Electrophysiology (EP) is a study that is performed to evaluate abnormal heart rhythms or arrhythmia and to check the heart’s electrical activity. When a patient’s heart does not beat at a normal pace, the doctor uses an EP to diagnoses the underlying causes. Furthermore, the travel of electrical signals through the heart shows if there any irregular patterns.

Some reasons, including, heart attack, aging, high blood pressure, may cause abnormal heartbeat. Also, the decision to have electrophysiology is entirely up to a doctor after considering each patient’s health condition; however, some common reasons why electrophysiology will be performed are explained below:

• To understand the origin of the arrhythmia.
• If some medicine will have an effect on treating arrhythmia.
• If the best choice of treatment would be a catheter ablation (removing what is causes the arrhythmia).
• If the patient is at risk of a heart problem.

Electrophysiology is performed in unique rooms that have all the essential equipment for the study. The patient will be placed on an X-ray table, and a sedative medication will be administered to help them feel relaxed. Also, to monitor the patient vital signs, electrodes will be attached in the chest and on the back. Afterward, the doctor with an antiseptic will wash and possibly shave the groin or neck area where the catheter will be inserted. The entry point in which the catheter is to be inserted will be numbed with a local anesthetic injection. Subsequently, in order to reach the blood vessels, a long, thin, and flexible tube will be inserted through the patient’s veins. Following that, the doctor will guide the catheter toward the heart, and all the movement of the catheter will be tracked on the screen.

Usually, there are no pains in this procedure, but because of the insertion area, the patient may feel some pressure. In the next part, when the catheter reaches the heart, electric pulses will be sent to the heart to change the rhythm and to make it beat at a different speed rate. The doctor sometimes, by administering some medication, will try to create abnormal rhythm so he or she can understand the reasons for the arrhythmia. During this time, the patient may feel a fast heartbeat or some discomfort, but there is no need to worry. In the last part, the catheters will record heart electrical signals that are produced, which later the doctor will choose the right therapy.

• The patient needs to take a few hours to stay in bed and keep the entry point elevated. 
• The nurse will check the patient frequently in case there is bleeding. 
• The doctor will give the patient instruction and preliminary test results. 

• During the study, the patient may feel dizzy due to the abnormal inducing heartbeat, which in these situations, a shock will be given to restore the normal heartbeat.
• Blood-thinning medication will be provided to prevent any blood clots.
• There can be an infection, bleeding, and bruising at the entry area of the catheter.

It would be good to mention that some Iranian researches who are active in the Department of Pacemaker and Electrophysiology in Iran have contributed some grounding works in the field of Cardiovascular studies. Although few countries possess adequate knowledge and expertise in performing such a procedure, Iran has shown tremendous growth by establishing 15 active Electrophysiology centers. Both invasive and non-invasive electrophysiology procedures are performed in Iran. Furthermore, the Iranian Heart Association has established a specialized Heart Rhythm Branch that will give access to patients to benefit from the most suitable treatments.