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An electrophysiology study (EPS) is an invasive procedure that tests the heart's electrical system. The procedure is performed in an area similar to a cardiac catheterization lab. In fact, in some ways, the procedure itself is similar to a cardiac catheterization.
A small, plastic catheter (tube) is inserted through the groin (or arm, in some cases) and is threaded up into the heart, using a special type of x-ray, called fluoroscopy, to guide the catheter. Once in the heart, electrical signals are sent through the catheter to the heart tissue to disconnect the electrical pathway between the upper chambers (atria) and lower chambers (ventricles) of the heart (AV nodal ablation).
The results of the study will help the physician determine further therapeutic measures, such as the insertion of a pacemaker or defibrillator, adding or changing medications, additional ablation procedures, or other treatments.
A pacemaker is a small device that is powered by a battery. It helps the heart beat in a regular rhythm. Pacemakers are needed for those who have a slow and irregular heart rhythm.
A pacemaker can pace the heart's upper chambers (the atria), the lower chambers (the ventricles), or both chambers at times. Pacemakers may also be used to prevent the heart from going into fast, irregular rhythms.
A pacemaker is about the size of a small matchbox. The pacemaker "can" or container has two parts inside:
The pacemaker is implanted under the skin and fatty tissue near the collarbone. If only one lead is needed, it is placed in the lower-right chamber (the right ventricle). If two leads are needed, the other lead is placed in the upper-right chamber (the right atrium). The leads are then attached to the pacemaker (pulse generator).
Once the pacemaker is implanted, the leads carry signals back from the heart. The pulse generator "reads" these signals. When the heart rate is too slow, it sends an impulse to the heart to help beat in a regular rhythm.
An Implantable Cardioverter Defibrillator is a small, battery powered, pager size device.
Once the ICD is implanted, the leads monitor the heart rate. If the ICD detects ventricular tachycardia or fibrillation, it sends out a controlled burst of impulses (called "overdrive" pacing). If this does not work, the ICD "shocks" the heart to restore a normal rhythm. ICDs are very effective in preventing sudden deaths and can be implanted with a low rate of complications.
The defibrillator is implanted beneath the skin, near the collarbone. The leads are placed inside the heart or on its surface and are attached to the defibrillator.