Electrophysiological Study

Electrophysiological Study (EPS) and Ablation
It is the English abbreviation of a diagnostic examination called Electrophysiological Study (EPS). This examination is used in the diagnosis of diseases of the rhythm and conduction system of the heart. This procedure may be needed in the investigation of palpitations, in the investigation of fainting, or in the investigation of a number of disorders detected in other heart examinations. The basis of the procedure is to record electrical signals from inside the heart via electrode catheters sent to the heart via peripheral vascular access and to reveal rhythm disturbances that may cause palpitations by giving small electrical impulses. The procedure is roughly similar to coronary angiography from the outside.
In this procedure, too, the process begins when the patient is hospitalized, prepared for the procedure, and brought to the laboratory where procedures such as angiography are performed. Usually, the veins passing through the groin are entered under local anesthesia (the artery in the same region is entered in the angiography), through the provided pathways, and special materials (electrode catheter) with wires and covered with plastic-like materials are inserted into the heart. Then, recordings are taken from various points in the heart by means of these catheters, small electrical impulses are given to try to reveal the rhythm disorder that may cause the patient to complain of palpitation. The whole process takes 20-30 minutes. General anesthesia is not administered during the procedure. Only the groin area is anesthetized locally. However, in very excited and anxious patients, additional intravenous sedative drugs can be given. The patient is sent to the bed after the procedure. The patient can go home in 4 to 6 hours. As a result of the procedure, it is determined whether a rhythm disorder is the cause of the patient's palpitations, what type of rhythm disorder is present, whether the cause of fainting is due to the heart, and whether there is a vital disorder in the electrical system of the heart.

Ablation, from its Latin origin, means to destroy, to eliminate. The method we use in heart diseases (cardiology) is usually in the form of catheter ablation. An area of 3-5 mm that causes arrhythmia in the heart is destroyed by means of special catheters (ablation catheters), which are in a slightly different form of the electrode catheters that we described in the EPS section. In this way, for example, a cause that leads to palpitation (tachycardia) is eliminated, and the patient gets rid of the palpitation problem. This treatment method is performed either as a continuation of the process called EPS or in the second session. The process takes place just like in EPS. The patient cannot distinguish the difference between the two procedures. In ablation alone, the procedure may take 1-2 hours. The reason for this is that finding the small focus causing tachycardia and destroying it takes longer than EPS. The destruction is done either by heating with radiofrequency current or by freezing with cryothermal energy. The procedure is basically painless. Therefore, it is not performed under general anesthesia. Intravenous sedatives are used more often because of the length of the procedure and the pain in some parts of the heart. After the procedure, the patient can get rid of palpitations completely (without medication). In this respect, this treatment method is one of the rare treatment methods that can provide full curing (full recovery) among many treatment methods in many diseases.
What is the potential risk of the procedure?
There are risks such as swelling in the groin, bruising, pain in the chest, permanent pacemaker implantation. Their incidence is less than 1%. However, it should not be forgotten that all invasive procedures are recommended and performed in cases where the risk of disease is much higher than the risk of the procedure.