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INTRODUCTION

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Electrophysiology studies (EPS) are minimally invasive procedures utilized for the diagnosis and treatment of cardiac arrhythmias. They can provide insight into the mechanism underlying a variety of cardiac rhythm disorders when noninvasive testing has been unrevealing. Abnormal findings often require device therapy or catheter ablation, which is often performed concomitantly with EPS.

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INVASIVE DIAGNOSTIC ELECTROPHYSIOLOGY STUDIES

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Indications for Electrophysiology Studies

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EPS is recommended when noninvasive investigations do not establish the diagnosis or etiology of arrhythmia and the result will change the clinical management. It is indicated for the evaluation of documented or suspected bradyarrhythmias and tachyarrhythmias, syncope, and for risk stratification of individuals at risk for sudden cardiac death (SCD).1,2 Indications are summarized in Table 82–1. EPS should not be performed in patients who have unstable angina, systemic infection, deep venous thrombosis in the region of venous access, or any other medical condition where the risks of the procedure outweigh the benefits derived from testing.

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Table Graphic Jump Location
TABLE 82–1.Indications for Diagnostic Electrophysiology Studies
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Technique

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EPS involves placing catheters equipped with electrodes at the tip in the right atrium, right ventricle, coronary sinus, and the His region. AV node activity cannot be measured directly, and therefore, His region conduction, which is ...

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