Electrophysiological study

An electrophysiological study, also called “EPS,” is performed in a specialized electrophysiology lab, either on an outpatient basis or sometimes with a short hospital stay, depending on the medical context. It is carried out under the supervision of a specialized team including an interventional rhythmologist, an anesthesiologist, a radiology technician, and a nurse.

1. Preparation

• The patient is positioned lying on the examination table in a room equipped with real-time fluoroscopy (X-rays).
• All monitoring devices are set up (ECG, blood pressure, pulse oximetry).
• Light sedation is administered intravenously to ensure comfort and relaxation throughout the procedure.
• Local anesthesia is applied to the groin area to allow catheter insertion.

2. Catheter insertion

• A femoral vein puncture is performed to insert a sheath (small vascular introducer).
• Several flexible catheters are inserted and guided to the right heart (atria and right ventricle) via the vena cava.
• Positioning is done under radiological guidance and is painless thanks to local anesthesia.

3. Electrophysiological analysis

• Recording of intracardiac electrical signals to analyze conduction times between the heart chambers.
• Programmed stimulation of the heart at different rates to induce and map arrhythmias.
• Identification of reentry circuits or abnormal conduction areas in cases of supraventricular or ventricular tachycardia.

In many cases, if an abnormality is identified and precisely located, a radiofrequency ablation can be performed immediately to definitively treat the rhythm disorder, depending on the patient’s clinical condition and the established protocol.

Electrophysiological study is a minimally invasive and well-tolerated procedure. However, like any medical act, it carries certain potential risks, which the medical team ensures are minimized at every stage.

• Main risk: a bruise at the puncture site in the groin area. This is generally harmless and disappears within a few days without specific treatment.
• Rare risks: rhythm disturbances triggered during the examination (corrected immediately), reaction to sedation, and, in very rare and specific cases, internal bleeding or perforation.

After the examination:

• The patient remains under observation for a few hours in a recovery room.
• Manual or mechanical compression is applied to the puncture site to prevent any bleeding.
• Going home the same day is possible in most cases.
• Relative rest for 24 hours is recommended to avoid strain on the puncture site.
• Normal daily activities can usually be resumed the following day, unless otherwise advised by the cardiologist.

Electrophysiological study is a highly specialized diagnostic tool, offering significant clinical benefits in the management of cardiac arrhythmias.

• Precise diagnosis: it provides an electrophysiological mapping of the heart, specifying the nature, location, and severity of the rhythm disorder.
• Possibility of immediate treatment: when an arrhythmic circuit is identified, a radiofrequency ablation can often be performed during the same session, reducing the need for additional procedures.
• Safe procedure: performed in a controlled environment, under sedation, with strict safety measures and specialized staff.
• Patient comfort: light sedation and local anesthesia ensure an almost painless experience, while allowing for a quick recovery.
• Quick return home: most patients leave the center the same day, with clear instructions for follow-up at home.

EPS is fully part of interventional electrophysiology expertise. It enables a precise, personalized, and action-oriented approach for patients experiencing unexplained symptoms, palpitations, or syncope. Thanks to this technique, the electrophysiologists of the Rythmopôle group are able to identify the exact mechanisms of a rhythm disorder and propose a targeted and long-lasting treatment, in line with the highest medical standards.