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At UPMC Children’s Hospital of Pittsburgh, we believe parents and guardians can contribute to the success of this procedure, and we invite you to participate. Please read the following information to learn about the procedure and how you can help.
An electrophysiology (ee-LECK-tro-fizz-ee-ALL-o-gee) or EP study is a special type of heart cath that checks the electrical conduction system of the heart. The EP study is done by a pediatric electro–physiologist, who is a pediatric heart doctor with special training in the electrical conduction system of the heart. A patient is referred for an EP study when he or she has been diagnosed with a specific type of arrhythmia (a-RITH-me-uh) or irregular heartbeat.
In the EP study, the doctor uses special catheters to look at the electrical system of the heart and help find areas of abnormal electrical activity. Catheters that measure the heart’s electrical signals are positioned in the areas where the electricity of the heart is generated. Once there, the doctor can stimulate the heart to beat rapidly or irregularly. The heart’s response to the stimulation — and the way the electricity moves around the heart when it’s in an irregular rhythm — helps the doctor diagnose the nature of the arrhythmia.
If the electrophysiologist is able to find the source of the arrhythmia during the EP study, he or she may perform an ablation (uh-BLAY-shun). The source may be an extra pathway causing the heartbeat to go off track, or an area of abnormal heart tissue. When this area is found, catheters with special tips are placed over that spot, and tips are either heated or cooled. The process of heating the tips is called radiofrequency or RF ablation; the cooling of the tips is called cryoablation (CRY-o-uh-BLAY-shun). Both RF ablation and cryoablation have the same effect, which is to cause the tissue in that very tiny spot to die. That stops the area from conducting the extra impulses causing the rapid heartbeats.
The benefits of ablation are the improvement or complete cure of certain arrhythmias. But, like any medical procedure, there are some risks involved. Among the risks are:
Your child’s doctor will explain each of these risks in detail before your child’s EP study and ablation so that you will be able to make an informed decision about your child’s condition.
At the Heart Institute, the doctors and nurses work as a team with many other medical professionals. Among the team members is a pediatric anesthesiologist, who will give your child the medications to make him or her sleep and monitor his or her vital signs during the cath. The cath lab staff also will be involved by preparing your child for the cath and getting equipment needed by the doctor. Your child’s pediatric Zlectrophysiologist will do the heart cath, and may work with a cardiology fellow, who is a pediatric doctor training to be a cardiologist.
When general anesthesia is needed, there are important rules for eating and drinking that must be followed the night before and the day of the procedure. One business day before your child’s procedure, you will receive a phone call from a scheduling nurse between 1 p.m. and 9 p.m. (Nurses do not make these phone calls on weekends or holidays.) Please have paper and a pen ready to write down these instructions.
The most important role of a parent or guardian is to keep your child calm. The best way to keep your child calm is to be calm yourself. Knowing what to expect and explaining it to your child beforehand is the best way for both you and your child to be prepared for this procedure. Here are some guidelines to use when discussing the heart cath with your child.
At any age
Your child may bring along a “comfort” item — such as a favorite stuffed animal or “blankie” — to hold during the procedure. There are televisions in the Same Day Surgery rooms, but you are welcome to bring along a portable DVD player, laptop computer, or hand-held video game, if these items will help your child.
Birth to 2 years
Please bring along a “comfort” item for your child, such as a favorite blanket, stuffed animal, or toy.
2 to 7 years
The day before your child’s heart cath, explain the procedure using simple words. You might explain that the doctor “will take pictures of your heart while you are taking a nap.”
A medical play kit can be helpful so that your child is familiar with items he or she may see. For example, you can show your child how to use a stethoscope on a teddy bear. Books about going the hospital also might be helpful.
7 to 11 years
Older children may benefit from discussing the heart cath about a week or so before the scheduled date. At this point, kids understand more about the body, the organs, and how they work.
For that reason, they may be more afraid of pain. You might explain to your child that he or she will be getting medication that will make him or her very sleepy throughout the heart cath, and that this medication will keep him or her from feeling any discomfort during the procedure. It also will make it hard to remember much about the procedure afterward.
You might add that the heart is like a pump, and the heart cath will help the doctor understand how well your child’s heart is pumping. Books about going to the hospital also might be helpful.
12 years and up
Preteens and teens are able to understand the way the heart works, what their heart problem is, and why they need this procedure. They might ask very insightful questions. Use their questions to help guide your discussion.
You and your child will register for the heart catheterization at the Same Day Surgery Center on the 4th floor of UPMC Children’s Hospital. You and your child will be called to an examination room where your child’s vital signs will be checked.
You and your child should come to the hospital prepared for an overnight stay. As soon as the procedure is done, your child will be moved to a recovery room until the effects of anesthesia begin to wear off. You will be called to the recovery room so that you can be there as he or she wakes up. You can help by talking softly and touching your child so he or she knows you are there.
If your child has any special needs or health issues you feel the doctor needs to know about, please call the Heart Institute before the procedure and ask to speak with a nurse. It is important to notify us in advance about any special needs your child might have.
Children's Hospital's main campus is located in the Lawrenceville neighborhood. Our main hospital address is:
UPMC Children’s Hospital of Pittsburgh
One Children’s Hospital Way
4401 Penn Ave.
Pittsburgh, PA 15224
In addition to the main hospital, Children's has many convenient locations in other neighborhoods throughout the greater Pittsburgh region.
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