Catheter Electrophysiology Procedure (C2004)

Name of the Procedure:

• Common Name: Electrophysiology Catheter Procedure
• Technical Terms: EP Deflectable Tip Catheter (Octapolar Small Anatomy Models Only)

Summary

An electrophysiology catheter procedure involves using a specialized catheter to diagnose and treat abnormal heart rhythms (arrhythmias). The catheter is introduced into the heart through a blood vessel, allowing doctors to map and modify the electrical pathways of the heart.

Purpose

The procedure addresses conditions such as arrhythmias, including atrial fibrillation and ventricular tachycardia. The primary goal is to identify and correct electrical abnormalities within the heart, thereby restoring a normal heart rhythm and preventing future episodes.

Indications

This procedure is recommended for patients experiencing:

• Syncope (fainting) with suspected arrhythmias
• Palpitations or irregular heartbeats
• Documented arrhythmias not responsive to medication
• Risk of sudden cardiac arrest due to severe arrhythmias

Preparation

Patients may be required to:

• Fast for 6-12 hours prior to the procedure
• Adjust or temporarily discontinue certain medications, such as blood thinners
• Undergo pre-procedure tests like ECG, echocardiogram, or blood tests

Procedure Description

1. Preparation: The patient is prepped and possibly given a sedative or general anesthesia.
2. Catheter Insertion: A small incision is made, typically near the groin or neck, to access a blood vessel.
3. Navigation and Mapping: The catheter is threaded through the blood vessels to the heart under fluoroscopic guidance.
4. Testing: Electrical signals are measured, and abnormal pathways are identified.
5. Ablation (if needed): If a problematic area is found, it can be modified using radiofrequency energy to ablate (destroy) it.
6. Completion: The catheter is removed, and the insertion site is bandaged.

Tools and Equipment: EP deflectable tip catheter (octapolar small anatomy models), fluoroscope, mapping system.

Anesthesia: Local anesthesia with sedation or general anesthesia.

Duration

The procedure typically takes 2 to 4 hours, depending on the complexity of the arrhythmia and the number of sites that need mapping or ablation.

Setting

The procedure is usually performed in a hospital's electrophysiology lab.

Personnel

• Cardiologist specializing in electrophysiology
• Nurses
• Anesthesiologist (if general anesthesia is used)
• Radiology technician

Risks and Complications

• Common: Bleeding, infection, pain at the insertion site.
• Rare: Heart perforation, blood clots, stroke, or completely unintended damage to normal heart tissue.

Benefits

• Restoration of normal heart rhythm
• Reduction or elimination of symptoms like palpitations
• Decreased risk of stroke and sudden cardiac arrest
• Improved quality of life

Benefits are often realized immediately post-procedure but can take a few days to be fully appreciated.

Recovery

• Most patients can go home the same day or the next morning
• Avoid heavy lifting and strenuous activities for a few days
• Follow-up appointments are crucial for monitoring recovery and effectiveness
• Possible medication adjustments

Alternatives

• Medication: Antiarrhythmic drugs to control the heart rhythm
• Other procedures: Cardioversion or implantable devices like pacemakers or defibrillators
• Pros and Cons: While medications are non-invasive, they may have side effects and might not be effective long-term. Implantable devices are more invasive but provide continuous management.

Patient Experience

During the procedure, the patient might feel slight pressure or mild discomfort at the catheter insertion site. Post-procedure, some soreness or bruising is common, but pain management is provided. Most patients resume normal activities within a few days, with specific instructions given for optimal recovery.