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Electrophysiology Study & Ablation Singapore

An electrophysiology study (EP study) is a diagnostic procedure that evaluates the electrical activity of your heart to identify abnormal heart rhythms (arrhythmias). If irregular areas are detected, cardiac ablation can be performed during the same session. The goal is to restore a healthy heart rhythm and reduce symptoms like palpitations, dizziness, or breathlessness.

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Dr. Kua Jieli

MBBS (SG)|MRCP (UK)|MMed (Internal Med) (SG)|FAMS (Cardiology, SG)

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Indications Benefits Techniques Preparation Procedure Recovery Risks FAQ
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Indications
Benefits
Techniques
Preparation
Procedure
Recovery
Risks
FAQ

Indications for Electrophysiology Study and Cardiac Ablation

Your cardiologist may recommend an electrophysiology study and potential ablation for several heart rhythm conditions:

  • Atrial fibrillation

    This common irregular heart rhythm causes the upper chambers of your heart to beat chaotically. An EP study can locate the areas triggering this condition, and ablation may help restore normal rhythm.

  • Atrial flutter

    Similar to atrial fibrillation but with a more regular pattern, this condition causes rapid beating in the heart’s upper chambers. Ablation is often highly successful in treating this particular rhythm disorder.

  • Ventricular tachycardia

    This rapid heart rhythm originates in the lower chambers of your heart and can be life-threatening. An EP study helps identify the exact location, and ablation may prevent future episodes.

  • Supraventricular tachycardia (SVT)

    This condition causes sudden episodes of rapid heartbeat that can make you feel dizzy or short of breath. Ablation can often provide a permanent cure for many types of SVT.

  • Wolff-Parkinson-White syndrome

    This inherited condition involves an extra electrical pathway in the heart that can cause rapid heart rhythms. Ablation can eliminate this extra pathway and prevent symptoms.

  • Recurrent unexplained fainting

    When fainting episodes cannot be explained by other tests, an EP study may reveal underlying heart rhythm problems that could be treated with ablation.

Benefits of Electrophysiology Study and Cardiac Ablation

This treatment approach offers several potential advantages for patients with heart rhythm disorders:

Improved symptoms

Many patients experience significant improvement in palpitations, chest discomfort, breathlessness, and dizziness after successful ablation.

Reduced need for long-term medication

Following successful ablation, many patients can reduce or stop taking heart rhythm medications that may have unwanted side effects.

Lower risk of stroke

For patients with atrial fibrillation, successful ablation may reduce the risk of blood clots forming in the heart. This can lower your long-term stroke risk, though some patients may still need blood-thinning medication.

Electrophysiology Study and Cardiac Ablation Technologies and Techniques in Singapore

Different ablation technologies and techniques  may be used depending on your specific heart rhythm condition and its location:

Technologies
  • 3D mapping systems: Computer mapping creates detailed images of your heart’s electrical activity in real-time. This technology helps guide catheter placement with greater precision and reduces procedure time.
  • Radiofrequency ablation: This commonly used technique applies heat energy through the catheter tip to create small scars in heart tissue. The heat destroys the abnormal electrical pathways causing your irregular rhythm.
  • Cryoablation (freezing): This method uses extremely cold temperatures to freeze and destroy problematic heart tissue. Cryoablation is particularly useful for certain types of arrhythmias and may cause less discomfort during the procedure.
Techniques
  • Pulmonary vein isolation: This specialised technique is used primarily for atrial fibrillation, where electrical signals from the pulmonary veins trigger irregular rhythms. The procedure creates a barrier around these veins to prevent abnormal signals from reaching the heart.
  • Linear ablation: This approach creates longer lines of scar tissue to block electrical signals that cause certain types of atrial flutter. Multiple ablation points are connected to form continuous barriers that redirect the heart’s electrical activity.
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Preparing for Electrophysiology Study and Cardiac Ablation

Proper preparation helps ensure your procedure goes smoothly:

  • Medical evaluation: You will have blood tests, an ECG, and possibly an echocardiogram to assess your heart function before the procedure. Your cardiologist will review your medical history and current medications to plan the most appropriate approach.
  • Fasting requirements: You must not eat or drink anything for at least 8 hours before your procedure, typically from midnight the night before.
  • Pre-procedure arrangements: Arrange for someone to drive you home as you cannot drive for 24 hours after the procedure.

Step-by-Step Procedure

Here’s what happens during your EP study and ablation:

  • Sedation and local anaesthetic

    You will receive conscious sedation to help you relax while remaining awake enough to respond to instructions. Local anaesthetic is injected into the groin area to numb the insertion sites for the catheters.

  • Catheter insertion

    Several thin, flexible catheters are inserted through small punctures in blood vessels in your groin and guided to your heart using X-ray imaging. These catheters can both record electrical signals and deliver ablation energy when needed.

  • Electrical mapping

    The catheters record your heart’s electrical activity to create a detailed map of the abnormal rhythms. Your cardiologist may deliberately trigger your arrhythmia to identify exactly where the problem originates.

  • Ablation treatment

    Once the problematic area is located, energy is delivered through the catheter to destroy the tissue causing the irregular rhythm. You may feel some chest discomfort during this phase, but it typically lasts only a few seconds.

  • Testing and completion

    After ablation, your cardiologist will test whether the abnormal rhythm can still be triggered to confirm the treatment was successful. The catheters are then removed, and firm pressure is applied to the insertion sites to prevent bleeding.

Post-Surgical Care and Recovery

Immediate Care
  • Recovery room monitoring: You will be taken to a recovery area where nursing staff will monitor your heart rhythm and blood pressure for several hours. You must lie flat and keep your leg straight for 4-6 hours to allow the insertion sites to heal properly.
  • Pain management: Some chest discomfort is normal after ablation, and you may be given pain relief medication if needed. The groin area may feel tender where the catheters were inserted, but this usually resolves within a day or two.
  • Observation period: Most patients stay in hospital overnight for observation, though some may go home the same day depending on the procedure complexity. Your medical team will check for any signs of complications before discharge.
Recovery Timeline
  • First 24 hours: Avoid driving, lifting heavy objects, or strenuous activities for the first day after your procedure.
  • First week: Most people can return to desk work within 2-3 days, though you should avoid heavy lifting or vigorous exercise for about a week. Some patients experience mild fatigue as their heart adjusts to the new rhythm pattern.
  • Long-term recovery: Full recovery typically takes 2-4 weeks, after which most normal activities can be resumed. Your heart rhythm may take several months to stabilise completely, so some irregularities during this period are not uncommon.
Follow-up Care
  • Routine appointments: You will have follow-up appointments with your cardiologist at regular intervals to monitor your heart rhythm and assess the success of the procedure. These typically occur at 1-3 months, then 6-12 months after treatment.
  • Heart rhythm monitoring: Your cardiologist may arrange for you to wear a heart monitor for a period to check how well your heart rhythm has responded to treatment.
  • Medication review: Your heart rhythm medications may be adjusted or stopped following successful ablation, though this decision is made gradually over several months. Blood-thinning medication may still be required for some patients with atrial fibrillation.

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Potential Risks and Complications

Like all medical procedures, an EP study and cardiac ablation carry some risks, though serious complications are rare. The most common include minor bleeding or bruising at the catheter site and temporary irregular heart rhythms after the procedure. Less commonly, there is a small risk of blood clots, stroke, or damage to the heart’s electrical system, which may require a pacemaker.

A consultation with a qualified heart specialist in Singapore will help you understand your individual risks and whether this procedure is appropriate for your condition.

Frequently Asked Questions (FAQs)

How long does the procedure take?

An EP study typically takes 1-2 hours, though the time can extend to 3-4 hours if ablation is performed. The exact duration depends on the complexity of your heart rhythm problem and how easily the abnormal area can be located.

Will I be able to feel my heart rhythm change during the procedure?

You may notice your heart beating differently when your doctor triggers the abnormal rhythm for testing purposes. Many patients describe feeling palpitations or skipped beats briefly, but this is temporary and closely monitored throughout.

Can I return to work immediately after the procedure?

Most people need 2-3 days off work for desk jobs, though you may feel ready sooner. Physical jobs requiring lifting or prolonged standing typically require a week off to allow proper healing of the groin insertion sites.

What should I do if I experience chest pain or palpitations after going home?

Some mild chest discomfort is normal for the first few days, but severe chest pain, prolonged palpitations, or breathlessness should prompt you to contact your medical team immediately. You will be given specific instructions about when to seek urgent care.

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Dr. Kua Jieli

MBBS (SG)|MRCP (UK)|MMed (Internal Med) (SG)|FAMS (Cardiology, SG)

Dr. Kua is a senior consultant cardiologist specialised in interventional cardiology and is the medical director at Carrington Cardiology.

  • He is experienced in managing complex coronary artery disease and a variety of other cardiovascular diseases and conditions.
  • He also handles difficult coronary interventional procedures such as left main disease, chronic total occlusions, and calcified lesions.
  • He served as a Senior Consultant at National University Hospital Singapore and Ng Teng Fong General Hospital and was also the Director of the Cardiovascular Catheterisation Laboratory.

Prior to this, he served as an International Cardiology Fellow and Honorary Consultant at Hammersmith Hospital Imperial Healthcare Trust, where he gained valuable experience in various prestigious healthcare institutions.

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Singapore 228510

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    Image location

    Mount Elizabeth Medical Centre
    3 Mount Elizabeth, #12-02 Medical Centre
    Singapore 228510

    Image email info@carringtoncardio.com.sg
    Image phone +65 6956 6588
    Image mobile +Array
    Image time

    Mon to Fri: 09:00am – 05:00pm
    Sat: 09:00am – 12:30pm
    Sun & Public Holidays: Closed