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Ask An Expert

Abnormal Heart Rhythm Tests

Richard H. Hongo

Richard H. Hongo, M.D., FACC

Mills-Peninsula Medical Center

California Pacific Medical Center

Sutter Pacific Medical Foundation

Question:

My primary care doctor detected an abnormal heart rhythm and wants me to see a cardiologist for an EP study. What is an EP study and what is the cardiologist looking for?

Answer:

The EP study is an "electrophysiology study." This is a test that is performed by a cardiac electrophysiologist (a specialized cardiologist that is trained to manage heart rhythm problems). The EP study is a comprehensive test designed to assess many aspects of the electrical system in the heart.

The study looks at the health of the sinus node, the "natural pacemaker" in the heart that keeps the pulse even. It also measures the time it takes for a normal electrical impulse to travel from the sinus node to the atrio-ventricular node (the node that links the upper chambers to the lower chambers), and then thru the His-Purkinje system (a very fast electrical network that synchronizes the contraction of the lower chambers). It also looks to see if you have potential short circuits in the electrical system that can be the cause of fast, uncomfortable, sometimes unstable heart rhythms.

The EP study is extremely low risk, but still is an invasive procedure performed in the electrophysiology lab in the hospital. This test is not recommended for everyone who has an abnormal heart rhythm. There are other non-invasive tests that can be performed before going on to an EP study, and a consultation with a cardiologist or a cardiac electrophysiologist is important to figure out how best to evaluate an abnormal heart rhythm.

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