Electrophysiological Examination (EPU)

What Is an EPU of the Heart?

Cardiac EPU is a medical examination method that uses a special cardiac catheter to examine the heart's electrical conduction. Several of these cardiac catheters are positioned at specific points in the heart. Small electrical stimuli are then applied to trigger a cardiac arrhythmia to detect it deliberately.

When Is an Electrophysiological Examination Carried Out?

EPU is used to detect and classify cardiac arrhythmias. Commonly, arrhythmias are noticed in everyday life by palpitations, extrasystole, dizziness, fainting, and other similar symptoms. However, a distinction is made between bradycardic and tachycardic arrhythmias. In the former, the heart beats too slowly, which may be due to a sinus node or AV node defect. On the other hand, tachycardic problems involve extra beats that result in a fast heartbeat.

EPU Procedure

The EPU is performed under local anesthesia. First, the attending cardiologist will insert several catheters through the inguinal vein, which will be advanced through the great inferior vena cava to the right atrium. This procedure is neither painful nor felt. Eventually, the electrodes are forwarded through the foramen ovale into the left atrium. Then electrical signals are delivered to trigger cardiac arrhythmia. During this time, an ECG records the arrhythmia. The origin of the disturbance signals can also be determined, which allows radiofrequency ablation as a therapy. Next, a special catheter is inserted and forwarded to the site where the interfering signals are coming from for this procedure. Then, the cells at this site are obliterated. After the examination, all catheters are withdrawn.

Results of the Electrophysiological Examination

The EPU gives the treating physicians more information about the present cardiac arrhythmia. After the examination, treatment with medication or even implantation of a pacemaker can be done. The pacemaker can take over the impulse generating function when the heartbeat is slow and interrupt and redetermine the impulse when the heartbeat is fast. A second surgery is needed for implantation.

Possible Risks and Complications of an EPU

EPU is a proven and safe procedure in cardiology. However, as with any medical procedure, this examination carries certain risks.

• Allergies to the local anesthetic
• Injury to tissue by the catheter
• Bleeding and bruising at the injection site
• Infections at the injection site
• Blood clots

Which Specialists and Clinics Perform an EPU?

Specialists in cardiology with additional training in interventional cardiology are specialists in EPU. EPU is primarily performed in large hospitals, as not every cardiology department can offer EPU.

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