Electrophysiology study is an advanced evaluation of heart rhythm disorders. It is usually resorted to in cases where simple medications are not effective in controlling the rhythm abnormalities. Generally it is done without any sedation or general anaesthesia as it is not very painful. Local anaesthesia is given at the sites where the blood vessels are punctured to introduce small electrodes into the various chambers of the heart for recording the electrical activity of the heart internally. Each electrode has multiple recording poles – bipolar with two recording poles, quadripolar with four recording poles, decapolar with ten recording poles and duo-decapolar with 20 electrode poles.
The signals from the electrodes reach a junction box from where it reaches recorder which also displays multiple simultaneous channels on a screen. The signals can be electronically archived on a hard disc or printed on a calibrated recording paper. By analysing the sequence in which signals arrive at each electrode, the pattern in which the signals are conducted within the heart can be assessed. This gives valuable information on the origin of the heart rhythm disorder. The information gathered will guide further treatment in the form of medications or catheter ablation. Catheter ablation is the procedure by which a small electrode delivers an energy to produce localized damage a disease focus, curing the rhythm abnormality. Most commonly used source of energy is radiofrequency, while cooling with a cryo probe and microwave energy are other options.