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Electrophysiology

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Frequently Asked Questions

Your doctor has recommended that you see an electrophysiologist because you may have experienced symptoms of arrhythmias, or irregular heartbeats. An electrophysiologist can take a closer look at the electrical function of your heart.

We offer many tests and treatments to diagnose and treat irregular heart rhythms. An electrophysiology (EP) study will help your physician determine the treatment option most appropriate for you.

These frequently asked questions can help you prepare for your electrophysiology procedure. If you have questions or concerns that are not answered here, be sure to ask your doctor or nurse.

Cardiac Ablation Electrophysiology Study
Holter Monitor Testing Tilt Table Test
Implantable Carioverter Defibrillator (ICD) Testing Implantable Cardioverter Defibrillator (ICD)

 

Cardiac Ablation

What is cardiac ablation?

  • Cardiac ablation is a procedure done to treat heart arrhythmia, such as rapid or irregular heartbeat. Catheters are passed to the heart through blood vessels. The abnormal electrical conducting area is located, and a form of energy is delivered. The energy may be radiofrequency (heat), laser, or cryo (very cold). The area is scarred, stopping the abnormal path of conduction.
  • The procedure usually takes 2–3 hours, but can last longer.

 
Who does the cardiac ablation?

  • A doctor trained in the electrical system of the heart, a cardiac electrophysiologist, does the procedure.

 
What do I need to do before the test?

  • Your doctor will discuss the risks, benefits, and choices with you and ask you to sign an informed consent giving permission to perform the procedure.
  • Do not eat or drink anything after midnight the night before the test.

 
What happens before the procedure?
You will be brought to a room called the “Electrophysiology Laboratory”. It is sometimes called the EP or EPS Lab.

  • Our staff will help you get on the cushioned procedure table.
  • A registered nurse will monitor you during test.
  • An intravenous line (IV) will be started in your arm.
  • You will be given medicine to help you relax and make you sleepy.
  • You will be attached to monitors that check your heart, blood pressure, and oxygen level during the procedure.
  • A technician may shave and clean your groin, arm, and/or neck.
  • Sterile paper cloths will be placed over your body.
  • Your doctor uses medicine to “numb” the site where catheters (long flexible tubes) will be placed. This is usually your groin or upper thigh area. You may feel a brief stinging feeling at the site.
  • A sheath or tube is put at the puncture site.

 
What happens during the procedure?

  • Your doctor will move several catheters (long flexible wires) slowly toward your heart. You may have catheters placed in both groins. This is decided by your doctor during your procedure.
  • The doctor watches the movement of the catheters using an x-ray type camera above the procedure table.
  • Your doctor will stimulate your heart to locate the abnormal area.
  • You may feel your heart beat differently or faster than usual.
  • A special machine sends energy (heat, laser, or cryo) to the exact area.
  • You may have light-headedness, discomfort or burning in your chest.
  • It is important to lie still and only speak if you are uncomfortable.
  • You will get medicine to make you comfortable and sleepy several times throughout the procedure.
  • Our staff will ask questions about how you feel; your doctor needs this information to complete the procedure.

 
What happens after the procedure?

  • The one or two catheters may be removed in the procedure room or several hours later after blood thinning medication has worn off. After catheter removal, direct pressure will be applied to the area. Sometimes, a sandbag (weight) will also be placed for several hours.
  • If a catheter was placed in your groin, you will need to keep your leg straight and stay on your back for up to 6 hours, with your head slightly raised.
  • You will be brought to a recovery room and monitored often.
  • Notify your nurse if you have any pain, swelling, warmth, or bleeding from any of the insertion sites. Although discomfort is unusual, pain medicine may be given if needed.
  • You may begin to eat and drink after you are fully awake.

 
When will I go home?

  • You may go home the next morning. This will depend on your results. Your doctor will discuss this with you.
  • You will have blood work and you may have an echocardiogram before you go home.

 
What are my discharge instructions after the procedure?

  • You can take off the Band-Aid and shower in 24 hours. Keep the area clean and dry. No sitting in bathtubs or pools for 7 days. You may have mild soreness and black and blue at the groin site.
  • No driving, no strenuous activity or heavy lifting for 24 hours.
  • No unnecessary stair climbing for 24 hours.
  • You may have new medications or changes in your medications. Your doctor and nurse practitioner will discuss this with you.

 
Call your doctor immediately if you have:

  • any fast or irregular heartbeats.
  • fever or chills.
  • bleeding, pain, redness, swelling, warmth or drainage at or near the catheter(s) site.

 
What appointments do I need to make when I get home?
You must have a follow-up appointment in one month with the electrophysiology doctor and you should make an appointment to see your own private doctor after discharge.

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Electrophysiology Study

What are common symptoms of an electrophysiological condition?
Patients who require an electrophysiology study often have symptoms of heart palpitations, shortness of breath, fainting or chest pain.

What is an electrophysiology study?
A cardiac electrophysiology study, also called an EP study, is a test which will give you information about your abnormal heartbeats, or arrhythmias. Your doctor is able to study the electrical action of your heart by having you take this test.

Why am I having an electrophysiology study?
Your doctor may recommend that you have an EP study to:

  • find out the cause of your arrhythmia.
  • locate the exact area in your heart where your arrhythmia starts.
  • see if medicine that you are already taking is working well.
  • help decide what the best treatment is for you, such as medicine, or other EP treatments like an ablation, a pacemaker, or an implantable cardioverter/debribrillator (ICD).

 
Who does the electrophysiology study?
A cardiac electrophysiologist, a doctor trained in the electrical system of the heart, does the procedure with a team of specially trained nurses and technicians.

Where is the electrophysiology study done?
It is done in the Electrophysiology lab at the hospital.

What do I do to prepare for an electrophysiology study?

  • Do not eat or drink anything after midnight the night before the test.
  • Ask your doctor about any changes in your routine medicines.
  • You may be able to take your medicines with a small sip of water. Please speak with your doctor.
  • Your doctor will speak to you about the risks, benefits, and choices, and ask you to sign an informed consent giving permission to perform the procedure.

 
What happens before the test?

  • You will be brought to the EP lab. Our staff will help you get on a cushioned table. EKG pads are placed on your chest. Your heart rate, blood pressure, and oxygen level will be monitored during the test.
  • An intravenous line (IV) will be started in your arm. You will be given medicine to help you relax and make you sleepy several times throughout the test.
  • A technician may shave and clean your groin, or in some cases your arm.
  • Sterile paper cloths will be placed on your body.
  • Your doctor uses medicine to “numb” the groin or arm, where a sheath or tube, is placed. You may feel a brief stinging feeling when this is done.
  • Your doctor will ask you questions during the test. It is important for you to let us know how you are feeling.

 
What happens during the test?

  • The EP study usually takes 2–3 hours, but can last longer.
  • EP catheters are placed through the sheath, and up to the heart. A catheter is a long soft tube. This is done by using an x-ray type of camera that is above you over the test table.
  • The EP catheter has electrodes, which are attached to special monitors.
  • The electrodes “read” the information about your heart’s electrical system, sending it to the monitor. During this “electrical mapping,” your doctor may try to cause your abnormal heart beat to happen with tiny electrical impulses. This is helpful so your doctor can find the exact heart area of your arrhythmia.
  • You may feel your heart beat differently or faster than usual. If you have any discomfort or pain in your chest, neck, jaw, back or arm or if you have any breathing problems or feelings like you are going to faint, please tell us right away.
  • If the abnormal rhythm happens, your doctor may try to stop it with medicine through the IV. Sometimes an electric shock may be needed to bring your heart beat back to normal. You will receive medicine to make you sleepy before this shock.

 
What happens after the test?

  • You will be brought to a recovery room, and moved from a stretcher to a bed. You will be attached to monitors. Your nurse will watch your blood pressure, heart rate, and oxygen level. Your catheter site will be checked for bleeding, swelling, pain, temperature and circulation.
  • The one or two catheters may be taken out right after the test or several hours later after blood thinning medicine has worn off. After the catheter is taken out, a nurse or doctor will put pressure on the site for a few minutes to keep it from bleeding. Then, a small bandage will then be placed.
  • If a catheter was placed in your groin, you will need to keep your leg straight and stay on your back for 3 to 4 hours, with your head slightly raised. The total amount of time you will need to stay in bed will be from 2 to 6 hours. This depends on your own clinical condition. It is important for you not to bend the leg or arm used in the test. Please tell us when you need a bedpan or urinal. You will be helped to sit and walk when your time of bed rest is done.
  • Tell your nurse if you feel any pain including chest pain or tightness, or any feelings of warmth, bleeding, or pain at the catheter site. Even though discomfort is unusual, you will get pain medicine if needed.
  • You will be able to eat and drink soon after you get to the recovery area.
     

 
Is the procedure painful?
The study is relatively painless. You will be numbed with a local anesthetic at the location where the catheter is inserted. As the catheter travels through your body, you should feel no pain.

What happens if an abnormality is discovered?
The results of an electrophysiology study can lead to the insertion of a pacemaker or defibrillator, cardioversion or even cardiac ablation of the part of the heart anatomy that is malfunctioning.

What can I expect during recovery?
After your study, your heart rate, blood pressure, pulse and insertion site will be continuously monitored. You lie flat with your head elevated for a few hours. Upon discharge, your daily activities will be limited for a short period of time. After your electrophysiology study, your doctor will discuss the results with you and determine the next step.

When will I go home?
You may go home the same day as your EP test, or your doctor may want you to stay to do more tests or procedures. Your doctor will discuss this with you. If you do go home the day of your test, you will need to have someone drive you home.

What are my discharge instructions after the test?

  • You can take off the bandage and shower in 24 hours. Keep the area clean and dry. No sitting in bathtubs or pools for 7 days. You may have mild soreness and black and blue at the groin or arm site.
  • No unnecessary stair climbing for 24 hours.
  • No driving, no strenuous activity or heavy lifting for 24 hours.
  • You may have new medicines or changes in your medicines. Your doctor and nurse practitioner will speak to you about this.

 
Call your doctor immediately if you have:

  • any fast or irregular heartbeats.
  • feelings like you are going to faint.
  • fever or chills.
  • bleeding, pain, redness, swelling, warmth or drainage at or near the catheter(s) site.

 
What appointments do I need to make when I get home?
You should make an appointment to see your own private doctor after discharge. You may need to make an appointment with your EP doctor. Please speak to your doctor and nurse practitioner about when you should make your next appointment.


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Holter Monitor Testing

What is a Holter Monitor?
A Holter monitor is a device that records your heart’s electrical activity or electrocardiogram (ECG). Holter monitors give nonstop recordings of your ECG. You wear the Holter monitor in your pocket or in a small pouch over your shoulder for about 24 – 48 hours.

Your doctor may order this test to look at how your heart rate and rhythm may change with different activities and symptoms.

What do I need to do before the test?
You should tell your doctor if you are allergic to any tape or adhesive. You should bathe or shower before the test, since you cannot while you are wearing the monitor. You should wear comfortable clothing for the Holter monitor placement and testing.

What can I expect during the test?
You will be asked to remove clothing from the waist up so that the electrodes or ECG pads can be placed on your chest and stomach area. A technician may need to shave patches of your chest hair so the sticky ECG pads stay in place. The technician will then attach the ECG pads to wires connected to the Holter monitor. You will be shown what to do if an ECG pad becomes loose or falls off.

You will be asked to write in a diary for the next 24 – 48 hours about any activities or symptoms. You should include the date and time when you do an activity or feel symptoms. Some symptoms may be dizziness or a fast heartbeat, or other feelings that you have told your doctor about before the test. You should still write down the time of your activities even if you have no symptoms. Do not shower, take a tub bath, or swim while you are wearing the monitor. You usually are told to go about your normal activities.

What can I expect after the test?
After the 24 – 48 hours, the monitor is taken off, and returned to your doctor. The recordings of your ECG and your diary will be reviewed. Your doctor will discuss with you the test results and your plan of care.

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Implantable Cardioverter Defibrillator (ICD)

What is an Implantable Cardioverter Defibrillator (ICD)?
An Implantable Cardioverter Defibrillator (ICD) is a small battery-run device that is placed under your skin, through a vein, and into your heart chamber. The ICD works in your heart to monitor and treat abnormal heart rhythms.

There are 3 parts of an ICD:

  1. Pulse Generator - The pulse generator is placed through an incision in your chest, usually below your collarbone. It weighs about ⅛ of a pound and is about the size of a pager. It contains a lithium battery and a computer chip that watches, treats, and stores the information about your heart’s electrical activity. It can be programmed by your doctor to treat your heart rhythm problems.
  2. Lead Wire - The lead wire is insulated or coated. It is placed into a heart chamber and connected to the pulse generator. It watches the heart’s electrical activity. It can send electrical signals and/or shocks to the heart if and when needed. One or more lead wires may be placed. Your doctor will decide where your leads will be placed. It depends on your medical condition.
  3. Electrode - The electrode is at the tip of each lead. It is placed on the heart and delivers the electric signals or shocks that are carried by the lead wire. Each lead wire has one electrode at its tip.

 
What can an ICD do?
An ICD can be used to do the following:

  • Monitor how many times your heart beats per minute (heart rate), and your heart rhythm or pattern.
  • Detect a very fast heart rate and help it return to a normal rate by sending mild electrical shocks. This is called cardioversion.
  • Defibrillate or give strong electrical shocks to the heart when your heartbeat is too fast or chaotic.
  • When your heartbeat is in a rhythm called ventricular defibrillation, the ICD can help prevent sudden cardiac death.
  • Detect a slow heart rate and send electrical signals that you will not feel. It helps keep your heart rate normal.
  • Help your heart beat better if you have a condition called “congestive heart failure.” This is when your heart muscle is not as strong as it should be, and you may have signs of too much fluid in your lungs, arms, and legs.

 
Why do I need an ICD?
Your doctor may recommend that you have an ICD placed if you:

  • Had heart attacks in the past that left you with a weakened heart muscle.
  • Survived a cardiac arrest in the past.
  • Had ventricular tachycardia or ventricular fibrillation in the past.
  • Have a low ejection fraction, less than 35%, which means that your heart muscle is not as strong as a normal heart muscle.
  • Have a family history of cardiac arrest or sudden cardiac death.

 
What type of ICD is right for me?
There are different types of ICDs. Your doctor will choose the ICD that will work best for you. This depends on the condition of your heart muscle, your heart rhythm, and your symptoms.

Single chamber ICD - has one lead attached in the right ventricle (RV). If your heart beats too fast, a shock will be delivered to slow it down.

Dual chamber ICD - has leads attached in the right atrium (RA) and right ventricle (RV), to help the heart beat in a normal sequence. It can tell if an abnormal rhythm is coming from the top or the bottom of the heart, to choose the most effective treatment.

Biventricular ICD - has leads attached in the right atrium (RA), right ventricle (RV) and the left ventricle (LV). In addition to controlling your heart rhythm, it also helps the heart beat in a more balanced way. This feature is called cardiac resynchronization therapy (CRT), and may help improve symptoms of severe heart failure.

Who does the ICD implant?
Your ICD is placed by a doctor, called a Cardiac Electrophysiologist, who is trained in the care and treatment of heart rhythm problems or conditions.

Where is the ICD procedure done?
It is done in a special room called the Electrophysiology (EP) lab.

How long does it take?
The ICD procedure usually takes about 1-2 hours.

Will I be awake for the ICD procedure?
When you have an ICD placed, it is considered minor surgery. General anesthesia is not usually given. You will get medicine to help you feel sleepy and relaxed. Other medicine will be given to numb the area at the incision site.

What happens before the procedure?
You should discuss your routine medicines with your doctor to see if any changes should be made before your ICD insertion. Your doctor will discuss the risks, benefits, and choices with you. You then will be asked to sign an informed consent giving permission to have the procedure.

  • Do not eat or drink anything after midnight the night before your surgery. You may take your regular medicines with a small sip of water.
  • You will be brought to the EP lab.
  • Our staff will help you get on the cushioned procedure table.
  • A registered nurse will monitor you during the procedure.
  • A surgical cap will be placed on your head.
  • Small probes will be placed in your nose to give you oxygen.
  • An intravenous line (IV) will be started in your arm.
  • You will be given medicine through the IV to help you relax and make you sleepy. Large pads will be placed on your back, chest and thighs. You will be attached to monitors that check your heart, blood pressure, and oxygen level during the procedure.
  • Your wrists will be loosely restrained so that you do not move your hand toward the sterile field. Sterile paper cloths will be placed over your body. You will receive antibiotics and the skin over the surgical site will be cleaned with a special soap. You may be shaved where the ICD is to be placed, if needed.

 
What happens during the procedure?

  • You will be asked to turn your head to one side. This helps keep germs away from the sterile area.
  • The nurse will clean your chest with soap several times and then cover the area with sterile drapes.
  • Medicine will be given through your IV to help you relax and sleep.
  • You will then receive medicine to numb the area where the cut will be made, (incision site). This may feel like a “pinch” and a brief stinging.

 
After, you should only feel pressure as your doctor makes the incision (cut into your skin) and creates a “pocket” under the skin. This is where the pulse generator or ICD device will be placed. This is usually your left side, just below your collarbone.

  • Under x-ray guidance, your doctor will pass the lead through a vein to the inside of your heart, where the tip of the lead will rest. The lead is tested to make sure it is sensing your heart’s electrical signals. It is then connected to the pulse generator.
  • If you have more than one lead, this process will be repeated.
  • After lead placement, the ICD pocket will be rinsed with an antibiotic solution. You may feel a slight burning at this time.
  • The ICD device is then put under the skin. Your doctor may then test your ICD. This will depend on your medical condition. If this check is done, a special computer sends signals to your ICD. The signals cause your heart to beat fast and abnormal. Your ICD will treat the heartbeat with an electric shock. You will get heavy sedation before this, so you will not feel the shock.

 
What happens after the ICD procedure?
You will begin to wake up after the testing is complete and the doctor is closing the incision with stitches that dissolve. The top of your incision is closed with either small band aids (called steri-strips) or clear medical glue. You will be observed in the EP lab until you are awake, which is usually for about 15 minutes.

You may then be monitored either in the overnight recovery area, called the EDU (Early Discharge Unit) or on the cardiac floor you were on before the procedure. Both areas have specially trained nurses who will monitor you after your ICD procedure.

You will be moved on to a bed and attached to the monitor. Your nurse will check your blood pressure, heart rate, breathing, and bandage site often.

You cannot get out of bed for 4 hours. Please tell us when you need a bedpan or urinal. After 4 hours, you can get out of bed with help from the EDU staff.

You will be able to eat and drink, starting with a small light meal, soon after you get to the recovery area.

If your doctor needs to test the ICD the next day, you may be asked not to eat or drink anything after midnight. This is because the testing, done from outside of your chest, will be done after you are given medicine that makes you sedated.

  • Do not raise your arm (on the same side of the incision) above your head.
  • Do not remove the bandages.
  • You may have bruising and soreness. You can have pain medicine.
  • You will have a chest x-ray, electrocardiogram (EKG), and bloodwork drawn.
     

 
When will I go home?
You may be discharged from the hospital after one or two days. You may even go home the next day. This will depend on your results. Your doctor will discuss this with you.

What are my discharge instructions after the ICD procedure?

  • You must have a follow up appointment with the doctor who implanted your ICD, in 10-14 days after discharge. If you do not receive an appointment before discharge, call the day after you are discharged home to make one.
  • After your first EP office visit, you will return every 3-4 months to evaluate the ICD, or as advised by the EP staff. Some patients can have their ICD checked over the phone. This is something you should ask your doctor.
  • You will receive instructions from the nurse practitioner. Your activities such as work, driving, travel, exercise, sexual activity, hobbies, and recreation will be discussed. Your instructions will be directed just for you, as they can be different from patient to patient.
  • Driving is usually an individual case. Some patients can drive after 6 months. It is something that you need to discuss with your doctor.
  • Do not raise your arm over your shoulder on the side of your incision for 2 weeks. This means that you need to be very careful when you do simple things, like brushing your hair, or putting on a shirt. Your arm should not go above your shoulder. This will help keep the leads in the place as they heal inside the heart.
  • Do not lift anything greater than 10 pounds, such as heavy pocketbooks, suitcases, children, dogs, cats, groceries, and laundry. You should not do any vigorous exercise or contact sports for 12 weeks. Certain activities may be limited even longer, such as golf, tennis, and swimming.
  • No stretching, reaching, pulling, or pushing with the arm that is on the same side as your incision for 2 weeks.
  • Before you leave the hospital, the dressing will be removed. If you have the paper tapes (steri strips) under the dressing, they will stay until you see your doctor.
  • The ICD incision site must be kept dry for one week. You may use a sponge to clean the other areas of your body. You can get the incision wet in the shower after 1 week, but do not soak the incision area under water, like in a tub or pool, for approximately 2-4 weeks.
  • Wear loose clothing around the ICD insertion site for 1-2 weeks.
  • You will receive an ICD identification card which you should carry with you at all times. You will need to show it to all of your other doctors, your dentist, and other health care providers. If you have not received a card or booklet, please ask your doctor or nurse. You may also consider buying a Medic Alert bracelet or necklace.
  • We encourage that one or more of your family members take a CPR class.

 
Notify your doctor immediately if you:

  • Develop any signs of infection, such as, fever, chills, redness, swelling, increased tenderness, warmth or drainage at the surgical incision site.
  • Have hiccups for a long time, fainting, dizziness, lightheadedness, palpitations, chest pain, or the same symptoms that you experienced before the procedure.

 
What about electrical and magnetic interference?

Please see the ICD booklet you were given for the most up-to-date information.

General statements: ICD and electrical and magnetic interference

  • It is safe to use most household appliance that are in good working condition.
  • Some shopping security systems can interfere with your ICD. It is safe to quickly walk through them, but you should not stand near them.
  • Airport security systems or other metal detectors can interfere with the ICD. You should show your ICD identification card to the security officers, and walk around the detectors. You should avoid hand held security wands.
  • You should not have an MRI unless authorized by the physician who implanted your ICD.
  • You should use cell phones on the ear opposite the side of your ICD site.
  • You should not carry mp3 players or cell phones in pockets close to your chest.
  • Working with heavy running engines, such as machinery and trucks, arc-welding, and some other electrical tools can interfere with your ICD. You need to speak with your doctor.

 
What if I receive a shock?

  • Stay calm and sit or lie down. Think about how you feel. If you are not alone, tell the person(s) with you how you feel.
  • When a person with an ICD gets a shock, it feels like a thump in the chest. If someone is touching you when you get the shock, they will not be in danger. They may see your chest and muscles tighten and your body may jump.
  • If you receive 1 shock, and then feel okay after the shock, you must call our electrophysiology (EP) office.
  • If you receive 2 or more shocks, or if you continue to feel bad or you are not awake, you, or someone helping you should call 911 and go to the nearest emergency room.
  • Have a plan about what to do if you receive a shock. Keep your identification card and a list of your medicines with you at all times. Talk to your family and friends about what should be done if your ICD sends a shock.

 
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Implantable Cardioverter Defibrillator (ICD) Testing

What is an Implantable Cardioverter Defibrillator (ICD) Testing?
ICD testing is done to get detailed information about how well your ICD recognizes your heartbeat. It checks to see if your ICD is at the correct settings so that you would receive the right treatment or shock if needed.

Where will the ICD testing take place?
The ICD testing is done in the hospital by an electrophysiologist, a cardiac doctor who is trained in the care and treatment of heart rhythm conditions. A specialized team of technicians and nurses will assist your doctor.

Why do I need ICD testing?
Your doctor may suggest ICD testing to see if you need changes in your treatment or ICD settings.

This may be done if you:

  • Felt a shock from your ICD.
  • Had a change in your medicine.
  • Are not feeling well.

 
How long will the testing take?
Although the testing takes about 5-10 minutes, the entire time spent having the procedure can be up to 1 hour. Most patients will be at the hospital for 4-6 hours.

Can I drive the day of the testing?
You cannot drive or use public transportation to get home after the test. Please make plans to have someone drive you home.

What should I do the day before the testing?

  • Discuss your routine medicines with your doctor to see if any changes are needed before your ICD test.
  • Your doctor will discuss the risks, benefits, and choices with you. You then will be asked to sign an informed consent giving permission to have the test.
  • You will have blood tests and an electrocardiogram (EKG).
  • Do not eat or drink anything after midnight the night before your surgery. You may take your medicines that your doctor said you can take, with a small sip of water.

 
What happens the day of my ICD testing?

  • You will be brought to the Electrophysiology (EP) lab.
  • A registered nurse will monitor your heart rate, blood pressure, and oxygen level.
  • You will receive oxygen through two small prongs made of flexible plastic tubing, that are placed in both nostrils.
  • A large sticky pad will be placed on your chest and on your back. They will be attached to a device that will help your heart if it beats too fast or too slow.
  • An intravenous line (IV) will be started in your arm to give you medicine to help you relax and make you sleepy.

 
What happens during the test?

  • To test your ICD, a special computer will send radio waves to connect with your ICD. These radio waves will not harm you.
  • The programmer then makes your heartbeat fast and in a way that is not normal. Your ICD “detects” the abnormal heartbeat and sends an electric shock to your heart. The medicine you receive before this will help you not to feel the shock. Your heartbeat will then go back to its normal rhythm.

 
What happens after the ICD testing?

  • After the testing is completed, you will wake up.
  • A specially trained nurse will monitor you in the recovery area, called the EDU (Early Discharge Unit).
  • You will be moved on to a bed and attached to a heart monitor. Your blood pressure, heart rate, and breathing will be checked closely.
  • Soon after you get to the recovery area, you will be able to drink and eat. Your first meal will be small and light.
  • After 4 hours, you can get out of bed with help from the staff to be sure you are steady on your feet.

 
What are my discharge instructions after the ICD testing?

  • When you are ready to go home, your IV will be taken out.
  • You will be asked to sign paperwork, and will be given written and verbal discharge instructions.
  • We encourage you to ask questions or have a family member or a friend present.
  • The doctor or nurse practitioner will explain your:
    • Test results and medicines.
    • Activities such as work, driving, travel, exercise, sexual activity, hobbies, and recreation.
    • You will be told when to schedule your next doctor appointment and when to have your next ICD check over the phone.

     
    If you have any questions, please contact your electrophysiologist's office.
     

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    Tilt Table Test

    What is a tilt table test?

    • A tilt table test, also called a Head Up Tilt (HUT), is done to find out why you faint or feel faint when you change your body position. You will be asked to lie on a flat table. The table is then tilted to an 80-degree angle. It is done to see if you feel faint while you are being closely monitored.
    • At any time during the tilt test, if you feel faint, the table will be placed flat. You will be monitored closely as you recover.

     
    Who does the tilt table test?

    • A doctor or nurse practitioner trained in cardiac electrophysiology (the electrical system of the heart), performs the test with a specially trained nurse.

     
    Where is the tilt table test done?

    • It is done in the Tilt Table Procedure room at the hospital.

     
    How long does the tilt table test take?

    • A tilt table test most often takes between 45 minutes to 1 hour and 15 minutes.

     
    What do I need to do before the test?

    • Your doctor will discuss the risks, benefits, and choices with you and ask you to sign an informed consent giving permission to have the procedure.
    • Do not eat or drink anything after midnight the night before the test.
    • Ask your doctor what medicines you should stop or continue to take.

     
    What happens during the tilt table test?

    • You will lie down on a bed that has a belt to hold you safely on the bed. A foot platform will support you while the bed tilts upward.
    • The nurse will start an intravenous (IV) in your arm. This is begun in case you need fluid or medicine during the test.
    • EKG pads are placed on your chest.
    • Your heart rate, blood pressure, and oxygen level will be monitored during the test.
    • To have a baseline EKG, you will be asked to lie flat and rest for ten minutes.
    • The tilt table will move to an 80-degree angle. You will feel like you are almost standing. Your head will be up, and your feet will be on the platform. You will be belted onto the bed to keep you from falling.
    • You will be asked not to move your body or your legs during the test.
    • Every five minutes your blood pressure and EKG will be taken. Your doctor or nurse practitioner will be with you during the entire test. If you feel dizzy or have other signs that you may faint, please tell your nurse or doctor.
    • If you do not faint or have signs of fainting after 30 minutes, you may be given medicine through your intravenous. The medicine will speed up your heart rate as if you are exercising.
    • You will continue to have your EKG, heart rate, and blood pressure monitored for about another 10 minutes after you receive the medicine. After the 10 minutes, the table will be placed flat and the intravenous will be stopped.

     
    What happens after the test?

    • After the test, you will be taken back to your room or discharged home (if your test was done as an outpatient).
    • Your doctor will discuss your test results and your plan of care. Your tilt test is “positive” if you faint or if you have signs of fainting during the test. It is “negative” if you had no fainting or fainting signs.

     
    References:
    Heart Rhythm Society
    National Heart Lung and Blood Institute
    American Heart Association
    Medline Plus (National Institutes of Health)

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