How To Prepare continued...
Tell your doctors all the medicines, vitamins, supplements, and herbal remedies you take. Some of these can increase the risk of bleeding or interact with anesthesia. Your doctor will tell you which medicines to take or stop before your procedure.
If you take blood-thinning medicine, be sure to talk to your doctor. He or she will tell you if you should stop taking this medicine before your procedure. Make sure that you understand exactly what your doctor wants you to do.
Arrange for someone to take you home after the test. You may not have to stay in the hospital overnight.
Do not eat or drink (except for a small amount of water) for a few hours before the test. If you are taking any medicines, ask your doctor if you should take them on the day of the test.
Take off any nail polish. That will make it easier for doctors and nurses to check the circulation in your fingers and toes.
Be sure to empty your bladder completely just before the test.
How It Is Done
Before the test
- You will be taken to a special room, sometimes called a "cath lab" or "EP lab." You will lie on a flat table under a large X-ray machine.
- Several small electrodes will be attached to your legs and arms with a special paste or gel. These are connected to an EKG machine that keeps track of the electrical activity of your heart during the test.
- A device called a pulse oximeter may be clipped to your finger. It measures oxygen levels in your blood and monitors your pulse.
- An intravenous (IV) needle will be inserted into a vein in one of your arms to give you fluids or medicine during the test. You will receive a medicine to help you relax (sedative) through the IV line. You may be awake during the test. But even if you are awake, the sedative may make you so sleepy that you may not remember much afterward.
- The area where the doctor plans to insert a catheter will be shaved and cleaned. Sterile towels will be draped over your body, except for the area over the insertion site.
During the test
- A local anesthetic is injected into your skin at the insertion site. This is usually in your groin or neck. When the area is numb, a doctor called a cardiac electrophysiologist inserts the catheter through your skin and into the vein.
- The doctor slowly pushes the catheter through the vein toward your heart. Usually several catheters are used. The doctor moves the catheters into various places in the heart. An X-ray screen shows the doctor where to move the catheters.
- The catheters have small electrical conductors, called electrodes, on their ends. The doctor can use the electrodes to do what is called "pacing." This means sending electrical currents through the catheters to try to re-create your heart rhythm problem. This can tell the doctor what kind of problem you have and the best way to treat it. The doctor may also use pacing to see how well medicines work to control your problem.
- The electrodes also send information to a computer. The computer uses the information to draw pictures of your heart and its rhythm problems. This is called "mapping," because the pictures serve as maps that show the doctor exactly where the problem areas are.
- The doctor might give you a medicine through the IV that starts the abnormal heart rhythm. You might feel your heart beat fast and strong. You might also feel jittery or very nervous.
- A nurse or other assistant will help you stay comfortable and resist the urge to move around. Be careful not to touch the sheets or reach for your groin area, because you could contaminate the sterile areas and increase the risk of infection.
- Your doctor may let you watch the video monitor so you can see the pictures of your heart.
- The test takes 1 to 3 hours. Catheter ablation usually takes 2 to 6 hours. In rare cases, it can take longer.
After the test
- It's important to prevent bleeding after the catheter is pulled out. For example, if the catheter was in your groin, firm pressure will be applied there for about 10 minutes to stop the bleeding. Then a pressure dressing will be placed over the area.
- You will be taken to an observation room where nurses and others can watch your heart rate, blood pressure, and temperature for a while and check for signs of bleeding. They also watch the pulse, color, and temperature of the arm or leg in which the catheter was placed.
- If the catheter was in your groin, you may have to lie in bed with your leg extended for as long as 4 to 12 hours. This allows your blood vessels to heal.
- If you have an EP study only, you will likely go home the same day. If you also have ablation or other treatment, you may stay overnight in the hospital. How long you stay in the hospital depends on the type of ablation you have. Most people can go back to work and their normal routine in 1 or 2 days.