Pediatric Electrophysiology Study with Cardiac Ablation

What is an electrophysiology (EP) study?

An EP study is an invasive test that examines the electrical activity of the heart in detail. EP studies are performed by specialists called cardiac electrophysiologists. An EP study allows the electrophysiologist to see the electrical activity in the heart and treat heart problems called cardiac arrhythmias. EP studies and interventions take place in a specialized procedure room called an electrophysiology lab.

At Children’s Hospital Colorado, our pediatric electrophysiologists have specialized training in caring for kids and patients with pediatric heart conditions. The experts in our Pediatric and Adult Congenital Electrophysiology Program perform EP studies for patients from birth all the way through adulthood for patients with adult congenital heart disease.

What happens during an EP study?

An EP study is almost always done under sedation or general anesthesia. During an EP study, long, soft, flexible tubes called catheters are put into the large blood vessels (almost always the veins) in the leg or neck and moved through these vessels into the heart. These tools can sense the activity of the heart’s electrical system to help find out where an arrhythmia or abnormal electrical pathway is coming from in the heart.

The electrophysiologist uses X-rays to direct the catheter through the veins. During the test, the doctor uses an electrocardiogram (EKG) to monitor the heart’s response to electrical pulses that come through the catheter.

What is a cardiac ablation?

Ablation is a procedure designed to find the source of an arrhythmia or the problem with the heart’s electrical system. Once the doctor has information about the heart’s electrical system, they will put heat (radiofrequency) or cold (cryotherapy) energy on the heart muscle cells to safely remove the arrhythmia source.

About cardiac radiofrequency (RF) ablations

Radiofrequency energy (heat) is the most common type of energy used during an ablation. It is safe to use in even the smallest patients and allows the doctor to target very specific parts of the heart muscle. An ablation using radiofrequency energy is commonly abbreviated as an RF ablation.

About cardiac cryotherapy (cryo) ablations

Cryotherapy means that the arrhythmia source is frozen rather than heated. It is used whenever the arrhythmia is near the normal electrical system and allows the doctor to ablate safely. In a cryo ablation, the energy is delivered more slowly. This allows the normal electrical system to be monitored during the ablation.

What to expect during an EP study and cardiac ablation

How to get ready for an EP study and ablation

Use the following tips for how to prepare and what to bring to an EP study at Children’s Colorado:

• Bring any questions you may have.

Young children

• Pack your child’s favorite toys and books to help comfort them before and after the procedure.

Adolescents, teens and adults

• Plan to bring music or electronics before the procedure.
• Wear comfortable clothes the day of the procedure.
• Don’t wear makeup to your procedure.
• You may want to trim/shave your groin area before the procedure. The adhesive drape and bandages used for the procedure can pull on hair when they get taken off. If you don’t trim or shave the area, the staff may have to do it before the procedure.

The day of the EP study

Follow instructions of when to stop eating and drinking. If you don’t follow these rules the procedure may be canceled.

After you have checked in and been shown to your room, a member of our care team will explain the planned tests and EP procedures. You may need to give a urine sample. Feel free to ask questions at any time. Child life specialists will be available to help children and teens understand and prepare for the procedure.

The anesthesiologist may order medicine for you to take before going to the Electrophysiology Lab. This medicine will help you relax and may make you sleepy. You’ll get sedation from our pediatric cardiac anesthesia team for this procedure. You won’t remember the procedure.

During the procedure, the EP Lab team will update your family hourly on a designated phone number. During the procedure your family may go to the cafeteria or coffee shop, but they need to stay in the hospital.

How long does an EP study with ablation take?

An EP study and ablation can take 2 to 3 hours, depending on what procedures or corrections the patient needs.

What to expect after an EP study and cardiac ablation

• When the procedure is finished, the electrophysiologist who did the procedure will discuss the results with your family in the waiting room.
• You will be taken back to Cardiac Pre-Post Unit where a nurse will monitor your recovery. The nurse will get your family from the waiting room when you are settled.
• You’ll need to lie flat on your back for 2 to 4 hours to help the blood vessels heal.
• You’ll be able to have clear liquids like water, lemon-lime soda or apple juice once you are awake.
• The nurse caring for you will give you instructions on how to take care of yourself, discuss the signs and symptoms of potential complications, go over any medications, tell you when you can go back to your normal activity and when to come back for a follow-up visit.

Why choose us for your EP procedure

Pediatric expertise

At Children’s Colorado’s nationally ranked Heart Institute, we specialize in treating heart conditions that are present at birth or in childhood, which are different than acquired heart diseases in adults. Specialists in our Pediatric and Adult Congenital Electrophysiology Program have additional training in pediatrics and experience in the latest pediatric research and techniques. This means our patients receive care that is uniquely designed for the needs of kids’ hearts as they grow – and well into adulthood.

Dedicated pediatric cardiac anesthesiologists

Children born with heart disease like congenital heart defects often have complex anatomy and physiology, which is why our cardiac team includes specialists in pediatric cardiac anesthesiology. Our specially trained anesthesiologists are dedicated to ensuring each patient is comfortable and safe during tests and procedures.

Our team has extensive training in pediatrics, cardiology and anesthesiology, and is also trained in adult cardiac anesthesia to care for patients with adult congenital heart disease.

Lower radiation

Our pediatric electrophysiologists are committed to using the lowest amount of fluoroscopy (video X-ray) possible. Most of our procedures use no fluoroscopy. This makes getting an EP procedure here safer, because there is less radiation exposure during treatment.

Vast experience

Our volumes and success rates put the Heart Institute among the best of the best.

See why our outcomes make us one of the top heart hospitals

Learn more about our Pediatric and Adult Congenital Electrophysiology Program.