It’s easy to wonder if electrophysiology testing can trigger a heart attack or stroke, since it involves catheter placement in the heart.

The electrophysiology test is designed to detect a heart rhythm disorder (arrhythmia).

Another question that might pop into one’s mind is if an EP test can miss an arrhythmia.

“The test is meant to provoke the arrhythmia, not wait for it to happen spontaneously,” says Peter R. Kowey, MD, FACC, Professor of Medicine and Clinical Pharmacology, Jefferson Medical College; Chief, Division of Cardiovascular Diseases, Main Line Health System; and author of “Lethal Rhythm,” a medical mystery. Dr. Kowey specializes in heart rhythm disorders.

Can electrophysiology testing cause a heart attack or stroke by dislodging plaque buildup in a coronary artery?

Dr. Kowey explains, “The EP catheter doesn’t go into coronary arteries or carotid arteries.

“It rarely can cause stroke or MI [heart attack] by provoking arrhythmias that in turn cause hypotension and under-perfusion.”

Hypotension means blood pressure that is too low. During an EP test, the patient’s blood pressure is continuously monitored via an arm cuff.

Under-perfusion simply means not enough blood supply.

The area of insertion of the catheter may either be a vein in the groin or in the neck, where a local anesthetic will be applied.

The patient also may — or may not — be given a sedative, depending on what’s determined to be best for the patient.

If an arrhythmia is not detected and the test is negative, the doctor may decide to place an implantable loop recorder into the patient.

Dr. Kowey says that this device “is very useful for recording spontaneous arrhythmias to correlate them with specific but highly sporadic symptoms.”

Implantable Loop Recorder

This device records the patient’s heart rhythm for up to three years.

The instrument, which is placed just under the skin of the chest, will catch deviations from a normal heart rhythm that an EKG and Holter monitor can easily miss.

Dr. Kowey’s principal area of interest is cardiac rhythm disturbances, and his group has participated in a large number of pivotal international clinical trials.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


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