Intro to EP Study

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Author:
jordan1128
ID:
242339
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Intro to EP Study
Updated:
2013-10-23 12:42:19
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Ep
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Ep
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  1. The goal of the EP study is to?
    find the sight of arrthymia
  2. 4 types of noninvaise EP evaluations
    • -12 ECG
    • -Signal-averaged ECG
    • -Exercise Testing
    • -Tilt table tests
  3. Two types of Invasive EP
    • Diagnostic procedures
    • Interventional procedures
  4. Singnal-Averaged ECG's
    • Not very common anymoe
    • Multiple ECg's are blended over a certian time period
  5. Components of EP study
    • EP workstation
    • Stimulator (either bloom or computer)
  6. Arrhythmia Diagnosis
    • Bradycardia
    • Tachycardia
    • -Supraventricular & Ventricular
  7. What treatment do you do for Supra-ventricular arrhythmia?
    ABLATION
  8. What device therapy do you do for Bradycardia
    Pacemakers
  9. What devicetherapy do you give to ventricular arrythmias
    ICD's
  10. Typical venous access site for EP study?
    • Right femoral VEIN!
    • -could go jugular or subclavian
  11. What speed is EP tracing usually at
    50-100ms and not 25ms
  12. 4 main cathodore placements
    • 1. High right atrium
    • 2.Coronary Sinus
    • 3. His Bundle
    • 4. Rv Apex

    -RVOT & LV
  13. Whats the most important aspect of EP study
    • Timing!
    • -Not concerned with morphology
  14. Basic Cycle Length (BCL) aka Sinus Cycle Length (SCL)
    • measured AA or VV
    • 1000-600ms (60-100 ppm)
  15. AH interval
    • time from firing of SA node through the AV node to the bundle of his
    • -inital artial deflection to deflection on his channel
    • -60-120ms
  16. HV interval
    • time it takes singnal to travel from bundle of His to ventricles
    • 35-55ms
  17. AH abnormal values
    Less than 60ms= enhanced atrial conduction or low atrial pacemaker

    Longer than 120ms= conduction delay
  18. Abnormal HV values
    Less than 35ms = ventricular preexcitation

    More than 55ms= His delay or Bundle Bloclk
  19. Train
    single burst of paced stimuli
  20. Burst Pacing
    Delivery of multiple fast stimuli
  21. 4 things you look at in a Brady EP study
    • 1. cycle length
    • 2. AH interval
    • 3. HV interval
    • 4. SNRT
  22. SNRT
    Sinus Node Recovery Time

    • -Overdrive SA node for 30-60 secs
    • -Stop and see how long it takes to recover
    • -under limit is 1500ms (1.5 sec)
  23. PES
    • Programmed Electrical Stimulation
    • -run of rapid pacing pulses
    • Pacing output pulss from external equipment are delivered to the heart

    -trying to enduce tachycardia
  24. Why do we do programed stimulation?
    • Induce re-entrant arrhythmias
    • Rule out re-entrant arrhythmias
    • Identify extra pathways
    • Terminate arrythmias
  25. How long does an arrhythmia have to last to be substained?
    over 20 seconds
  26. What signifys a positive EP study?
    If you can induce an arrythmia
  27. NIPS
    none-invasie programable stimulation
  28. DFT testing
    Only different between ICD implant and Pacemaker implant

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