Invasive cardiac electrophysiology studies
- Munther K Homoud, MD
Munther K Homoud, MD
- Associate Professor of Medicine
- Tufts University School of Medicine
Invasive cardiac electrophysiology (EP) is a collection of clinical techniques for the investigation and treatment of cardiac rhythm disorders [1,2]. These techniques permit a detailed analysis of the mechanism(s) underlying the cardiac arrhythmia, precise location of the site of origin, and, when applicable, definitive treatment via catheter-based ablation techniques. Thus, electrophysiology studies can accomplish the following goals (table 1):
●Definitive diagnosis of an arrhythmia (supraventricular or ventricular tachyarrhythmias or a bradyarrhythmia)
●Establish the etiology for syncope (bradyarrhythmia or tachyarrhythmia), especially in patients with structural heart disease
●Stratification for risk of sudden cardiac death
●Evaluate the feasibility or outcome of nonpharmacologic therapy (eg, transcatheter radiofrequency ablation, antiarrhythmic surgery, or implantable cardioverter/defibrillator therapy)
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- INDICATIONS AND CONTRAINDICATIONS
- PREPROCEDURAL EVALUATION
- PREPARATION AND MONITORING
- VASCULAR ACCESS AND ELECTRODE CATHETER PLACEMENT
- ELECTROCARDIOGRAPHIC AND ELECTROPHYSIOLOGIC RECORDINGS
- Baseline recordings
- AH interval
- His bundle electrogram duration
- HV interval
- VA conduction
- Sinoatrial conduction time (SACT)
- Sinus node recovery time
- PROGRAMMED ELECTRICAL STIMULATION
- MEDICATIONS USED FOR DIAGNOSTIC PURPOSES DURING EPS
- MAPPING AND ABLATION
- COMPLICATIONS OF INVASIVE CARDIAC ELECTROPHYSIOLOGY STUDIES
- Complications with concomitant catheter ablation
- SUMMARY AND RECOMMENDATIONS