Advice and questions - Electrophysiology and implantable devices

Find out the most important advice given by our consultant and the most adequate medical responses for each particular case.


How do we prepare for an electrophysiologic test?

  • The patient shall be informed with regard to all the medication that can be administered in the days preceding the investigation;
  • In certain cases, the physician can interrupt the administration of certain medication for three to five days before the investigation. For example, patients suffering from diabetes need to request information regarding the administration of the medication specific of their pathology;
  • Patients are not allowed to eat on the evening before the investigation;
  • If the patient does not comply with the medical indications regarding the preparation for this investigation, results may be inconclusive.

How is the test performed?

The electrophysiologic study lasts approximately 45 – 50 minutes. The patient undergoing the investigation receives local anaesthesia in the area of the puncture, usually at the level of the femur. Through this area we insert two catheters in a larger blood vein, which are then manoeuvred inside the heart. The catheters are similar to flexible, smooth cables, two millimetres in diameter. They are manipulated through radioscopy and they are used to constantly register the cardiac activity and the electrical stimulation, through a connection to an external stimulator. Moreover, in order to determine the diagnosis, we need to administer certain pharmacological substances during the procedure.

What are the risks?

The benefits of this procedure are superior to the risks and this is why we consider that the procedure should be performed. Puncturing the cutaneous tissue can lead to certain complications such as: the formation of a local haematoma that resorbs itself in time. Major complications are purely exceptional, 1 in 3,000 cases, and they involve haemorrhage that requires transfusions, pulmonary embolism or systemic embolism and cardiac perforation that requires cardiac tamponade. The medical personnel are prepared for any complications and they have all the necessary means to solve the problem.

Results obtained

Electrophysiologic studies are investigations used to determine types of arrhythmias by testing the electrical activity of the heart, in order to discover the place of origin of a certain abnormal cardiac rhythm. The electrophysiologic test can significantly diminish the risk of spontaneous arrhythmias and helps the medical personnel offer the most adequate treatment to the patients.

When does the patient sign the consent form?

  • The patient signs the consent form for this test before taking the test;
  • Before signing the consent form, patients should not hesitate to request additional information in relation thereof.

ADVICE after receiving a CARDIAC PACEMAKER implantation

What happens after I get back home?

In the first days or weeks after the surgery you need to recover. The wound will heal gradually. You will start feeling better. At first, you might be aware of the presence of the pacemaker, but in time, you won't even notice it anymore. Immediately after surgery you should:
  • Keep the wound clean and dry. If you notice that the wound is red, hot, swollen, more painful or it stars leaking, contact your physician immediately;
  • Follow the instruction regarding bathing, dressing and resuming activities;
  • Make only slow movements with the arm that is closer to the cardiac pacemaker. Avoid stretching, lifting weights and making sudden movements. As you heal, start increasing the use of the arm gradually;
  • Do not play with the pacemaker and do not move it underneath the skin. Try not to hit it or to crash into it;
  • Respect your physician appointments;
  • Keep the cardiac pacemaker identification card with you at all times;
  • If your health does not improve, contact your physician. Do not wait for the monitoring visits;

What happens during monitoring visits?

Monitoring visits usually take place at the physician's office or at the clinic. The examination is painless. After a short exam, the clinician or the physician attach the ECG electrodes to your chest. Then, s/he puts the baton on the chest and uses the programming device (the computer that communicated with the cardiac pacemaker) to display and print the information received about the heart and about the cardiac pacemaker. Using this information, the physician can check the pacemaker's settings. If certain changes need to be made, they can be made on the spot. The physician will also check the pacemaker's battery. Inform the physician or the clinician of any problems related to the cardiac pacemaker, the heart or to your general health status. This is also a good time to ask questions about the cardiac pacemaker.

When can I go back to the life I had before?

The recovery period is different for each person, but you should be able to get back to your normal life, with a few minor changes. The wound must be completely healed before resuming your daily normal activities. Talk to your physician about the moment you can go back to work, to driving the car, to doing physical exercises or to going on trips.

ADVICE after receiving a CARDIAC DEFIBRILLATOR implantation

After leaving the hospital you have to take a few months to get used to the situation. Talk to your family and friends about the defibrillator. Although this device cannot heal your disease, it can offer you a high level of safety. Initial doubts and fears can often be overcome through conversation. Most of the patients adapt quickly to the defibrillator. For them, this is their only chance at having an active life once again. In the majority of cases, the defibrillator can prevent the effect of certain potential tachycardias, thus the patients' quality of life improves significantly.


Immediately after surgery you have to pay attention to several things. You have to monitor the scar and to inform the physician if it becomes red, if it swells or if it festers. In the first few days you shouldn't move the shoulder that is closest to the implantation too much in order not to affect the healing process. Afterwards you can move freely, since the shoulder's mobility is not restricted. In the beginning, you also shouldn't lift heavy objects. After you have discussed it with your physician, strolls, sports and baths will no longer represent a problem. Your clothes shouldn't be too tight around the shoulder, in order to prevent irritation. Do not stretch your arms too much, as this can cause an unfavourable tension to the electrodes. After the scar is completely healed, nothing will stop you from resuming an active lifestyle. As long as your physician has no objections and as long as you feeling good, you can do whatever you want. With a defibrillator implantation most of the patients can improve their level of activity, since the defibrillator eliminates the fear of finding oneself helpless during an arrhythmic attack. The most important aspect of resuming your normal lifestyle is that you should feel better regardless of what you do.


You can start being active at work and at home, once again. It is true that you should avoid several activities, such as climbing scaffolds or ladders, welding or navigating alone, because during these activities a short moment of dizziness can put your and the others in jeopardy. You can do your daily shopping without any problem. Usually, the burglar-proof devices in shops do not represent a risk for the patients with defibrillator implants. However, just to be sure, you should pass quickly through these areas, without stopping. Other activities, such as using the computer or the house equipment are possible without any problems. Virtually, your defibrillator cannot be influenced by the vicinity of any usual electromagnetic fields. Nevertheless, a minimum distance of an arm's length should be kept from certain pieces of equipment. You can also resume your old means of entertainment. As a defibrillator carrier you can use household equipment without any problem, as long as they are adequately grounded and you do not try to repair them.


In case of tachycardia, the defibrillator will try to stop in a gentle manner, through anti-tachycardia stimulation. If this does not work, the defibrillator will apply an electric shock of cardioversion or defibrillation. In this case, you have to pay attention to the following things:
  • Find a place where you can relax, even lie down, if possible;
  • Ask someone to stay with you and to call for an ambulance in case the problem persists;
  • Call your physician if you are not feeling good after the defibrillator has acted;
  • If you feel good after the defibrillator has acted, there is no need to call the physician. If you consider that it is necessary, you can call your physician in order to let him/her know what has happened. The physician might ask things such as:
    • What were you doing before the defibrillator acted?
    • What did you feel (fear, nausea, palpitations, weakness etc.)?
    • How are you feeling after the event?
Patients usually understand that this action is necessary and they accept it. After all, it is the rhythm irregularity that is dangerous, not the defibrillator. This is also valid for the fainting sensation that might occur. It is caused by the arrhythmia, not by the defibrillation. The defibrillator gives the sense of security in critical situations. Patients feel the shock of the defibrillator in various ways. The electrical impulse can be perceived as a strong and painful punch in the chest. The chest muscles and those of the superior part of the arm can contract in such a strong manner that you might be frightened. As long as this means that the defibrillator is working, you shouldn't be alarmed.