The radiofrequency ablation procedure is divided into two main steps: first, electrophysiological examination is performed to clarify the type of tachycardia, and second, the lesion is found and treated by radiofrequency ablation. How is the electrophysiological examination performed? The electrophysiological examination and the RF ablation procedure require the assistance of an X-ray machine and are usually performed in the catheterization laboratory. In the cardiovascular medicine department of Beijing Fu Wai Hospital, Ma Jian, the medical staff will connect various monitoring devices to your body on the X-ray bed. The skin of the puncture site (groin, arm, shoulder or neck) is disinfected and anesthetized with a puncture vessel (often a vein), and an electrophysiological examination catheter is sent into a specific part of the heart cavity to record and analyze the electrical signals in the heart cavity; afterwards, a weak electrical stimulus is issued through the electrode catheter to pace the heart to induce certain arrhythmias, allowing the doctor to observe these abnormal heart rhythms under artificially controlled conditions, helping the doctor to find the This allows the physician to observe these abnormal heart rhythms under artificially controlled conditions, helping the physician to find the exact site of abnormal electrical activity. Determine the site and type of arrhythmia so that the best treatment can be selected. You will be awake during the entire procedure and the electrophysiological examination is generally painless, but you may feel some pressure at the insertion site during the catheter insertion. In addition, lying flat for a long period of time may cause some discomfort. However, you will not feel anything as the catheter travels through your blood vessels. During the test, your doctor may stimulate your heart with weak electrical impulses that you will not feel, but which may trigger the arrhythmia that is causing your symptoms, and you may experience symptoms such as dizziness, palpitations, chest pain or shortness of breath. Electrophysiological exams usually take about half an hour, but some complex arrhythmias may take longer. For different arrhythmias, the full procedure may last from 2 to 6 hours. Is electrophysiology safe? Electrophysiological testing requires the insertion of a catheter into the body and is considered “invasive”. Therefore, there are some risks, but they are minimal, so electrophysiological testing is relatively safe. In a small number of patients, the catheter insertion site (groin or arm) may bleed and blood may pool under the skin, causing local swelling and/or ecchymosis. Although the vast majority of electrophysiological examinations do not present complications, there is a very small risk of vascular entrapment, thrombosis, cardiac rupture, pericardial tamponade, etc. Radiofrequency ablation Cardiac electrophysiology and catheter ablation are two very similar procedures. Both procedures are usually performed in a single session in the catheterization laboratory. During cardiac catheter ablation, a special electrode catheter is inserted into the heart, the tip of the electrode is placed next to the abnormal electrical conduction pathway, and radiofrequency energy (heat) is transmitted to the electrode, causing the myocardial tissue containing the abnormal conduction pathway to be heated and destroyed (ablation). After the electrophysiological examination, all catheters are removed and the doctor (nurse) will apply firm pressure to the catheter insertion site for 10 to 20 minutes to prevent bleeding. After returning to the room, you must lie flat for 2 to 6 hours (or even longer), mainly to allow the punctures of the vessels to crust over and close. Remember not to curl or elevate the leg on the side that was pierced during this time. However, you may move your foot or wiggle your toes in order to relieve stiffness in your lower extremity. The nurse will check your pulse and blood pressure frequently, as well as the puncture site of the catheter. If you suddenly feel pain or bleeding at the puncture site, please tell the nurse immediately. You will be discharged home the next day or the third day after you have passed the observation period. What to do when you return home 1. Limit your activities for 24 hours after you first return home. You may walk around, but do not exert yourself or lift heavy objects. 2. If you notice fresh blood leaking from the dressing at the puncture site, apply firm pressure to the wound with your finger for about 20 minutes. If the bleeding does not stop, call your physician or go to the nearest hospital emergency room for help. 3. Keep the dressing on the puncture site for about a day, and the dressing can be changed to a Band-Aid the next day. 4. Petechiae or small lumps at the skin puncture site are very common. They often subside 3 to 4 weeks after the examination. 5. Call your doctor immediately if you feel pain or heat when you touch the puncture site with your hand, if the petechiae or swelling worsen, or if you have a fever of more than 37.8°C. 6. Have an electrocardiogram checked nearby immediately when your arrhythmia recurs, to clarify whether it is recurrent.