His bundle electrography is part of an electrophysiology (EP) study. You are given a mild sedative prior to the test. An intravenous catheter (IV line) is started in your arm to allow for the administration of medication during the procedure.

Electrocardiogram (ECG) leads are placed on your extremities. A cardiologist inserts a 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. Your heart is monitored by ECG for arrhythmias during catheter placement.

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

Food and fluid are restricted 6 to 8 hours before the test. The procedure takes place in a hospital. Sometimes you enter the hospital the night before the test. Otherwise, you enter as an outpatient or inpatient the morning of the procedure. Your health care provider will explain the procedure and its risks.

His bundle electrography requires witnessed, signed consent prior to the procedure.

About half an hour before the procedure, you receive a mild sedative. The procedure may last from 1 to several hours. You must wear hospital clothing.

During the test, you are awake and able to follow instructions. 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 a prolonged period of time.

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 regimen
• To diagnose dysrhythmias

Conduction intervals that are appropriately spaced.

Abnormal results may indicate:

• Chronic conduction system disease
• Carotid sinus pressure
• Recent heart attack
• Ingestion of drugs
• Atrial disease

Risks of the procedure are cardiac arrhythmias, cardiac tamponade, trauma to the vein or artery, low blood pressure, infection, embolism from blood clots at the tip of the catheter, hemorrhage, stroke, and heart attack.