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The invasive electrophysiological study (EPS) became a widely used procedure, performed all over the world as an essential part of the diagnosis of arrhythmias. This activity describes the concept, steps, and indications of the electrophysiologic study (EPS) and highlights its utility for patients with different arrhythmia types. Objectives: Identify the clinical picture that indicates the use of EPS. Summarize the equipment, personnel, preparation, and technique regarding the EPS. Review the indications and clinical significance of the electrophysiologic study. Describe some interprofessional team strategies for improving care coordination and communication when using EPS for cardiac arrhythmias. Access free multiple choice questions on this topic.

A notable increase in invasive electrophysiological (EP) testing and catheter ablation procedures performed all over the world has been observed over the past twenty-five years. This activity will focus on the indications, technique, and complications of the electrophysiological study (EPS). The EPS is an invasive procedure that needs catheter placement into the right heart via the femoral vein, using the Seldinger technique. The aim is to stimulate the heart using two pacing techniques: extra-stimulus pacing and incremental pacing. The use of extra stimulus pacing reveals the refractory periods, conduction and activation changes, diagnostic for certain diseases. The incremental pacing helps for observing and measuring the impulse conduction during stress conditions and evaluates the recovery time of normal function at the cessation of stimulation.

As many of the challenging arrhythmic events leading to sudden cardiac death occur in athletes; a good collaboration between interprofessional team members from sports medicine and cardiologist is necessary. However, the complex adaptations induced by exercise present a continuous challenge to the cardiologist asked to evaluate athletes. A unique discipline of sports and exercise cardiology tailoring cardiovascular care in athletes and exercising individuals would be a fabulous resort in the future, allowing safe participation in sports or enhanced physical activity.[11] A patient safety program to design and implement a system that takes into account the concerns of the frontline personnel requires development.[12] An arrhythmia team with medical co-leads with specific responsibilities and roles formed by electrophysiologists and cardiovascular surgeons constitutes the future of the therapeutic strategy regarding complex patients. Besides, the arrhythmia team should include a general cardiologist, a cardiac anesthetist, an intensivist, a nurse coordinator, and not least a patient representative.[13] A cardiology specialty nurse can assist with setting up the procedure and answering the patient questions, as well as helping with whatever interventions may be necessary based on the outcome of the EPS, which places nursing as a vital component of the interprofessional team, leading to better patient outcomes. [Level 5]