Cardiologist Sanjiv M. Narayan, MD, PhD, a graduate of the University of Birmingham in England, completed training in internal medicine at Mount Auburn Hospital/Harvard Medical School, then trained in cardiology/electrophysiology at Washington University. Sanjiv Narayan was then faculty at the University of California San Diego and director of electrophysiology at the Veterans Affairs Medical Center. Currently, he is at Stanford University and holds titles including co-Director of the Arrhythmia Center, Director of electrophysiological research and the atrial fibrillation program.

1. Introduction to the
Electrophysiology Study
Sanjiv Narayan

2. Introduction
• Cardiologist Sanjiv M. Narayan, MD, PhD, a graduate of the University of
Birmingham in England, completed training in internal medicine at Mount
Auburn Hospital/Harvard Medical School, then trained in
cardiology/electrophysiology at Washington University. Sanjiv Narayan was then
faculty at the University of California San Diego and director of
electrophysiology at the Veterans Affairs Medical Center. Currently, he is at
Stanford University and holds titles including co-Director of the Arrhythmia
Center, Director of electrophysiological research and the atrial fibrillation
program.
A test performed on patients to diagnose heartbeats by assessing the electrical
activities of the heart, an electrophysiology study is done by inserting catheters
followed by wire electrodes through blood vessels that go into the heart. Before
the procedure, a patient will lie on a hospital bed while a nurse starts an
intravenous line in the arm or hand of the patient, in order to give the necessary
fluids and drugs to the patient during the procedure. Patients typically receive a
urinary catheter (Foley) during the procedure.
An electrophysiology study is performed in the electrophysiology lab of a
hospital. It is done by doctors to detect the cause of arrhythmia in patients,
determine the medication or other therapy that will be effective in treating the
patient, and assess the risk for health problems such as cardiac arrest.

3. Electrophysiology
• Display screens, cameras, heart monitors, and other instruments
are usually used to monitor patients’ cardiac electrical activities
while electrodes are positioned on the chest and back and
connected to monitoring instruments. In most cases, patients will
choose a position they find convenient and easily maintained
before the procedure begins.
During the procedure, a straw-sized tube known as a sheath is
inserted into the patient’s blood vessel. Once the sheath is
positioned, the doctor guides several specialized EP catheters into
the patient’s blood vessel through the sheath and directs these
catheters to the patient’s heart.
After the procedure, the electrodes and catheters are removed,
and pressure is exerted on the neck and groin areas. The patient
will need to lie still in the hospital bed for about four to six hours
to allow the sealing of the sites where catheters were inserted.