Electrophysiological Study And Transcatheter Ablation

Electrophysiological study can be useful in evaluating a broad spectrum of cardiac arrhythmias. It can help to: (1) assess the function of the sinus and atrioventricular nodes and the His-Purkinje system; (2) determine the characteristics of reentry tachycardias; (3) assess the efficacy of antiarrhythmic drugs and devices; (4) map the location of arrhythmogenic foci; and (5) identify sites for ablation to treat many forms of tachycardia.

Electrophysiological study is performed in a laboratory similar to a heart catheterization laboratory. The minimum equipment requirement for a comprehensive electrophysiological study includes: (1) a radiographic table; (2) a fluoroscopy unit; (3) a physiological recording and analysis system; (4) a programmable stimulator; (5) a radiofrequency generator; (6) a variety of electrode catheters and introducers; (7) the capability of providing a sterile working environment; and (8) resuscitation equipment.

An electrophysiological study is usually performed on fasting and antiarrhythmic drug-free patients in a sterilized fashion using various degrees of conscious sedation (fentanyl and midazolam), depending on the specific procedure. Vascular accesses are obtained percutaneously through the femoral, subclavian, or internal jugular veins using 1% lidocaine for local

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