Index
Ep Defined | Getting Started | Working in the EP Lab
Right Atrium | Right Ventricle | Left Atrium | Left Ventricule | Cardiac Conduction | Cardiac Cell Properties | Action Potential | Sympathetic or Not | Med Page
Electrograms Defined | Recording Modes | Electrode Spacing | Filters | EGM Interpretation | Arrhythmia Analysis
The Physical Lab | Tools of the Trade
Setting Up | Catheter Placement | Baseline Measurement | SNRT | Conduction Study | Arrhythmia Induction | Pacing Protocols | Ablation | Tilt Table | Secrets to Success
Bradycardia | Atrial Tach | Atrial Flutter | Atrial Fibrillation | AVNRT | AVRT | Ventricular Tachycardia
Surface ECG's | Intracardiac Questions | Med Challenge | Advanced

The Physical Lab - Are You Sterile?

Should the EP Lab meet the requirements for a "sterile room"?

          While many labs today operate as procedural rooms and are not built with the same specifications as a sterile surgical room with features such as positive pressure, advances in cardiac medicine may suggest the need for an EP lab to function as a sterile room. Historically, I am aware of no data that indicates percutaneous procedures such as heart caths or electrophysiology procedures require the higher level of sterility that are utilized in operating theaters. This does not mean that you should build all your labs without the extra modifications necessary to achieve a fully operational sterile room

Hybrid Labs

         While pediatric EP has routinely used Hybrid Labs, this is one of the more recent developments in adult electrophysiology. One procedure that has brought the need for the hybrid lab to adult EP programs is atrial fibrillation ablation. This procedure utilizes a combined surgical and percutaneous approach to atrial fibrillation ablation. The initial aspect of the procedure is surgical using a system that ablates cardiac tissue from the epicardial approach. Access is through 2-3 laprascopic incisions. Once the epicardial ablation has been completed, the percutaneous approach is initiated. This type of procedure is used for patients with persistent atrial fibrillation in which other approaches have not produced successful results. If you build all your labs without the capacity of a sterile surgical suite, this is one procedure your facility would not be able to perform.

Disclosure

         The information presented above should, in no manner, indicate condoning or approving any off label utilization of any device or equipment on the part of the author or anyone associated with the author. This is simply a discussion of how changing technology should be considered when designing a new EP lab.

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