What is EPS and catheter ablation?

An electrophysiology study (EPS) is a test to see if there is a problem with your child's heartbeat (heart rhythm). The test can also find out how to fix the problem. Sometimes a procedure called catheter ablation is done during an EPS. This destroys (ablates) small areas of your child's heart that are causing the heart rhythm problem.

The doctor puts long, flexible plastic tubes called catheters into a blood vessel in your child's groin, arm, or neck. The doctor then uses an X-ray machine to guide the catheters to your child's heart. Your doctor uses them to record the heart's electrical signals.

If the doctor thinks your child's problem can be fixed with ablation, he or she can destroy a small part of the heart tissue. This is usually done with radio waves.

It may seem like a bad idea to destroy parts of the heart on purpose. But the areas that are destroyed are very tiny. They should not affect the heart's ability to do its job.

Your child will probably be awake during the procedure. The doctor will give your child medicines to help him or her feel relaxed. Medicines also numb the areas where the catheters go in. Your child may feel a little discomfort. But he or she should not feel pain.

If your child has EPS only and does not need more treatment, your child may go home the same day.

If your child also has ablation, he or she may have to stay in the hospital. How long your child will stay depends on the type of ablation.

At home, your child should not exercise hard until your doctor says it is okay. Your doctor will tell you when your child can go back to school or daycare.

Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.

What happens before the procedure?

Procedures can be stressful both for your child and for you. This information will help you understand what you can expect. And it will help you safely prepare for your child's procedure.

Preparing for the procedure

• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• Tell the doctors ALL the medicines and natural health products your child takes. Some of these can increase the risk of bleeding or interact with anesthesia. Your doctor will tell you which medicines your child should take or stop before the procedure.
• Talk to your child about the surgery. Tell your child that the procedure will help the heart work as it should. Hospitals know how to take care of children. The staff will do all they can to make it easier for your child.

What happens on the day of the procedure?

• Follow the instructions exactly about when your child should stop eating and drinking. If you don't, the procedure may be cancelled. If the doctor told you to have your child take his or her medicines on the day of the procedure, have your child take them with only a sip of water.
• Have your child take a bath or shower before you come in. Do not apply lotion or deodorant.
• Your child may brush his or her teeth. But tell your child not to swallow any toothpaste or water.
• Do not let your child wear contact lenses. Bring your child's glasses or contact lens case.
• Be sure your child has something that reminds him or her of home. A special stuffed animal, toy, or blanket may be comforting. For an older child, it might be a book or music.

At the hospital or surgery centre

• A parent or legal guardian must accompany your child.
• Your child will be kept comfortable and safe by an anesthesia provider. Your child may get medicine to bring on a light sleep or to relax him or her. The area being worked on will be numb.
• This procedure can take 2 to 6 hours. In rare cases, it can take longer.
• After the procedure, your child will be taken to the recovery room. As your child wakes up, the recovery room staff will monitor his or her condition. The doctor will talk to you about the procedure.

Going home

• Expect your child to be sleepy. Encourage extra rest the first day. Most children can be more active on the day after the procedure.
• Follow your doctor's instructions about when your child can do vigorous exercise. This includes sports, running, and physical education.
• When you leave the hospital, you will get more information about how to take care of your child at home.
• The doctor or nurse will tell you when your child can start normal activities again.

When should you call your doctor?

• You have questions or concerns.
• You don't understand how to prepare your child for the procedure.
• Your child becomes ill before the procedure (such as fever, flu, or a cold).
• You need to reschedule or have changed your mind about your child having the procedure.