Electrophysiologist

What is an electrophysiologist?

An electrophysiologist is a heart specialist with a deep understanding of your heart’s electrical system. This is what makes your heart beat and circulate blood to your body. Normally, your heart beats in an orderly and efficient way. Electrical signals follow a normal pathway to make your heart pump again and again.

When something goes wrong with your heart’s electrical impulses, you may need to see an electrophysiologist. They can figure out what’s happening in your heart and fix it.

A pediatric electrophysiologist treats children or teens who have heart rhythm problems.

What does an electrophysiologist do?

An electrophysiologist diagnoses and treats conduction problems in your heart. They find out why your heart has an irregular rhythm and why your heart’s electrical signals aren’t going through the normal pathways. A cardiac electrophysiologist can tell the difference between an annoying but harmless arrhythmia and a dangerous one.

They can figure out what’s causing your electrical problem and where the problem starts. Once they know what’s causing the issue, they can treat it. With a method like a catheter ablation, more than 90% of treatments are successful. Because of this, electrophysiologists can improve the quality of life for many people they treat.

What is the difference between a cardiologist and an electrophysiologist?

An electrophysiologist is a specialized type of cardiologist. A cardiologist treats heart disorders and diseases. An electrophysiologist is an expert in your heart’s electrical system that controls your heart rhythm.

What diseases do electrophysiologists treat or help you prevent?

An electrophysiologist treats heart issues that have to do with your heart rhythm. Many of these involve heartbeats that are irregular or too fast. Some conditions are more dangerous than others. Heart rhythm-related conditions include:

• Atrial fibrillation.
• Atrial flutter.
• Atrial tachycardia.
• Heart block.
• Wolff-Parkinson-White syndrome.
• Ventricular fibrillation.
• Ventricular tachycardia.
• Supraventricular tachycardia (SVT).
• Premature atrial contractions.
• Premature ventricular contractions.
• Sick sinus syndrome.
• Long QT syndrome.

Why would I be referred to an electrophysiologist?

A provider may refer you to an electrophysiologist if they believe you have an electrical problem with your heart. You may see a cardiac electrophysiologist if your heart rate is faster or slower than normal or irregular instead of consistent.

What kind of tests does an electrophysiologist do?

An electrophysiologist can do rhythm recording or heart imaging to look for the cause of your issue. Many of these procedures are noninvasive. Some may require an IV in your arm. Tests may include:

• Electrophysiology study.
• Tilt table test.
• Electrocardiogram (EKG).
• Holter monitor.
• Event monitoring.
• Transthoracic echocardiogram (TTE).
• Transesophageal echocardiogram (TEE).
• Computed tomography (CT).
• Heart MRI.

When should I see an electrophysiologist?

You should see a cardiac electrophysiologist when you’re having symptoms that include:

• Shortness of breath.
• Chest pain.
• Heart palpitations.

Many heart rhythm issues have similar symptoms in common. It takes an electrophysiologist’s expertise to determine which kind of abnormal heart rhythm you’re having.

Do I need a referral to see an electrophysiologist?

Most likely, you’ll need a referral to see an electrophysiologist. Even if your insurance company doesn’t require a referral, another provider will probably refer you when they suspect a heart rhythm issue.

What can I expect at an electrophysiologist appointment?

An electrophysiologist will review your medical history and discuss any symptoms you’re having. They’ll also want a list of all medicines you’re taking, including those you buy without a prescription. A cardiac electrophysiologist may do a quick test like an electrocardiogram (EKG) or send you home with an event monitor that can record your heart rhythms for a certain length of time.

If you’ve already had these tests, an electrophysiologist may do a test that provides more information for a diagnosis. After making a diagnosis, an electrophysiologist can do a treatment. Sometimes they can do this during the same visit. Treatment may consist of a procedure or device implantation.

How do electrophysiologists treat heart rhythm issues?

Electrophysiologists can pinpoint your issue and determine the right treatment for you. It could be as simple as a new medication. Other people may need a device to ensure a reliable heartbeat.

Treatments include:

• Medicine. You take this regularly or receive it in an IV when the need is urgent.
• Pacemakers. These use electrical impulses to correct an issue with your heart’s electrical system.
• Implantable cardioverter defibrillators (ICDs). These can shock your heart when you need it.
• Cardioversion. An external device shocks your heart to get its rhythm back to normal.
• Catheter ablation. A provider uses this to make scars that keep irregular impulses from getting through and causing abnormal heart rhythms.

What kind of training does an electrophysiologist have?

After medical school, electrophysiologists fulfill a general internal medicine residency. They also complete a cardiovascular disease fellowship and then another year or two of training. Then they can pursue board certification from the American Board of Internal Medicine. They have to take and maintain multiple board certifications.

Where do electrophysiologists work?

Electrophysiologists work in private practice with other cardiologists. They also work in hospitals and do testing in an electrophysiology lab. This is also known as an EP lab or catheterization “cath” lab.

A note from Cleveland Clinic

If you’ve had several fainting episodes, you may be able to get answers from an electrophysiologist. They can do tests to find what’s causing your heart rhythm issues. Ask questions if you don’t understand the test they want to do. Once they have a diagnosis, they’ll explain possible treatments to you. Although seeing a specialist may be out of your comfort zone, rest assured that electrophysiologists are experts when it comes to understanding and treating heart rhythms.