WHAT IS A CARDIAC ELECTROPHYSIOLOGY STUDY?

Electricity usually flows through the heart in a pattern that is ordered and regular. The hearts electrical system initiates contractions or beats of the heart muscle. In a healthy heart, the electrical conduction system produces a carefully coordinated contraction which enables the heart to function effectively as a pump and push blood around the body.

Disruption of one or more of the electrical pathways may result in a cardiac arrhythmia or unusual rhythm which will usually cause the heart to beat less effectively. Whilst some arrhythmias are life threatening, others can be relatively harmless. Symptoms of arrhythmia may include persistent palpitations (being aware of your heart beating), dizziness, chest pain, shortness of breath and fainting.

The precise nature and, if possible, cause of the abnormal heart rhythm need to be diagnosed to enable ion of the best treatment. As part of his or her investigation into possible cardiac arrhythmia, your doctor may recommend a test called Cardiac electrophysiology study (EPS). Whilst EPS is a fairly invasive test and involves catheters being placed in the heart, it allows your specialist to collect and analyse very precise data about your hearts electrical activity.

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WHY IS IT DONE?

Non-invasive tests such as an electrocardiogram (ECG) or a holter monitor (which involves monitoring the hearts rhythm over a 24-48 hour period) can provide valuable information about the hearts electrical activity. However, in many cases the arrhythmia is intermittent and therefore not captured at the time of these tests, which only record activity during the time of attachment.

During an EPS study the specialist can actually provoke an arrhythmia which then enables extremely precise data to be collected about the abnormal electrical activity. It is also possible that the problem can be treated during the study. This may involve using a special catheter to ablate or remove a cluster of cells responsible for the abnormal rhythm. It may also be necessary to implant an artificial pacemaker to initiate and control the heart rhythm or a defibrillator which can interrupt any life threatening arrhythmias.

HOW DO I CHOOSE A SPECIALIST?

Your GP or cardiologist will be able to recommend and refer you to a cardiologist who has completed further specialist training in EPS.

You may be happy to accept their advice and recommendation, or you may like to investigate your choices; either option is safe and valid. In Australia each medical speciality has a governing body to which the consultants belong. You can access the Royal Australasian College of Surgeons via their website www.surgeons.org. This is a very informative website.

The list of questions below may help you to better understand your care, and if necessary decide on a particular doctor. Practical issues you may also like to consider are what hospital(s) does a particular doctor operate from, and what are their fees. (If you need more information about fee setting and gap arrangements, please refer to our brochure “what you should know before going into hospital”, which is also available on the HCF website).

To access a list of Cardiologists who participate in HCF’s Medicover no gap arrangement

Call HCF Member Services on 13 13 34

Visit one of HCF’s customer service branches

Access HCF’s website at www.hcf.com.au/members/findahealthprofessional/findadoctor

Please note: Participation in HCF’s no gap initiatives is at the doctor’s discretion. HCF does not guarantee that every medical service provided by these doctors will be a no gap service. Some doctors who participate in the HCF Medicover no gap arrangement have chosen not to be listed on the HCF website. Patients are encouraged to confirm with their doctor whether they will support HCF’s no gap initiatives for their treatment.

WHAT SHOULD I ASK MY SPECIALIST?

Do not be afraid to ask your doctor questions about the procedure and any side effects which can occur. It is your right to know all the relevant information, as this is part of informed clinical and financial consent. Your doctor will ask you to sign a consent form.

If your doctor recommends a pacemaker or defibrillator, will this be done at the same time or on a separate occasion?

In addition to what the procedure involves, you should also ask about

Preparation

Follow up appointments, jot down any questions or concerns you may have so that you can ask your doctor at your next appointment

Aftercare

Most medication should be continued as usual, but some may interfere with the operation. Your doctor will inform you of the medication you should stop. As a guide, the following medication may require special instruction:

Aspirin (or any related products)

Blood thinners (Warfarin, heparin.)

Arthritis medication

Pain medication

Anti-inflammatory medication

Insulin

Don’t forget to mention any homeopathic or herbal remedies you are taking, as these can have interactions and side effects too.

WHERE IS IT DONE?

An electrophysiology study is done in a special room called an EPS laboratory, located within a hospital. It is often attached to the cardiac ward or coronary care unit. The average length of stay is approximately 2 days.

HOW LONG IS THE PROCEDURE?

Although a simple cardiac electrophysiology test generally takes anywhere from 20 minutes to one hour, it may take longer if other procedures are required for treatment of the problem.

WHO IS INVOLVED?

The people involved in the procedure are

The Electrophysiologist, your Specialist doctor

Anaesthetist : they give you medication that makes you relaxed and sleepy and look after you whilst the procedure is being carried out

Nurses for the procedure and recovery

Technicians who assist with the machinery

HOW DO I PREPARE FOR AN ELECTROPHYSIOLOGY STUDY?

In most cases you will be required to fast for six to eight hours prior to the procedure.

Your doctor will have his/her own specific preparation requirements, including possibly stopping some of your medication. These instructions should be strictly followed or the procedure may not be able to go ahead, or be unsatisfactory and have to be repeated later.

WHAT DO I TAKE WITH ME TO THE HOSPITAL?

Do not bring any valuables with you

Leave all jewellery at home, a wedding ring is acceptable

Wear comfortable clothing

Bring any medication that you would usually take during the day, under most circumstances you may still be able to take these

Bring any relevant x-rays or scans