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Intro to EP Study
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The goal of the EP study is to?
find the sight of arrthymia
4 types of noninvaise EP evaluations
-12 ECG
-Signal-averaged ECG
-Exercise Testing
-Tilt table tests
Two types of Invasive EP
Diagnostic procedures
Interventional procedures
Singnal-Averaged ECG's
Not very common anymoe
Multiple ECg's are blended over a certian time period
Components of EP study
EP workstation
Stimulator (either bloom or computer)
Arrhythmia Diagnosis
Bradycardia
Tachycardia
-Supraventricular & Ventricular
What treatment do you do for Supra-ventricular arrhythmia?
ABLATION
What device therapy do you do for Bradycardia
Pacemakers
What devicetherapy do you give to ventricular arrythmias
ICD's
Typical venous access site for EP study?
Right femoral VEIN!
-could go jugular or subclavian
What speed is EP tracing usually at
50-100ms and not 25ms
4 main cathodore placements
1. High right atrium
2.Coronary Sinus
3. His Bundle
4. Rv Apex
-RVOT & LV
Whats the most important aspect of EP study
Timing!
-Not concerned with morphology
Basic Cycle Length (BCL) aka Sinus Cycle Length (SCL)
measured AA or VV
1000-600ms (60-100 ppm)
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
HV interval
time it takes singnal to travel from bundle of His to ventricles
35-55ms
AH abnormal values
Less than 60ms= enhanced atrial conduction or low atrial pacemaker
Longer than 120ms= conduction delay
Abnormal HV values
Less than 35ms = ventricular preexcitation
More than 55ms= His delay or Bundle Bloclk
Train
single burst of paced stimuli
Burst Pacing
Delivery of multiple fast stimuli
4 things you look at in a Brady EP study
1. cycle length
2. AH interval
3. HV interval
4. SNRT
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)
PES
Programmed Electrical Stimulation
-run of rapid pacing pulses
Pacing output pulss from external equipment are delivered to the heart
-trying to enduce tachycardia
Why do we do programed stimulation?
Induce re-entrant arrhythmias
Rule out re-entrant arrhythmias
Identify extra pathways
Terminate arrythmias
How long does an arrhythmia have to last to be substained?
over 20 seconds
What signifys a positive EP study?
If you can induce an arrythmia
NIPS
none-invasie programable stimulation
DFT testing
Only different between ICD implant and Pacemaker implant
Author
jordan1128
ID
242339
Card Set
Intro to EP Study
Description
Ep
Updated
2013-10-23T16:42:19Z
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