Electrophysiology Study/Standard Catheter Ablation

(Also called: EP study)

Purpose

An electrophysiology (EP) study is a specialized procedure that allows your doctor to have a detailed look at the electrical signals in your heart and pinpoint the source of any abnormal rhythms (arrhythmias).

Standard catheter ablation is a related procedure for correcting abnormal electrical signals in your heart. Small amounts of radiofrequency current are used to burn out the tiny areas of cells to prevent these abnormal signals from occurring. Standard ablation procedures are often performed immediately after an EP study.

EP studies are recommended for people with certain types of heart arrhythmias. Soft catheters with tiny electrodes at their tips are threaded in a thin tube through blood vessels in your groin up to your heart. They are used to “map out” and evaluate the electrical activity inside your heart.

Catheter ablation is done much the same way as an EP study. The tip of the ablation catheter is directed towards the precise locations in your heart causing the abnormal rhythms. Once properly positioned, it delivers a small radiofrequency electrical current to burn out tiny areas.

Conditions that are treated with standard ablation include:

  • Typical atrial flutter
  • AV re-entrant tachycardia (AVRT)/Wolff-Parkinson-White (WPW) Syndrome
  • AV node re-entrant tachycardia

Description

  1. Before you go for the procedure, the doctor will come and meet with you in the Day Unit; this will be a good time to ask any final questions you may have.
  2. Your study will take place in the EP Lab at the Heart Institute. You will be given a medication to help you to relax and you may fall asleep. If you continue to feel anxious even after receiving the medication, let the nurse know.
  3. There will be a team of doctors, nurses and lab technologists involved in your procedure. All staff will be wearing gowns and special lead aprons. 
  4. The doctor will use a local anesthetic to numb the area around your groin. Once the area is numb, small thin tubes will be inserted. 
  5. Anywhere from three to five soft catheters will be inserted through the tubes and threaded up into your heart. A small amount of X-ray imaging will be used to help with proper placement of the catheters.
  6. When the catheters are properly positioned, various recordings and measurements of the electrical activity in your heart will start.  An EP study usually lasts anywhere from 15 to 45 minutes.
  7. Catheter ablation may take an extra one to four hours. During the ablation, an extra soft catheter is inserted. The tip of the catheter is directed towards the areas in your heart that are firing off the irregular impulses. Once properly positioned, it delivers a small radiofrequency (RF) electrical current to burn out the tiny areas. 
  8. Once the ablation is completed, there is further observation and testing to ensure that the arrhythmia has been eliminated. When the team is satisfied with the results, the catheters are removed. Once you are ready, you will be brought back to the day unit to complete your recovery. 

After Your Procedure

  1. You will be on bed rest for up to six hours after your procedure.  
  2. You may eat and drink as normal upon return to your unit. Your nurse will assist you as needed
  3. Before you are discharged, your doctor and nurse will go over the procedure with you. The nurse will tell you how to take care of your insertion site and will discuss any changes in your medications.

Patient instructions

Follow the Patient Responsibility Checklist to help you prepare for your procedure.

Although your procedure will take anywhere from one to four hours, expect to be at the Heart Institute for a total of eight to 12 hours. You will be in the Day Unit until you are ready to go to the EP Lab.

Make transportation arrangements: you cannot drive yourself home. 

For your first night home from the hospital, arrange for someone to stay overnight with you.

Only one relative or friend will be able to sit with you while you are waiting because space is limited. During your procedure, your relative/friend will be able to wait in the lounge area. When your procedure is completed, the staff will notify your designated contact person. Visiting hours in the Day Unit are from 8:00 a.m. to 8:00 p.m.