Overview of the procedure.
Electrophysiology techniques that seek to define the mechanism of cardiac arrhythmias (heart rate accelerations) are entered into clinical practice for decades.
These techniques involve recording local electrical activation of the heart as it exists at a time, or after trying to trigger arrhythmias by specific methods.
For this study are used specific devices (catheters / electrophysiology probes), which are electrically conductive wires covered by an insulating material.
The catheters are inserted under local anesthesia by venous or arterial puncture in the thigh or / and neck in large pots and are placed inside the heart by control stations (radiological). The number of probes and vascular access type (thigh or neck, in the arteries or veins) is different depending on the characteristics of your arrhythmia and will be stated before the intervention.
Achieving electrophysiological investigation
There is no general anesthesia; therefore you can always communicate with the doctors. You can receive, depending on the clinical situation, a soothing treatment (sedative). Intervention can take more than 1 hour.
During the proceedings are made evidence of cardiac stimulation that you will feel in the form of acceleration of the rhythm and can trigger arrhythmias to clarify the mechanism of rhythm disorder that is your affection.
To avoid local bleeding a tourniquet is made for a few minutes at the puncture level after the end of the intervention; If the point was arterial the tourniquet may take longer and a pressure dressing may be left in place.
After completing the procedure you must stay lengthened without moving your feet a specified amount of time and it depends on the vessel (artery or vein) through which access was made.
Electrophysiological invasion is safe?
Most complications are benign: hematoma at the puncture location, feeling embarrassed at advancing probes to the heart (mention that once located here in the heart, you will not feel this sensation) and transient arrhythmias induced by the doctor.
Some complications are more severe, but rare, occurring in 1.5% of cases in experienced centers:
– Pericardial effusion (in the part covering the heart) and by sometimes perforation of some cardiac veins for example coronary sinus or thoracic (in the part covering the lungs) which may require emergency evacuation;
– Installation of AV block requiring a pacemaker and which occur in special situations (you will be informed if it is your case);
– Heart rhythm disorders may require external cardioversion by applying an electric shock after anesthesia (asleep for a few minutes); some of these arrhythmias may cause transient loss of consciousness;
– Thromboembolic accidents by formation of blood clots which can migrate into circulation;
– Vascular injuries at the access places and may require local surgical treatment and sometimes thrombosis (sealing vessels which made access to the formation of local blood clots);
– Injury to some heart valves;
– Arterial hypotension reflex with dizziness and feeling sick;
– Damage to the nerves that are close to the access vessels;
– Infection of the puncture place or endocarditis (heart);
The risk of serious development, leading to death is low, on the order of less than 1/1000 in large series. You must know that interventional team will take all precautions to limit to the maximum these risks.
What benefits you can expect from an electrophysiological investigation.
The decision of this procedure was taken considering that the noninvasive tests that have been conducted are not sufficient to specify the manner of producing of your arrhythmia and therefore the best treatment for it.
In some cases (and if it is your case this will be explained to you) even without arrhythmias felt your heart disease may expose you to the risk of subsequently developing a severe arrhythmia that you could possibly put your life in danger.
Depending on the results of the investigation, we will explain the modalities of the best treatment that can be: administration of the selected antiarrhythmic medicines, curative procedures of arrhythmia by applying radiofrequency currents, or implantation of antiarrhythmic devices such as pacemakers.