Electrophysiological study( EFI of the heart): indications, price, preparation for the procedure

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In case of a violation of heart health, it is important to establish an accurate diagnosis, to understand the nature of the causes that cause malfunctions. An electrophysiological study examines the biological signals of the heart, which helps diagnose a number of problems and correctly select the treatment.

What is cardiac ESI

A procedure that provides information about biological potentials from the inner surface of the heart. The method is designed to diagnose patients with conduction problems and heart rhythm disorders.

The examination procedure, the cardiac ESI, provides electrical stimulation aimed at the heart department, which is of interest to specialists. During the study, the registration of electrograms is carried out.

To whom it is prescribed

The procedure is performed if the patient:

• paroxysmal form of tachycardias( ventricular and supraventricular),
• , there is a lack of proper response to antiarrhythmic drugs,
• there are loss of consciousness of unclear etiology.

The procedure is prescribed for patients who have a need to understand the causes of rhythm disturbances or conduction of the heart. The method makes it possible to find the focus of arrhythmia.

Why and how often to undergo the procedure

The study is conducted to make an accurate diagnosis of the type of arrhythmia. The patient may have several types of arrhythmia. The study of the conductivity of the heart allows you to find out which part of the fault occurs.

If the patient has a need to test the effects of drugs, then with this study, you can select with a high accuracy the medicine that will suit the patient and determine the dose. It is necessary to perform the procedure as often as it dictates the need.

Next we will talk about modern methods of electrophysiological study of the heart.

Types of diagnosis

Electrophysiological study has the following varieties:

• non-invasive study,
• invasive examination.

The first type is also called transesophageal research. It is carried out using the readings of sensors that are at the level of the heart. The mini-device is based on the tip of the probe, which, in turn, is inserted through the nose( or mouth) into the esophagus.

The invasive method has three varieties:

• The epicardial method - the procedure is performed under general anesthesia on the open heart. The study is conducted at the time of surgery on the organ.
• Endocardial method - the method of cardiac EFI is applied not only in a hospital environment, but also on an outpatient basis. Anesthesia is not used in this study.
• Combined method - the procedure combines two methods.

Indications for

The invasive method is used for diagnosing, and in some cases, treatment for such problems:

• conduction of the bundle conduction in the area of ​​the legs,
• if there is a loss of consciousness in bradyarrhythmia,
• all degrees of complexity of atrioventricular blockade,
• supraventricular tachycardia.

Transesophageal examination is performed in such cases:

• Monitor the effects of drugs to determine their effectiveness.
• Identify information about whether there is a need for a pacemaker.
• Clarification: whether a particular drug gives a provocation for the development of arrhythmia.
• To obtain the necessary information for diseases:
  • bradyarrhythmia,
  • supraventricular tachyarrhythmia( paroxysmal).

Contraindications for

Invasive examination is not performed if the patient has one or more of the following problems:

• elevated temperature,
• aortic aneurysm,
• acute myocardial infarction,
• thromboembolism,
• heart failure,
• ischemic or hemorrhagic stroke,
• coronary syndrome of acute form,
• heart disease or cardiomyopathy in case of significant circulatory disturbance,
• revealed angina, or if this problem progressesruet.

Non-invasive type of study has the same contraindications as invasive. The list completes the negative manifestations of esophagus condition:

• acute inflammation of the esophagus walls,
• esophagus diseases:
  • tumors,
  • esophagitis,
  • polyps,
  • diverticulosis,
  • scars,
  • fistulas,
• infectious diseases.

Is the

method safe? The study is related to manipulations with a small degree of risk. Possible violations after the procedure:

• angina attack,
• vascular injury,
• development of a heart attack,
• cardiac arrhythmia,
• infectious process,
• thrombosis,
• hypotension.

Preparing for the

procedure Before the examination, a patient examination is carried out, which may include some procedures at the doctor's discretion:

• magnetic resonance imaging of the brain,
• echocardiogram,
• ultrasound results,
• electroencephalogram,
• Holter monitoring,
• and others.

The patient is told that it is necessary to exclude everything that can affect the heart:

• cigarettes,
• medicines in this direction,
• alcoholic beverages,
• toning beverages, including coffee.

How, how the procedure is done, and what testimonies about the feelings of those who did the EFI of the heart, is told further.

How the session passes

Invasive method

Invasive method is used in a special room - X-ray surgery room. The room should be equipped with resuscitation procedures.

• The patient is located on the operating table. On the eve of it, intravenous sedatives and pain medications are administered, if the specialist sees this as a necessity. Drugs with antiarrhythmic effect do not apply.
• Before starting the procedure, read the electrocardiogram and measure blood pressure. Installation of electrodes is carried out. The procedure is carried out under the supervision of a fluoroscope. The catheter is inserted into a large vessel and the apparatus reaches the desired section of the heart. The injection site can be:
  • neck area,
  • groin,
  • arm.
• Before the puncture the place is prepared: shave your hair and disinfect. Before the introduction of the catheter, local anesthesia is performed.
• During the catheter connection, patients sometimes experience discomfort, it manifests as some pressure, but not pain. Pain must be reported to the doctor.

Discomfort is possible only at the time of catheter installation. In the heart there are no receptors that transmit a signal of pain from the presence of the catheter, so in general the procedure is carried over easily and has no unpleasant moments, except changes in the heart, which is normal for this manipulation.

• The study is to monitor the heart signals through the equipment. Record different modes: natural signals and signals after electrostimulation with a catheter.
• An electrocardiogram is performed inside the heart. Her specialist will compare with the parameters of the electrocardiogram, which was carried out in the usual way on the surface of the body.
• To determine the type of arrhythmia with the help of a catheter, an arrhythmia is initiated. The patient feels that his heart beats faster, slower.

The procedure takes place with careful monitoring of the patient's well-being. He, too, can help in establishing an accurate diagnosis, telling the doctor details about his feelings.

Transesophageal examination of

Transesophageal examinations proceed as follows:

• The procedure is performed in the X-ray room or in the ECG study. It is possible to do the manipulation in an outpatient setting if there is necessary equipment.
• The patient is placed on the couch. If necessary, perform a local anesthesia. Through the nose or mouth, enter the esophageal electrode. He sinks about half a meter. The task of the device is to record the electrocardiogram readings.
• During stimulation, an electrogram is recorded. The procedure determines whether a rhythm disturbance occurs during exercise.

The study takes a third of an hour. Negative effects of transesophageal electrophysiological examination of the heart( PE EFI) usually does not.

The significance and decoding of the results of electrophysiological studies will be described below.

Decoding of the results

Read the readings from the arrhythmologist. Based on the results of the analysis of the parameters, treatment is prescribed.

• If an arrhythmia or conduction problem is documented, then for every type of abnormality the full characteristic is given.
• Attention is paid to the ST segment on the cardiogram. Data are analyzed to clarify the possibility of myocardial ischemia. This problem is a consequence of tachycardia.

The prices of electrophysiological research on this system will be described below.

Average cost of procedure

Electrophysical examination in different medical institutions can have different costs. It ranges from 500 to 860 p. On average, the service is estimated at 700 r.

EFI is used not only for heart examination, but also for the detection of eye pathologies, as this video will describe: