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patient education : 01073--NIPS Study

Information about Non-Invasive Programmed Stimulation Study - an EP Study of an ICD

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    NIPS Study

    A Non-Invasive Programmed Stimulation Study (NIPs for short), is a type of specialized Electrophysiology (EP) study in which your internal cardiac defibrillator (ICD) is used to evaluate your irregular heartbeats from the bottom chambers of your heart, and the way your device stops them.  Sometimes a NIPS is used to test the your ICDs ability to shock your heart out of an irregular rhythm called ventricular fibrillation (VF) or if there is a concern about the device properly recognizing the rhythm. Lastly, a NIPS study may be ordered if you started a new drug to treat your irregular heart rhythm to see what effect it has on your heart rhythm and the ICDs ability to recognize it.

    This study is NON-invasive which means there are no new lines or tubes placed into your heart, and no incisions made. The entire study is conducted through your ICD using a device to talk with your ICD. This is usually a short procedure, lasting an hour or less


    Before the procedure:  Your healthcare provider might ask you to have bloodwork done before the procedure to make sure your electrolytes and blood count are normal.

    Medication Instructions:

    • If you take blood sugar control (diabetes) medications, you may be asked to hold a dose or take a smaller dose before the procedure
    • You may be asked to hold one or more of your other heart rate and rhythm drugs for a few days before the procedure.  We may want these drugs to wash out of your system so that we can see the abnormal heart rhythm.
    • If you take warfarin, your provider may want you to have your INR checked for 3 weeks in a row. This is to make sure your blood is thin and less likely to produce clots.

    Other Instructions:

    • You will be asked to have nothing to eat after midnight, clear liquids until 5 AM, before the procedure. You are usually allowed to take your other medications with a small sip of water on the morning of your procedure, but check with your doctor.
    • You will be prepared for the procedure by the nursing team. This may include shaving of the chest, and placement of several electrodes (EKG monitoring) patches on your chest and back.   An IV (intravenous line) will be placed in your hand or arm to deliver fluids, pain and sedation medications during the procedure, or certain heart medications.
    • For most of the NIPS studies, you are given sedation or anesthesia to put you to sleep briefly for the length of the procedure. This is to prevent you from feeling discomfort in case your ICD fires or shocks you. 

    During the procedure:  You will be taken into a room (EP Procedure room) for the procedure.  Your heart rate, blood pressure and sedation level will be monitored by a team of nurses and technicians throughout the procedure. There will be a physician or provider there who manages your sedation to keep you comfortable. 

    Once you are asleep, your EP physician will use your ICD to put your heart in a dangerous rhythm and watch how the device treats it, and to test different programmed settings to make your device work at its best.

    During your procedure we may use soft bands (called positioning devices or medical immobilizers) to protect you from moving your arms or legs into the “sterile field.” These bands also keep your arms close to your sides and/or keep you from bending your knees or hips. Accidental movements may interfere with your procedure and could result in bleeding or increased chance of infection.

    After the procedure: Once the procedure is finished, you will be allowed to wake up fully. Your physician will explain what the study showed and any programming changes that were made to your ICD device.

    The doctor may also change your heart-rhythm-controlling medication or the dosage of your medication. Many times there are no changes needed  if the test showed that everything is working well.

    Once you are fully awake, you will be allowed to sit up and walk around.  Most people are able to go home a few hours after the procedure is completed.

    Special Instructions:

    • You will be instructed about which of your medications you are to continue taking and if there are any NEW medications you are to start.   Make sure you have your entire list (including any medications that you stopped for the procedure) so that you can review them at the time of discharge.
    • You must have someone who can drive you home after the procedure.
    • You will receive instructions about when your next clinic visit should be before you leave.
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