, and best treatment for various abnormal heart rhythms, and are often followed by a
142:
254:
to destroy abnormal tissue. A 3D navigation system that tracks and records the catheter position and associated electrical signals may also be used.
42:
505:
Karen.E.Thomas and Peter J. Zimetbaum (2011). "Electrophysiology study: Indications and interpretations". In Gan-Xin Yan; Peter R. Kowey (eds.).
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250:), equipment to record electrical signals from the heart, a stimulator to electrically excite the heart and control the heart rate, and
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246:. These are specially equipped operating rooms that usually contain an X-ray machine capable of acquiring live X-ray video images (a
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If at any step during the EP study the electrophysiologist finds the source of the abnormal electrical activity, they may try to
1231:
821:
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An access site that will allow catheters to be passed to the heart via an artery or vein is shaved and cleaned, usually in the
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Handbook of cardiac electrophysiology : a practical guide to invasive EP studies and catheter ablation
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213:) to assess the conduction system of the heart and to look for additional electrical connections (
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Peter W. Macfarlane; Adriaan van
Oosterom; P. Kligfield; Michiel Janse; J. Camm, eds. (2010).
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304:) are punctured before a guidewire and plastic sheath are inserted into the vessel using the
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be asked to lie flat for several hours (3 to 6) to prevent bleeding or the development of a
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has formed. The patient will be moved to a recovery area where he/she will be monitored.
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This article is about the medical procedure performed on the heart. For other uses, see
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Josephson's clinical cardiac electrophysiology : techniques and interpretations
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378:. Trying to sit up or even lift the head is strongly discouraged until an adequate
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at various places. Last, the electrophysiologist may administer various drugs (
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Electrophysiological
Disorders of the Heart: Expert Consult – Online and Print
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209:. This electrical activity is recorded when the heart is in a normal rhythm (
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509:. Contemporary cardiology. Vol. 34. Hanumana Press. pp. 123–140.
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if you can. Unsourced or poorly sourced material may be challenged and
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462:. Preceded by: Josephson, Mark E. (Fifth ed.). Baltimore, MD.
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tell their doctor if they have these symptoms and if they last.
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is generally inserted to allow medication to be given such as
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the cells that are misfiring. This is done using high-energy
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Doctors conduct an electrophysiology study in the hospital's
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to measure the oxygen saturation of the blood. A peripheral
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198:
16:
Medical test to record electrical activity within the heart
265:. Monitoring equipment is attached including an automated
639:"Cryoablation for the Treatment of Atrial Fibrillation"
568:. Murgatroyd, Francis D. London: ReMEDICA Pub. 2002.
611:
Saksena, Sanjeev; Camm, A. John (12 December 2011).
365:, which is considered less risky and less painful.
242:An EP study is typically performed in an EP lab or
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292:. The blood vessels used to reach the heart (the
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205:to record electrical activity from within the
56:Please review the contents of the article and
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311:
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257:The procedure may be performed awake under
738:Cardiology diagnostic tests and procedures
703:
689:
490:: CS1 maint: location missing publisher (
141:
834:Transcatheter pulmonary valve replacement
549:
532:
424:Electrical conduction system of the heart
877:shunt from heart chamber to blood vessel
663:(2nd ed.). Springer. p. 1146.
319:
977:shunt from blood vessel to blood vessel
1478:
1107:Valve-sparing aortic root replacement
846:enlargement of existing septal defect
684:
841:production of septal defect in heart
171:Electrical activity within the heart
155:Electrophysiological study, EP study
25:
13:
938:transposition of the great vessels
863:creation of septal defect in heart
14:
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1238:Cardiac resynchronization therapy
507:Management of Cardiac Arrhythmias
458:Josephson, Mark E. (2015-08-10).
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30:
1245:Left atrial appendage occlusion
661:Comprehensive Electrocardiology
163:Diagnose abnormal heart rhythms
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228:
58:add the appropriate references
1:
1367:Radionuclide ventriculography
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1352:Myocardial perfusion imaging
617:. Elsevier Health Sciences.
237:
191:minimally invasive procedure
7:
411:
368:
344:
225:during the same procedure.
43:reliable medical references
10:
1522:
959:for univentricular defect
18:
1486:Cardiac electrophysiology
1459:
1438:
1410:
1299:Implantable loop recorder
1267:
1122:
1018:
943:Arterial switch operation
758:
751:
733:Interventional cardiology
723:
627:– via Google Books.
515:10.1007/978-1-60761-161-5
312:EP Study and inducibility
179:cardiac electrophysiology
167:
159:
149:
140:
135:
72:"Electrophysiology study"
49:or relies too heavily on
1378:Coronary catheterization
868:Blalock–Hanlon procedure
829:Mitral valve replacement
812:Aortic valve replacement
1374:Cardiac catheterization
1316:Electrophysiology study
1216:Radiofrequency ablation
1181:Alcohol septal ablation
429:Ventricular tachycardia
326:cardiac catheterization
136:Electrophysiology study
1420:Impedance cardiography
1042:Coronary artery bypass
596:: CS1 maint: others (
329:
219:abnormal heart rhythms
1451:Transcutaneous pacing
1255:Heart transplantation
1176:Ventricular reduction
992:Blalock–Taussig shunt
439:Antiarrhythmic agents
323:
197:introduced through a
1425:Ballistocardiography
982:systemic circulation
339:proarrhythmic agents
300:, and sometimes the
1304:Cardiac stress test
1282:Electrocardiography
1221:Pacemaker insertion
968:Kawashima procedure
932:compound procedures
807:Aortic valve repair
780:Mitral valve repair
306:Seldinger technique
267:blood pressure cuff
263:general anaesthetic
1491:Cardiac procedures
1357:Cardiovascular MRI
1287:Vectorcardiography
1142:Pericardial window
1137:Pericardiocentesis
1078:Drug-eluting stent
907:Rastelli procedure
856:Balloon septostomy
330:
252:ablation equipment
217:), and during any
215:accessory pathways
1501:Electrophysiology
1473:
1472:
1330:Angiocardiography
1276:Electrophysiology
1263:
1262:
1206:Catheter ablation
1189:Conduction system
1114:LeCompte maneuver
1102:Bentall procedure
963:Norwood procedure
953:Senning procedure
948:Mustard procedure
851:Atrial septostomy
802:Valve replacement
670:978-1-84882-047-0
524:978-1-60761-160-8
418:Electrocardiogram
401:Venous thrombosis
355:radio frequencies
259:local anaesthetic
223:catheter ablation
175:
174:
131:
130:
107:
21:Electrophysiology
1513:
1506:Electrodiagnosis
1465:
1464:
1430:Cardiotocography
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1362:Ventriculography
1335:Echocardiography
1326:
1278:
1194:Maze procedure (
1191:
1157:
1133:
1086:
1085:Obstacle removal
1073:Bare-metal stent
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1029:
986:pulmonary artery
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933:
918:pulmonary artery
891:Fontan procedure
886:pulmonary artery
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1402:Phonocardiogram
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1324:Cardiac imaging
1322:
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1171:Septal myectomy
1161:Cardiomyoplasty
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1147:Pericardiectomy
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1118:
1084:
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1019:Cardiac vessels
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1008:Glenn procedure
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743:Cardiac imaging
728:Cardiac surgery
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1234:implantation
1228:implantation
1211:Cryoablation
1052:Off-pump CAB
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770:Valve repair
760:Heart valves
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642:. Retrieved
633:
613:
606:
565:
506:
500:
459:
453:
420:(ECG or EKG)
406:
397:
388:
384:
372:
363:cryoablation
357:(similar to
348:
331:
315:
287:
285:, or drugs.
256:
241:
232:
211:sinus rhythm
186:
182:
176:
168:Test of
113:January 2022
110:
100:
93:
86:
79:
67:
47:verification
40:
1388:Cardiac PET
1131:Pericardium
1095:Atherectomy
1033:Angioplasty
775:Valvulotomy
335:endocardium
261:, or under
248:fluoroscope
229:Preparation
41:needs more
1480:Categories
1383:Cardiac CT
1250:Cardiotomy
1155:Myocardium
923:Sano shunt
713:procedures
711:Tests and
445:References
434:Arrhythmia
399:incision.
359:microwaves
328:laboratory
283:anesthesia
83:newspapers
1496:Catheters
763:and septa
592:cite book
486:cite book
478:938434294
279:sedatives
238:Procedure
195:catheters
1467:Category
1200:minimaze
1196:Cox maze
584:48363139
543:21253086
412:See also
376:hematoma
369:Recovery
345:Ablation
244:cath lab
187:EP study
151:Synonyms
752:Surgery
644:May 23,
534:2218957
294:femoral
189:) is a
183:EP test
181:study (
160:Purpose
97:scholar
62:removed
1439:Pacing
1047:MIDCAB
1038:Bypass
988:shunt
882:atrium
795:mitral
790:aortic
667:
621:
582:
572:
541:
531:
521:
476:
466:
351:ablate
269:and a
203:artery
193:using
99:
92:
85:
78:
70:
1396:sound
1268:Tests
1226:S-ICD
1123:Other
1057:TECAB
902:aorta
717:heart
290:groin
207:heart
104:JSTOR
90:books
1198:and
936:for
665:ISBN
646:2015
619:ISBN
598:link
580:OCLC
570:ISBN
539:PMID
519:ISBN
492:link
474:OCLC
464:ISBN
380:clot
199:vein
76:news
45:for
1345:TEE
1340:TTE
1232:ICD
1027:CHD
999:SVC
984:to
916:to
900:to
884:to
529:PMC
511:doi
296:or
201:or
185:or
1482::
1003:PA
594:}}
590:{{
578:.
551:^
537:.
527:.
517:.
488:}}
484:{{
472:.
308:.
281:,
177:A
64:.
1376:/
1202:)
1040:/
704:e
697:t
690:v
673:.
648:.
600:)
586:.
545:.
513::
494:)
480:.
115:)
111:(
101:·
94:·
87:·
80:·
54:.
23:.
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