Information for Parents

Electrophysiology Study and Ablation:
Information for Parents

CONTENTS:

Introduction

The evening before the EP study

At the hospital

The EP study and ablation

After the EP study and ablation

At home

Activity restrictions after the ablation

Preparing your child

Introduction:

Your doctor has recommended a test in order to learn about and treat your child,s heart rhythm.

The test is called an electrophysiology study (or EP study), and may also include an ablation procedure. It is done by a pediatric electrophysiologist and does not require surgery. The EP study and ablation usually takes 3-4 hours to complete. Your child will be scheduled to come to the hospital the morning of the test and will likely be discharged to home later that evening or the next morning.

The evening before the EP study

Your child should not eat or drink anything for several hours before the EP study. You will be told exactly when to stop solid foods and clear liquids, It is extremely important that your child have an empty stomach before receiving sedation for the procedure. The EP study will be canceled if your child eats or drinks anything after the times allowed.

If your child is currently on medications for their heart rhythm, we will ask you to stop them 3-5 days before the test. Please ask your doctor the best way to do this.

We ask that you give your child aspirin every day, beginning 3 days before the test if an ablation is likely to be done. Aspirin makes the ablation a safer procedure by preventing the blood from clotting too easily. The dose of aspirin depends upon your child,s weight. We will discuss the dose with you before the procedure.

Adolescents should shave off hair at the top of both legs where the EP catheters will be inserted. A "bikini cut" is appropriate. Shaving at home the night before may be more comfortable for the teen then being shaved at the hospital by a nurse.

IMPORTANT: If your child appears ill, has a fever, cold, cough, vomiting, diarrhea, diaper rash, or has recently been exposed to the chicken pox, the EP study may need to be postponed. Please call the cardiology office prior to the scheduled procedure date to discuss any symptoms your child has.

At the hospital

A nurse will check your child,s temperature, pulse rate, and blood pressure. Your child will be given pajamas to wear. A numbing cream will be placed over the sites where the EP catheters will be inserted, usually at the top of the legs and the right side of the neck. With this cream applied your child will have little or no pain when injected with a local anesthetic in the EP lab. A sedative may be given to help your child relax during the EP test and ablation. An IV will be placed in the hand or arm as a route to give medications during the procedure. When ready your child will be taken on a cart to the EP lab. During the EP study and ablation you will be given a beeper so that we can reach you.

The EP study and ablation

The EP study and ablation are done in a special lab with x-ray cameras and heart computers. All of the people in the room will be dressed in scrub suits. The area where the doctor will insert the EP catheters, usually the tops of the legs and the right side of the neck, will be washed with a yellow antiseptic soap. Your child will then be covered with sterile drapes from chin to toes.

The EP study and ablation involves inserting catheters (thin, flexible tubes) into the heart from the veins in the leg and neck. The catheters are guided into the heart by the electrophysiologist using x-ray cameras. The catheters assist us in locating the abnormal rhythm in your child,s heart. Because we will need to see this rhythm, your child may feel extra heart beats during the test. The nurses and doctors will be closely monitoring your child at all times. If an ablation is done, radiofrequency (or RF) energy is delivered through a catheter. The energy heats up the extra electrical tissue in the heart, which is the cause of the abnormal rhythm, and destroys it.

At the end of the procedure, the catheters are removed. Pressure is applied to the leg and neck area to stop any bleeding. No stitches are needed. A dressing will cover the site.

After the EP study and ablation

Your child will return to their room and may feel sleepy for several hours. He or she will be asked to lie in bed for 4-6 hours to prevent any bleeding from the catheter sites. When awake, your child will be able to drink clear liquids and later have something to eat. You will probably be able to take your child home the evening of the procedure or the next morning. You will be given a list of simple instructions before you leave the hospital. Please review these and write down any questions you might have.

At home

Once home, keep the catheter sites dry and clean (sponge bath or shower only). Change the Band-Aid daily until healed, usually 3-5 days. Bruising of the skin at the catheter site is common and is not dangerous. If bleeding from the site occurs, apply firm, constant pressure with a clean cloth, for 5 minutes. Call your cardiologist if any of the following occur:

bleeding
redness of the skin
green/yellow discharge at the catheter site
elevated temperature (over 101.5 F)
dizziness or near-fainting
rapid heartbeat

If a rapid heartbeat or dizziness should occur help your child to a relaxed lying position and call the cardiology office.

We want to stress that we are not expecting any of these problems, but if any should occur, please call, so they may be handled quickly.

Activity restrictions after the ablation

Your child should avoid heavy or strenuous activity and straddling toys for the first 24 hours after the EP study. The catheter sites may be tender at first, but will improve quickly. Tylenol may be given for the discomfort if needed.

Preparing your child

A few days before the EP study, explain to your child that he or she will be coming to the hospital for a day, possibly overnight. You should be honest! It is best to stress that the EP study is a special procedure and not an operation. It is also important that your child understand that not everything will be pleasant. However, your child will be made to feel as comfortable as possible and will be relaxed during the EP test. By preparing your child for the EP study and ablation and listening to your child,s feelings, you can help your child know what to expect and lessen his or her fears.

The cardiology team wants your child,s stay in the hospital to be as pleasant and worry-free as possible. If you have any additional questions, please call the cardiology office.


	Electrophysiology Study and Ablation: Information for Parents CONTENTS: Introduction The evening before the EP study At the hospital The EP study and ablation After the EP study and ablation At home Activity restrictions after the ablation Preparing your child Introduction: Your doctor has recommended a test in order to learn about and treat your child,s heart rhythm. The test is called an electrophysiology study (or EP study), and may also include an ablation procedure. It is done by a pediatric electrophysiologist and does not require surgery. The EP study and ablation usually takes 3-4 hours to complete. Your child will be scheduled to come to the hospital the morning of the test and will likely be discharged to home later that evening or the next morning. The evening before the EP study Your child should not eat or drink anything for several hours before the EP study. You will be told exactly when to stop solid foods and clear liquids, It is extremely important that your child have an empty stomach before receiving sedation for the procedure. The EP study will be canceled if your child eats or drinks anything after the times allowed. If your child is currently on medications for their heart rhythm, we will ask you to stop them 3-5 days before the test. Please ask your doctor the best way to do this. We ask that you give your child aspirin every day, beginning 3 days before the test if an ablation is likely to be done. Aspirin makes the ablation a safer procedure by preventing the blood from clotting too easily. The dose of aspirin depends upon your child,s weight. We will discuss the dose with you before the procedure. Adolescents should shave off hair at the top of both legs where the EP catheters will be inserted. A "bikini cut" is appropriate. Shaving at home the night before may be more comfortable for the teen then being shaved at the hospital by a nurse. IMPORTANT: If your child appears ill, has a fever, cold, cough, vomiting, diarrhea, diaper rash, or has recently been exposed to the chicken pox, the EP study may need to be postponed. Please call the cardiology office prior to the scheduled procedure date to discuss any symptoms your child has. At the hospital A nurse will check your child,s temperature, pulse rate, and blood pressure. Your child will be given pajamas to wear. A numbing cream will be placed over the sites where the EP catheters will be inserted, usually at the top of the legs and the right side of the neck. With this cream applied your child will have little or no pain when injected with a local anesthetic in the EP lab. A sedative may be given to help your child relax during the EP test and ablation. An IV will be placed in the hand or arm as a route to give medications during the procedure. When ready your child will be taken on a cart to the EP lab. During the EP study and ablation you will be given a beeper so that we can reach you. The EP study and ablation The EP study and ablation are done in a special lab with x-ray cameras and heart computers. All of the people in the room will be dressed in scrub suits. The area where the doctor will insert the EP catheters, usually the tops of the legs and the right side of the neck, will be washed with a yellow antiseptic soap. Your child will then be covered with sterile drapes from chin to toes. The EP study and ablation involves inserting catheters (thin, flexible tubes) into the heart from the veins in the leg and neck. The catheters are guided into the heart by the electrophysiologist using x-ray cameras. The catheters assist us in locating the abnormal rhythm in your child,s heart. Because we will need to see this rhythm, your child may feel extra heart beats during the test. The nurses and doctors will be closely monitoring your child at all times. If an ablation is done, radiofrequency (or RF) energy is delivered through a catheter. The energy heats up the extra electrical tissue in the heart, which is the cause of the abnormal rhythm, and destroys it. At the end of the procedure, the catheters are removed. Pressure is applied to the leg and neck area to stop any bleeding. No stitches are needed. A dressing will cover the site. After the EP study and ablation Your child will return to their room and may feel sleepy for several hours. He or she will be asked to lie in bed for 4-6 hours to prevent any bleeding from the catheter sites. When awake, your child will be able to drink clear liquids and later have something to eat. You will probably be able to take your child home the evening of the procedure or the next morning. You will be given a list of simple instructions before you leave the hospital. Please review these and write down any questions you might have. At home Once home, keep the catheter sites dry and clean (sponge bath or shower only). Change the Band-Aid daily until healed, usually 3-5 days. Bruising of the skin at the catheter site is common and is not dangerous. If bleeding from the site occurs, apply firm, constant pressure with a clean cloth, for 5 minutes. Call your cardiologist if any of the following occur: bleeding redness of the skin green/yellow discharge at the catheter site elevated temperature (over 101.5 F) dizziness or near-fainting rapid heartbeat If a rapid heartbeat or dizziness should occur help your child to a relaxed lying position and call the cardiology office. We want to stress that we are not expecting any of these problems, but if any should occur, please call, so they may be handled quickly. Activity restrictions after the ablation Your child should avoid heavy or strenuous activity and straddling toys for the first 24 hours after the EP study. The catheter sites may be tender at first, but will improve quickly. Tylenol may be given for the discomfort if needed. Preparing your child A few days before the EP study, explain to your child that he or she will be coming to the hospital for a day, possibly overnight. You should be honest! It is best to stress that the EP study is a special procedure and not an operation. It is also important that your child understand that not everything will be pleasant. However, your child will be made to feel as comfortable as possible and will be relaxed during the EP test. By preparing your child for the EP study and ablation and listening to your child,s feelings, you can help your child know what to expect and lessen his or her fears. The cardiology team wants your child,s stay in the hospital to be as pleasant and worry-free as possible. If you have any additional questions, please call the cardiology office.

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