ELECTROPHYSIOLOGICAL EXPLORATION

Electrophysiological exploration makes it possible to search for or specify the mechanism of an abnormality in conduction or heart rhythm. 

It requires the placement of one or more probes, after one or more punctures of veins in the groin crease, and sometimes in the neck or chest. These probes, or catheters, will record the electrical activity of certain parts of the heart, in order to look for any abnormalities. This examination can be carried out to determine whether a pacemaker or defibrillator should be inserted, it can precede a possible endocavitary ablation or be proposed to test the effectiveness of certain drugs.

How does this examination take place?

The EEP (electrophysiological exploration) takes place in a healthcare facility. It can be performed under local anesthesia, but is more generally performed under general anesthesia for the comfort of the patient and the practitioner.

It is necessary to be fasting, lying on an X-ray examination table located in a specially equipped room.

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A venipuncture is performed, usually in the groin crease. Cardiac pacing tests are usually performed as well as pharmacological tests (injection of medication). The examination itself is not painful. In order to avoid significant bleeding, a pressure bandage can be left in place several hours after removal of the catheters. Depending on the diameter of the catheter used, you will have to lie down for a longer or shorter period of time. During this period, it will be necessary not to mobilize the punctured leg.

Like any medical examination involving an invasive procedure, the EEP is not without risks, but it provides information that cannot be obtained by any other means with equivalent certainty. Complications are rare, around 1.5%:

• Haematoma at the puncture site is the most common complication as well as vagal discomfort at the time of punctures.

• Other complications are rare: significant hematoma that may require surgical treatment, thrombosis of the vein (phlebitis), pericardial effusion (accumulation of blood around the heart) by cardiac perforation, pneumothorax (breakage of the pulmonary pleura), pulmonary embolism.

• Exceptionally, a stroke, a complete atrioventricular block that can lead to the placement of a pacemaker, or death have been described. All precautions are taken before, during and after the examination to limit the risks as much as possible.

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What benefits can be expected from this electrophysiological exploration?

​Analyzing the evidence gathered during the examination helps to better understand your disease and better judge treatment options. Depending on the observations collected, the proposed treatments may be, depending on the case: therapeutic abstention, medication, implantation of a pacemaker, implantation of a defibrillator, intracardiac ablation, surgery. The resumption of professional activities or daily life will be explained to you in a way adapted to your personal situation by the doctor and his team.