Electrophysiology is a branch of medicine concerning the heart’s electrical system. An electrophysiologist tests the electrical activity of the heart and can diagnose and treat a number of conditions.

Heart disease is one of the leading causes of death in the United States. While cardiologists have the means to treat most heart conditions, some people may require a subspecialist.

Electrophysiology is an area of medicine that concerns the heart’s electrical system. To function correctly, the cells in the heart’s tissues send electrical signals to regulate heartbeat and rhythm.

An electrophysiologist is a type of doctor trained in the mechanism, function, and performance of the heart’s electrical activities. They test the heart’s electrical system and treat any conditions associated with a rhythm irregularity, such as arrhythmias.

Read on to learn more about the role of an electrophysiologist.

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Electrophysiologists are medical specialists. In addition to internal medicine training, they receive additional training to fulfill their role.

Here is a breakdown of what their education and training may look like in the United States:

  • 4 years of medical school
  • 3 years of residency training in internal medicine
  • 3-year fellowship in cardiac disease
  • 1–2 years training in electrophysiology

Upon completing their training, electrophysiologists work in hospitals with electrophysiology labs, cardiac centers, and private practices.

Electrophysiologists are responsible for testing and treating conditions associated with the heart’s electrical system. Some common conditions they deal with include:

There are several diagnostic tools an electrophysiologist may use. These include:

  • electrocardiograms, which test the heart’s rhythm and electrical activity
  • echocardiograms, which assess the structure and function of the heart
  • electrophysiology studies (EPS), a test where a doctor inserts a thin tube into a blood vessel leading to the heart, then places specialized electrodes in the heart to send electrical signals and measure electrical activity

Among performing diagnostic tests, electrophysiologists may also prescribe medications and recommend lifestyle changes.

Typically, a person is referred to an electrophysiologist instead of setting up an appointment directly.

A person may work with an electrophysiologist if their cardiologist or primary care doctor suspects an electrical problem or deems it necessary, such as if the person:

  • has a heart rate that is either irregular, too fast, or too slow
  • experiences dizziness, fainting, and fluttering feelings in their chest
  • is at risk of heart disease
  • is undergoing major heart surgery
  • is undergoing cardiac ablation

Generally, during an appointment with an electrophysiologist, they ask about a person’s medical history and perform a physical exam. They also make note of the person’s main concerns and symptoms.

Following this, the electrophysiologist develops a plan for diagnosis and treatment. They may order imaging tests on the day of the appointment and schedule further tests, such as an EPS, for another day.

Once an appointment has been made for an EPS, the electrophysiologist may ask the person to do the following before the appointment:

  • not eat or drink anything for 6–8 hours before the test
  • not take any medications or supplements before the test
  • have someone drive the person to their appointment and take them home

During the procedure, the following occurs:

  1. The person receives a sedative to help them relax.
  2. Medical staff cleans and shaves the area where the doctors will be working. This is usually the groin but may be the arm or neck.
  3. The person receives a local anesthetic to numb the area before the doctor makes a needle puncture to access a blood vessel.
  4. The doctor places a small tube, or catheter, into the blood vessel and gently guides it toward the heart.
  5. The doctor sends small electrical pulses through the catheter to make the heart beat at different speeds.
  6. The catheter picks up electrical signals made by the heart and records them. This is called cardiac mapping. It allows the doctor to identify potential problems.
  7. Once completed, the doctor removes the catheters and puts pressure on the puncture sites to stop any bleeding.

An EPS can last anywhere from 1–4 hours. Once finished, the doctor can identify the type and location of the arrhythmia and then decide on an appropriate treatment option.

The doctor may perform treatments, such as cardiac ablation or insertion of a pacemaker, during or immediately after the EPS.

Electrophysiology is a subspecialty of cardiology that deals with conditions concerning the heart’s electrical system. An electrophysiologist is a type of doctor who tests the heart’s electrical system and treats conditions regarding irregular heart rhythms.

A person may undergo a series of tests to determine the type and location of the problem with the heart’s electrical activity. These include electrocardiograms, echocardiograms, and electrophysiology studies.