Catheter ablation and electrophysiologic study (EPI) of the heart

Electrophysiologic study (EPI) and catheter ablation is an invasive study of the electrical activity and conduction of the heart, which provides very important data on its condition and possible arrhythmias during treatment in Germany.

The test is done by inserting electrode catheters that measure electrical activity. Access to the heart is through a blood vessel. The catheter enters the vessel, in most cases through a vein, sometimes through an artery, with minimal piercing of the skin over the relevant blood vessel.

How is catheter ablation performed?

Catheter ablation is done by an electrophysiologist (specially trained cardiologist). This procedure uses thin, flexible wires called electrode catheters. These are inserted through a blood vessel in the groin or neck, and are gently advanced to the heart. The doctor uses these catheters to find and remove problem cells.

Catheter ablation: preparation for the procedure

Shortly before the procedure, you will be told to stop or change your heart rhythm medicine. Follow the instructions your doctor gives you.

Other than that, by all means:

• Tell your doctor about any over-the-counter medications you are taking including: herbs, vitamins, and supplements. Be sure to mention insulin or blood thinners. Tell your doctor if you are allergic to a medicine.
• Have your routine blood tests and a heart exam ordered by your doctor just before ablation.
• Do not eat or drink after 11:00 p.m. the night before your procedure unless otherwise instructed by your doctor.

Catheter ablation: risks and complications

The risk of catheter ablation is relatively low compared to the benefit you receive .

Possible risks and complications include:

• bleeding or swelling;
• сгусblood clots, which are blood clots;
• slow heart rate (bradycardia) — then a permanent pacemaker will be needed;
• perforation of a heart muscle, blood vessel or lung — then emergency surgery may be required;
• heart failure (very rare);
• stroke or heart attack (very rare);
• fatal outcome (extremely rare).

What to expect with catheter ablation?

In most cases, catheter ablation is performed in the electrophysiology laboratory. The procedure usually takes 2 to 4 hours; sometimes longer. You will receive anesthesia and pain medication to rest or sleep during the procedure.

At the beginning of the

First, the skin in the groin or neck is washed. If there is hair, it is removed where the catheter will be inserted. All medicines and fluids are given intravenously. To keep the catheter insertion site sterile (germ-free), your entire body will be covered with a sheet. Only the area where the catheters will be inserted will be left open.

Catheter insertion

The skin through which the catheters will be inserted is treated with an anesthetic. This is done so that you do not feel any pain. Then, using a small needle, a puncture is made in a vein or artery and the catheters are inserted further into the heart under X-ray control.

The study consists of two parts:

1. Recording of the heart’s electrical signals to assess its electrical function. As the catheters pass over the inner surface of the heart, the electrical signals are recorded and analyzed. If these data are insufficient for diagnosis, programmed stimulation is continued.
2. Programmed stimulation. The stimulation system for the EFI machine sends harmless electrical impulses that cause the heart to contract. This can cause the heart to feel like it is «racing». This stimulation is designed to cause tachycardia (heartbeat) and find the focus of the extrasystole. The tachycardia is analyzed and diagnosed. Sometimes medications with a very short duration of action are used to induce arrhythmias that go away by the end of the procedure.

If the location and origin of the arrhythmia is established, catheter ablation can be performed in one or two stages. It is a modern approach to treating arrhythmias using a catheter whose tip has a radio-emitting area. Radiofrequency energy is not felt by patients and does not cause complaints. It does not cause localized dysfunction of the tissues it touches.

The result! Cauterization leads to cessation of arrhythmia and prevents its subsequent occurrence.

After the procedure is over.

The catheters are removed and, to prevent bleeding, a tight dressing is applied.

Then, you will lie in bed for four to six hours.

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