Electrophysiology studies are investigations used to screen for types of arrhythmias, testing the electrical activity of the heart to find where a particular abnormal heart rhythm originates.

• To determine the cause of an arrhythmia
• To assess the effectiveness of certain drugs in treating arrhythmias
• Treating a certain condition by destroying the tissue inside the heart responsible for abnormal electrical signals
• To determine whether a pacemaker or cardiac defibrillator may be a solution for the arrhythmia under investigation
• To assess the existence and degree of risk of sudden cardiac death due to cardiac arrest

This type of investigation involves inserting a catheter (a thin tube) through a blood vessel into the heart. Using an electrode, electrical signals are sent to the heart and its electrical activity is recorded.

The results of these tests help to make a correct diagnosis and therefore to choose the right treatment, whether medication, pacemaker implant, cardiac defibrillator, ablation or surgery.

• The patient should be fully informed about any medication that may be given in the days leading up to the investigation;
• There are situations in which the doctor may order the discontinuation of certain drug treatments three to five days before the investigation. Diabetic patients, for example, should ask for instructions on taking medication specific to their pathology;
• Prior to the investigation, patients should not consume food in the evening before the day of the investigation;
• The results of the investigation may be inconclusive if the patient does not follow medical instructions regarding pre-test preparations.

• The consent form for the test is signed by the patient before the electrophysiology test is performed;
• Before signing the consent form, patients should not hesitate to ask for further information about any questions they have about the investigation.

In the first days or weeks after surgery, you should recover. The wound will heal gradually. You will feel better. At first, you may be aware of the presence of the stimulator, but after a while you may not even notice it.

Right after surgery, you should:

• Keep the wound clean and dry. If you notice that the sore is red, hot, swollen, more painful, or starts to ooze fluid, call your doctor immediately;
• Follow instructions for bathing, dressing changes and resuming activities;
• Only make gentle movements with the arm near the pacemaker. Avoid reaching, lifting and sudden, jerky movements. As you heal, gradually increase arm use;
• Do not play with or move the stimulator under the skin. Try not to hit it or bump into it;
• Keep doctor's appointments;
• Keep your pacemaker identification card with you at all times;
• If your condition does not improve, call your doctor. Do not wait until follow-up visits.

The follow-up visit normally takes place at the doctor's surgery or clinic. The consultation is painless. After a brief examination, the clinician or doctor usually attaches ECG electrodes to the chest.

He then places the wand on his chest and uses the programming device (the computer that communicates with the pacemaker) to display and print out the information about the heart and pacemaker. With this information, the doctor can check the pacemaker settings. If changes are needed, they can be made on the spot. It will also check the pacemaker's battery.

Tell your doctor or clinician about any problems with your pacemaker, your heart, or your health in general. It is also a good time to ask questions about your pacemaker.

The recovery period for each person is different, but you will probably be able to return to a normal life with small changes. The wound must be completely healed before you can return to your normal daily activities.

Talk to your doctor about how soon you can return to work, drive, exercise or go hiking.

It provides effective protection against these dangerous, very fast heart rhythm disturbances. The device prevents or stops rapid ventricular arrhythmias in time and restores normal heart rhythm. The possibility of implanting a defibrillator has saved the lives of tens of thousands of people in recent years.

The heart rate can be not only too fast but also too slow; this is called bradycardia. In this case, the heart has a rate of less than 60 beats per minute. In healthy people these rates generally have no negative consequences (e.g. during sleep or in athletes the heart rate can go below 60 without problems). But there are heart conditions that cause the heart rate to be too low, which can have consequences for the patient. These include sick node syndrome and absolute bradyarrhythmia. As the implantable defibrillator can also act as a pacemaker, it ensures optimal protection of the patient in all conditions.

The electrical pulse generator is inserted under the skin (subcutaneously) in the area of the chest muscles. Local anesthesia is often sufficient for this operation. In some cases general anesthesia may be necessary.

The connection to the heart is made with electrodes. During the operation they are inserted through a vein into the heart. The defibrillator's functioning is then tested and adjusted according to the characteristics of each patient. Most patients are able to leave the hospital about two to three days after implantation.

The battery in an implantable defibrillator has a life expectancy of between 5 and 10 years. This depends on the type and pulse rate of the device. The defibrillator has been designed in such a way that it registers and alerts us to the need to change the battery well in advance of the need. Since the battery is an essential component of the defibrillator, the entire defibrillator will be replaced during the battery change. In this case the doctor makes an incision over the old scar and removes the old defibrillator. The electrodes are fixed as tightly as possible, they are then checked and, after all this, the new device is connected, tested and inserted into the existing pocket. Electrodes are only changed in exceptional cases.

After leaving hospital, you should allow a number of months to get used to the situation. Talk to family and friends about the defibrillator. Although it cannot cure your heart condition, it can give you a high degree of security. Initial doubts and fears can often be overcome through conversation.

Most patients adapt quickly to the defibrillator. For them, it is a chance to have an active life again. In the majority of cases, the defibrillator can prevent the effect of possible tachycardia, allowing a real improvement in quality of life.

Immediately after surgery, there are a few things to pay attention to:

• Observe the scar and inform your doctor immediately if it becomes red, swollen or suppurating;
• For the first few days, avoid moving the shoulder on the side of the implant too much;
• Afterwards, shoulder mobility will not be restricted and you can move freely;
• Initially, avoid lifting heavy objects;
• Clothes should not be too tight around the shoulder to prevent irritation;
• Once the scar is completely healed, you can return to an active lifestyle if your doctor has no contraindications.

You can start being active again at work and at home. It is true that you should avoid certain activities:

• Climbing scaffolding or escalators;
• Welding or sailing alone (because of the risk of dizziness);

Other activities are not a problem:

• Working with computers or household equipment is safe;
• The defibrillator is not affected by ordinary electromagnetic fields if you keep at least one arm's length away from the source;
• You can use household appliances without restrictions if they are grounded and you don't try to repair them yourself.

If a tachycardia develops, the defibrillator will try to stop it more gently with antitachycardia pacing.

If this is not successful, an electric shock will be applied. What to do:

• Look for somewhere to sit quietly, even lie down if you can;
• Ask someone to stay with you and call an ambulance if symptoms persist;
• Call your doctor if you feel unwell after the defibrillator has worked;
• If you feel fine after the shock, you can still let your doctor know, who will ask you questions such as:
  
  • What did you do before the shock?
  • What did you feel (fear, nausea, palpitations, weakness)?
  • How do you feel after?

Patients generally understand that shock is necessary. The rhythm disturbance is dangerous - not the defibrillator. So is fainting - it is caused by arrhythmia, not shock. The defibrillator provides reassurance that critical situations can be managed.

Patients feel the shock differently - as a sharp or painful blow to the chest. Chest and arm muscles may twitch strongly. Although it may seem scary, this reaction shows that the defibrillator is doing its job.