Cardiac (Heart) Electrophysiology Tests

Electrophysiology tests allow UPMC experts to provide advanced care for abnormal heart rhythms called arrhythmias and other potentially serious disorders affecting your heartbeat. Cardiac electrophysiology examines and treats your heart's electrical system, which controls your heart rhythm.

At UPMC, our heart patients benefit from the depth and breadth of our electrophysiologists' experience. Our physicians perform thousands of cardiac electrophysiology tests each year using the latest diagnostic technology and techniques.

What Are Cardiac Electrophysiology Tests?

Electrophysiology is a branch of cardiology that deals with conditions related to the electrical activity of your heart and abnormal heartbeats called arrhythmias. Cardiac electrophysiology tests map the electrical activity within your heart.

What does an electrophysiologist do?

Electrophysiologists diagnose and treat patients with atrial fibrillation and other heart rhythm disorders.

Types of Cardiac Electrophysiology Tests

If your doctor thinks that you may have an abnormal heart rhythm, he or she may refer you to an electrophysiology specialist. To find out what is causing your heart rhythm disorder, your electrophysiologist will use the latest diagnostic technology, including:

Noninvasive cardiac electrophysiology tests

• Electrocardiogram (ECG or EKG) — An electrocardiogram (ECG or EKG) is a simple and fast outpatient diagnostic procedure used to evaluate the electrical system of the heart.
• Holter monitor — A Holter monitor is a wearable device that performs an electrocardiogram (EKG) while you go about your daily activities.
• Event recorder — An event recorder is a smaller wearable recording device that only records when symptoms occur.
• Echocardiogram — An echocardiogram is a widely used test that creates moving images of your heart.

Invasive cardiac electrophysiology tests

• Electrophysiology (EP) study — An EP study is a series of invasive tests performed using catheters that are inserted through an incision in your groin and guided to your heart. The catheters monitor and record how your heart responds to different signals and map your heart’s electrical signals.

Conditions we diagnose with cardiac electrophysiology tests

Heart conditions we diagnose include:

• Irregular heart rates.
• Cardiac syncope (fainting).
• Cardiac arrest.
• Other heart rhythm disorders.

Why Would I Need Cardiac Electrophysiology Tests?

Cardiac electrophysiology tests are performed when your symptoms or diagnostic tests suggest there is a problem with the rhythm of your heartbeat. The problem can be a fast heart rhythm (tachycardia), a slow heart rhythm (bradycardia), or another type of arrhythmia (irregular heart rhythm).

Who’s a candidate for cardiac electrophysiology tests?

You may be a candidate for cardiac electrophysiology tests if you have symptoms of a heart rhythm disorder, including:

• Heart palpitations, including a feeling of racing or fluttering inside your chest.
• Chest pain.
• Shortness of breath.
• Fatigue.
• Reduced ability to exercise.
• Lightheadedness.
• Dizziness.
• Confusion.

What Should I Expect From Cardiac Electrophysiology Tests?

Before: How to prepare for cardiac electrophysiology tests

Depending on the type of test you are having, your cardiac electrophysiology test may be performed in a specialized cardiac electrophysiology laboratory, at your doctor’s office, or while you go about your everyday activities.

If you are having an invasive EP study, your doctor will let you know if you will be sent home the same day or if you will need to stay in the hospital overnight. You should arrange for someone to drive you home after you are discharged.

How long does cardiac electrophysiology testing take?

If you are having an EP study, your test could take several hours. ECG is a fast, painless outpatient test that takes a few minutes. Cardiac electrophysiology testing with wearable devices such as Holter monitors and event recorders can take place over 24 hours or longer as you go about your daily activities.

Are you awake during electrophysiology tests?

Whether you are awake depends on the type of test you are having. You will be awake for ECG, Holter monitor, and event recorder testing. You may be asleep or lightly sedated for an EP study.

During your cardiac electrophysiology testing

ECG

An ECG may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your doctor's practices. Generally, an ECG follows this process:

• You will be asked to remove any jewelry or other objects that may interfere with the procedure.
• You will be asked to remove clothing from the waist up. The technician will ensure your privacy by covering you with a sheet or gown and exposing only the necessary skin.
• You will lie flat on a table or bed for the procedure. It will be important for you to lie still and not talk during the procedure, so as not to interfere with the test.
• If your chest, arms, or legs are very hairy, the technician may shave or clip small patches of hair, as needed, so that the electrodes will stick closely to the skin.
• Electrodes will be attached to your chest, arms, and legs.
• The lead wires will be attached to the skin electrodes.
• After the leads are attached, the technician may key in identifying information about you into the machine's computer.
• The ECG will be started. It will take only a short time for the test to be completed.
• After the test is completed, the technician will disconnect the leads and remove the electrodes from your skin.

Holter monitor or event recorder

The procedure to place a Holter monitor or event recorder requires no preparation and is usually done on an outpatient basis. However, you will need to shower beforehand since you cannot get the device wet after it is on.

It takes about 10-20 minutes to place a Holter monitor or event recorder. This appointment includes putting on the electrodes, testing the monitor, and giving you instructions on how to care for the device.

EP study

An electrophysiologist will perform your EP study in an electrophysiology lab. After you receive a local anesthetic to numb the insertion site and a sedative to help you relax, one or more catheters will be inserted into your veins – usually through your groin – and passed through your body to your heart.

The catheters record the electrical activity of your heart, such as when and where electrical signals begin and how often they are sent.

What is an electrophysiology procedure?

Electrophysiology procedures may be performed during your EP study, including:

• Electrical cardioversion or defibrillation, which delivers an electric shock to your heart to help adjust your heart rhythm.
• Cardiac ablation, which destroys abnormal electrical pathways or cells in your heart.
• Pacemaker implant, which corrects slow heart rhythms.
• Defibrillator implant, which corrects fast heart rhythms.

Is an electrophysiology test painful?

You should not feel any pain during an electrophysiology test. If you had an invasive EP study, you may feel mild soreness at the site of your incision after your procedure.

Recovery after cardiac electrophysiology testing

You should be able to resume your normal diet and activities, unless your doctor instructs you differently. Generally, there is no special care following an ECG, Holter monitor, or event recorder test.

However, if you had an invasive EP study, you should talk to your doctor about when you can resume normal activities or return to work. You may be instructed not to drive for a certain amount of time after the procedure, so you should arrange for someone to drive you home. It also is very important that you see your doctor for follow-up visits as recommended.

When to call your doctor about cardiac electrophysiology test complications

Notify your doctor if you develop any signs or symptoms you had prior to the test (for example, chest pain, shortness of breath, dizziness, or fainting).

If you had an EP study, you should call your doctor if you are experiencing any unusual symptoms, including:

• Pain, redness, bleeding, drainage, or increased swelling at the insertion site.
• Burning or pain in your chest.
• Rapid or pounding heartbeat.
• Severe pain, coldness, numbness, or discoloration in the limb where the catheter was inserted.
• A fever of more than 100.0°F.
• New or increasing shortness of breath.
• Difficulty breathing.
• Difficulty swallowing, throat pain, or bloody cough.
• Redness or rash on your chest or back.

If any of these symptoms are severe, you should call 911 immediately.

Why Choose UPMC for Cardiac Electrophysiology Tests?

Our physicians perform thousands of cardiac electrophysiology tests each year using the latest diagnostic technology and techniques. And, if you require additional cardiovascular care, the specialists at UPMC have the skills and experience needed to perform advanced cardiovascular procedures and offer you the latest treatment options.

By UPMC Editorial Staff. Last reviewed on 2024-10-01.