His bundle electrography

How the test is performed:

You are given a mild sedative prior to the test. An intravenous catheter is started in your arm to allow for the administration of medication during the procedure.

Electrocardiogram (ECG) leads are placed on your extremities, and your heart is monitored during catheter placement for arrhythmias.

A radiologist or cardiologist inserts the catheter through a small incision in a vein in your arm, neck, or groin after cleansing the site and numbing it with a local anesthetic. The catheter is then carefully threaded into the heart using an X-ray image technique called fluoroscopy to guide the insertion.

The catheter, which is equipped with an electrode, then measures the electrical activity of the bundle of His.

How to prepare for the test:

Food and fluid are restricted 6 to 8 hours before the test. The procedure takes place in the hospital. Sometimes, you enter the hospital the night before the test. Otherwise, you enter as an outpatient or inpatient the morning of the procedure. The health care provider explains the procedure and its risks and requires witnessed, signed consent for the procedure. About 1/2 hour before the procedure, you receive a mild sedative. The procedure may last from 1 to several hours. You must wear hospital clothing.

Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:

• infant test or procedure preparation (birth to 1 year)
• toddler test or procedure preparation (1 to 3 years)
• preschooler test or procedure preparation (3 to 6 years)
• schoolage test or procedure preparation (6 to 12 years)
• adolescent test or procedure preparation (12 to 18 years)

How the test will feel:

During the test, you are awake, able to follow instructions, and will remain on a stretcher. An incision is made into a vein in your arm, neck, or groin for threading the catheter into the heart. Local anesthesia is given to insert the catheter, so the only sensation is one of pressure at the site. Discomfort may arise from having to remain still for prolonged periods of time.

Why the test is performed:

This test may be performed for the following reasons:

• to find the specific location of a block in the electrical conduction through the heart
• to determine if there is a need for pacemaker placement or implementation of a medication regime
• to diagnose dysrhythmias