An electrophysiology [ee-lek-troh-fiz-ee-AW-loh-jee] (EP) study is a test that shows how electrical signals move in pathways through your heart. When the pathway is normal, your heartbeat is regular. When these signals are abnormal, your heartbeat is irregular. An irregular heartbeat is called an arrhythmia

Symptoms of an arrhythmia are different in each person. They can include:

• A pounding or rapid heartbeat
• A heart “flutter”
• Dizziness or feeling lightheaded
• Shortness of breath

Radiofrequency Ablation

(RFA) is a procedure used to treat some types of arrhythmias. In most cases, it can be done at the same time as an EP study. Your doctor will tell you if you are scheduled for an EP study, an RFA procedure, or both.

What happens during an EP study or RFA?

An EP study usually takes 1 to 2 hours. An RFA procedure also takes 1 to 2 hours, so it may take 3 to 4 hours to do both procedures.

• You’ll receive medicine through the IV to make you feel relaxed and drowsy. Depending on your type of heart rhythm problem, you might receive general anesthesia so you sleep through the procedure. If you are awake, your doctor may give you directions during the procedure.
• A sheath (a short plastic tube) will be placed into a blood vessel. You may feel some pressure at first.
• The doctor moves one or more catheters (thin, flexible tubes) through a vein to your heart. You won’t feel this.

During an EP study:

The doctor uses special x-rays to see the catheter as it moves through your body. The catheters contain tiny sensors that measure how electrical signals move through your heart.

The doctor may use a catheter to cause a temporary irregular heartbeat. Measurements taken during this period help your doctor understand what is causing the irregular heartbeat, where it starts, and the best way to treat it.

During RFA:

A catheter is placed next to the heart cells that are creating the abnormal electrical signals. The tip of the catheter sends RF energy to destroy the abnormal cells in that area. This can bring the heart back to a normal rhythm.

You may feel uncomfortable when the energy is used on the cells in your heart. Tell the doctor if you’re feeling pain. You may need more pain medicine.

What happens after an EP study or RFA?

After EP or RFA:

• You’ll be moved to a recovery unit where nurses can monitor your heart rate and rhythm.
• Your leg may be numb or weak for a short while. Special steps will be taken to make sure you’re safe when you first get up.
• You will need to lie quietly for 2 to 4 hours. (You may be asked to use a bedpan rather than getting up to use the toilet at first).
• Your doctor will decide when it’s okay for you to leave the hospital. Some patients can go home at the end of the day. Other patients will need to stay overnight.
• During the first 48 hours, you may have a heartbeat that feels strange at times. This is common as your heart muscle adjusts to the new heartbeat.