What is the EP (Electrophysiological) study?

An electrophysiology study (EP study) is a test used to evaluate the heart's electrical system and detect abnormal heart rhythms. The heart's electrical system produces signals (impulses) that control the timing of the heartbeat. During an EP study, doctors can create a very detailed view of how these signals move between each heartbeat by inserting a thin tube called a catheter into a blood vessel. For this process, a specialised electrode catheter is designed that sends electrical signals to the heart and records its electrical activity.

Purpose of the EP Study

  • Diagnose the source of arrhythmia symptoms
  • Assess the effectiveness of certain medications used to control HRD
  • Predict the risk of a future cardiac event (sudden cardiac arrest)
  • Check the need for artificial pacemakers or other treatments (such as radiofrequency ablation)
  • To find the source of a heart rhythm problem perform an ablation once the source is identified
  • To see how well medications given to treat a rhythm problem are working
Electrophysiologicals are used to treat two distinct forms of arrhythmias:
  • Rapid pulse is known as tachycardia.
  • Sluggish heartbeat is known as bradycardia.

Some people need a biventricular Electrophysiological, also known as bivent Electrophysiological. If you have serious heart disease, you may need a bivent.

EP Study Procedure

There are several types of Electrophysiologicals used to diagnose a variety of conditions.

Before the procedure

  • Do not eat or drink for six to eight hours before the test.
  • A blood test may be required on the day of the procedure.
  • An intravenous (IV) line will be placed.
  • Monitors (electrodes) are placed on the chest to monitor heartbeat during the test.
  • A patient should tell the doctor about any medications, including over-the-counter medications, herbs, and vitamins.

During the procedure

  • Medications may be given to relax during the test.
  • A patient may be asked to remove their dentures.
  • A blood pressure cuff will be placed on the arm.
  • EKG patches are placed on the skin to monitor the heartbeat.
  • An oxygen probe will be placed on the finger to monitor the breathing
  • The procedure sites will be prepped and cleaned with an antibacterial agent.
  • Stimulating catheters (thin tubes) will be used to stimulate the heart.
  • Be sure to report any pain or discomfort.
  • The patient is required to remain still during the procedure.

After the procedure

  • The IV and heart monitor will be removed.
  • The patient will be asked to rest in bed for four to six hours.
  • Limit the activity for the first 24 hours.
  • Do not strain or lift heavy objects for the first week
  • Keep the incision area clean and dry.
  • The patient is monitored for bleeding or swelling at the puncture site.
  • After the effect of the sedative wears off, the doctor will review the test results.
  • It is normal to have some soreness for a few days where the catheters were inserted.

Risks and Complications of EP Study

Like many tests and procedures, an EP study involves risks. Some can be serious. Possible risks of the EP study include:

  • Bleeding or infection
  • Bleeding around the heart
  • Damage to the valves or blood vessels in the heart
  • Damage to the electrical system of the heart
  • Blood clots in the legs or lungs
  • Heart attack
  • Career

Procedures to Treat Irregular Heartbeat

Cardiac ablation

This procedure involves the use of special catheters with electrodes placed inside the heart to measure its electrical activity and burn off abnormal areas that cause heart arrhythmias.

Hybrid (convergent) ablation

Hybrid (convergent) ablation is a new, minimally invasive approach that combines the best techniques of the electrophysiologist and cardiac surgeon to help restore normal heart rhythm in patients with atrial fibrillation.


These are small devices that are usually placed in the chest or abdomen to help regulate abnormal heart rhythms with wires passed through the veins to the heart.

Cardiac Resynchronization Therapy (CRT)

Also called biventricular pacing, it is used to relieve arrhythmia symptoms and is recommended for patients with irregular heart rhythms caused by heart failure, heart damage, medications, or age.

The MAZE procedure

The MAZE procedure: is a surgical procedure that is usually performed in conjunction with open chest surgery, such as coronary artery bypass grafting, mitral valve repair, and/or valve replacement.

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Frequently Asked Questions

1. How long will an electrophysiology study last?

An electrophysiology study can take between three and six hours, depending on the condition.

2. What can an E.P study diagnose?

An E.p study may stimulate and diagnose abnormal heart rhythms and identify areas in the heart that are affected.

3. How long does it take to recover after an EP study?

After the EP study, the patient is moved to a recovery area to rest for four to six hours.

4. Is E.P Study painful?

Although an EP study is painless, a person may feel uneasy when the pulse speeds up or slows down.

5. Is E.P study an outpatient procedure?

An EP study can be on an outpatient depending on the condition of the patient. If there are any abnormalities one may need to stay in the hospital for treatment.

6. What is the cost of EP study in India?

It ranges from Rs 500 to Rs 1000 depending on the city and the hospital.