Electrocardiologists are cardiologists who have received additional training in testing for and treating heart rhythm problems.

Electrocardiologists are also known as electrophysiologists, cardiac electrophysiologists, or cardiac EPs.

The heart is partly a muscular pump that pushes blood through the circulatory system. It has a complex electrical system that regulates heart rate and rhythm.

Problems in the electrical, endocrine, or nervous systems can dramatically affect heart rate and rhythm. Sometimes, these disruptions classify as arrhythmias.

Electrocardiologists work to return the heart to a typical rate and rhythm.

This article explains their education and training, when to contact one, how to find one, and what to expect from the visit.

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Electrical impulses that come from specific parts of the heart manage heart rate and rhythm. These impulses travel through the heart on conduction pathways, creating the contraction that pushes blood through the arteries.

At rest, a heart typically beats 60–100 times per minute.

Arrhythmia (irregular heartbeat) can occur for several reasons. If the sinus node (portion of the electrical system that acts as the heart’s natural pacemaker) becomes diseased, it may slow down the heart rate. The path of electrical conduction can become disrupted.

Another part of the heart may take over the job of the sinus node and start pacing the heart’s rhythm too fast or too slow. Doctors call arrhythmia that starts at the sinus node sinus arrhythmia.

Electrocardiologists treat problems with heart arrhythmia through medication, surgical procedures, or implanting a pacemaker. They treat several types of irregular heart rhythm:

Atrial fibrillation

Atrial fibrillation occurs when the heart’s upper chambers, called the atria, beat out of rhythm. The heart does not empty all the blood in these chambers, which may cause it to pool, increasing the risk of blood clots.


On average, a typical heart rate for adults is higher than 60 beats per minute. Doctors call a resting heart rate lower than this bradycardia. Problems in the sinus node or the heart’s electrical pathways may slow the heart rate.

Other causes of bradycardia include:


Doctors call a heart rate over 100 beats per minute tachycardia.

Disruption of electrical signals in the heart’s upper chambers or structural abnormalities typically cause tachycardia. As the heart beats more quickly, it cannot fill with blood between beats and is less able to push blood out to the circulatory system.

Long QT syndrome

Long QT syndrome is a type of conduction disorder that appears on an electrocardiogram (EKG) as an anomaly between two peaks of the heartbeat.

On an EKG, there are five distinct electrical waves in a heartbeat: P, Q, R, S, and T. The space between the Q and T waves is generally about one-third of the heartbeat, but this space is longer in some people. This brief interruption can disrupt the regular pace of the heart and cause fast heart arrhythmia.

A doctor trained in cardiology has completed undergraduate education and 4 years of medical school. Following medical school, they do an additional 6–8 years of training, 3 years of internal medicine residency, and 3–5 years of fellowship training for cardiovascular disease.

The cardiac training includes some electrophysiology training, pacemaker implantation, and implantable cardiac devices.

After training, electrocardiologists must pass a certification exam by one of the American Boards of Medical Specialties. Most are members of the American College of Cardiology.

Following board certification, electrocardiologists must undergo an additional 2 years of training specific to electrophysiology.

Electrocardiologists typically require a referral from another doctor to set an appointment. A doctor may refer a person to one for symptoms of arrhythmia or if they hear an irregular heart rate during an exam.

Some of the symptoms an individual might experience that would cause a doctor to send them to an electrocardiologist include:

How to find an electrocardiologist

The most reliable way to find an electrocardiologist is for a person to work with their referring doctor’s office and their insurance company to find one that accepts new patients and can offer an appointment in a reasonable time.

An electrocardiologist might recommend running a test called an electrophysiology (EP) study. This requires threading a thin catheter into a vein or artery that leads to the heart. Electrodes then send signals and take readings of the heart’s rhythm and electrical activity.

The electrocardiologist will then record and map the electrical signals in the heart through the catheter. This allows them to pinpoint the source of the arrhythmia.

This test typically lasts between 1–4 hours. A person will typically receive a mild sedative to help them relax.

An EP study can identify:

  • the source of an arrhythmia
  • whether medications are helping treat the arrhythmia
  • whether an ablation to stop the arrhythmia could help
  • whether a pacemaker or implantable cardioverter defibrillator could help
  • whether there is a risk of fainting or sudden death due to cardiac arrest

EP studies are generally very safe, but a person should still discuss possible risks with a doctor in advance.

An electrocardiologist is a cardiologist who completes additional training on the electrical system that causes the heart to maintain rhythm. When the heart gets out of rhythm, doctors call this an arrhythmia. Arrhythmia can create a range of symptoms and, in some cases, may become a medical emergency.

An electrocardiologist may recommend a test called an EP study that locates the source of arrhythmia and looks for damage to the heart. Using information from this test, they can determine whether to proceed with surgical intervention or treat the condition with medication or other recommendations.

Visiting an electrocardiologist generally requires a referral from another doctor, such as a primary care doctor or cardiologist. They should be able to recommend one in the area, and the electrocardiologist’s office can confirm what insurance plans they accept.