Treatment of Arrhythmia

Treatment for arrhythmia depends on the cause and the severity. Options for treatment include changes in lifestyle, medication, a minimally invasive surgical procedures such as catheter ablation and Minimaze, and the implanting of electronic devices such as a pacemaker or an implanted cardioverter defibrillator.

Major surgery is rarely used to treat abnormal heart rhythm. Surgery is more often used to treat other heart problems such as coronary artery disease. Treating other heart problems may reduce the likelihood of abnormal heart rhythm.

First, a specialist must diagnose the nature of the arrhythmia.

Electrophysiology Study

An electrophysiology study—also called an electrophysiology evaluation, an intracardiac electrophysiology study, or EPS—is a test to determine the characteristics, or specific features, of an abnormal heart rhythm. The test is done to see if an arrhythmia does indeed exist or to find the exact location of a known arrhythmia. The test helps your doctor decide the best treatment for an arrhythmia.

Who conducts the test?
A team of medical professionals led by an electrophysiologist conducts the test. An electrophysiologist is a specially trained cardiologist (heart doctor) who studies and treats the heart's electrical system.

How is an electrophysiology study done?
The electrophysiologist makes a small incision in a vein in your neck, arm, or groin and inserts a thin, flexible tube called a catheter. Using real-time x-rays displayed on a video screen for guidance, the electrophysiologist threads the catheter into the heart. Inside the catheter are electrodes connected to a monitor. The electrodes measure electrical activity in the heart, which helps the electrophysiologist establish the severity of the problem and determine the best course for treatment.

You wear a hospital gown. You are given a local anesthetic in the area where the catheter is inserted and, if you need it, medication to help you relax. Most people remain awake during the procedure. If you do fall asleep, the staff will monitor you constantly.

Is it safe?
The procedure is safe and painless. When the electrophysiologist tests the electrical activity of the heart, you may feel your heart beating faster or stronger. You will have to lie still for between 1 and 2 hours, which may make you feel a little uncomfortable and stiff.

As with many nonsurgical procedures, however, complications sometimes do occur. If you have any questions about potential risks or your condition, ask your doctor.

How should I prepare for this test?
You should not eat or drink anything after midnight the night before the procedure. Be sure to tell your doctor what medications you are taking, whether you have any allergies, and if you are pregnant. You should prepare for an overnight stay in the hospital and arrange for someone to take you home.

What can I expect after the test?
You may feel tenderness or soreness at the site where the catheter was inserted. Let your doctor or the nurses know if you are experiencing any bleeding, pain or unusual symptoms.

After returning home, limit your activity for several days. Avoid physical exertion and strain. Follow your doctor’s instructions. If you notice any complications or unusual symptoms—such as bleeding that does not stop, fever, rapid heartbeat, chest pain, dizziness, or shortness of breath—call your doctor immediately.