Welcome to the EP Lab...

          This section of the web page is designed to provide some insight on how to deal with some of the issues that confront those who are developing their EP programs. The Physical Lab deals with some of the challenging issues of power, cables and storage. If you are planning on adding a new lab, please read this section first. Tools of the Trade will provide an overview of the equipment that is often found in the lab.

 The EP Lab of Yesterday…

          In the early days of cardiac electrophysiology, many programs were offshoots of the cardiac cath lab. Rooms and staff were shared and the EP cases were often relegated to the last case of the day. This approach to performing electrophysiology procedures lead to some very long days, making life difficult on both the physicians and the staff. It did not take long before there was a push from practitioners of electrophysiology for separate procedure areas. As with all things in the medical field, allocation of resources was in direct proportion to finances. For this reason, many EP labs started out in rooms no longer needed by cath programs who had moved on to bigger and better things. Often these rooms were less than ideal in terms of size and location. How many of you did EP in a small lab located somewhere in the basement?

The EP Lab of Today…

          Since the time when I first started working in cardiac electrophysiology, this field of medicine has experienced phenomenal growth. So too, has my own knowledge. I look back on the time when the idea to create a web site dedicated to the Allied Professionals who worked in this field first came to mind. A good friend of mine and I were discussing the lack of EP education available for lab staff over dinner one night after a case. “Dog gone Dave from Daig, how the heck are you?” Both of us were pretty new to EP and finding any information that was beyond what you would tell a patient but not so advanced that only a physician would understand it was just about impossible. My wife had recently started working with web design when it seemed that the three of us came to the same idea at about the same time. And so, The EP Lab was born.

           Now, ten years later, it is getting a much needed makeover. I have learned a lot since those early days, and the field of EP has moved from the basement to become an integral part of any self respecting Cardiology Service. In many facilities, Cardiac Electrophysiology has become a separate section of cardiac services. There are even facilities that now have multiple rooms dedicated to the practice of EP. In good sized medical centers, It is common to see two to four EP labs while in larger centers there may be four or more. I have been in one facility that had ten dedicated EP Labs.

          The EP labs of today are large, well lit rooms that contain a wide variety of specialized equipment. Advances in medical technology have extended the realm of cardiac electrophysiology to provide therapies for arrhythmias that were once considered untreatable by anything other than a palliative pharmaceutical approach. Ablation for atrial fibrillation has become common in many facilities. To make these advances has required the addition of new tools and new tools require storage space as well as extra power. There are also extra cables that must be dealt with.

The EP Lab of Tomorrow

          As technology continues to advance, integration will play a key role in shaping the EP labs of tomorrow. The various systems in the lab must be able to exchange information that extends beyond patient specific information. The first indications of this trend can be seen in the interaction between the Carto cardiac mapping system and the Stereotaxis magnetic navigation system. Each of these systems has a specific function that, when combined, provides greater functionality for those who work in the lab. The St. Jude EnSite System utilizes information from CT or MRI scans to augment and even replace the highly detailed geometries used for its three dimensional cardiac mapping. These “interactions” between systems will be one of the key factors that will shape the labs of tomorrow.