An electrophysiologist — also referred to as a cardiac electrophysiologist, arrhythmia specialist, or EP — is a doctor with a specialization in atypical heart rhythms and the electricity of the heart.

Electrophysiologists test the electrical activity of your heart to diagnosis the source of arrhythmias (irregular heartbeats) and to help determine a suitable treatment.

Keep reading to learn more about electrophysiologists and what type of tests they perform.

Education and training

Most electrophysiologists are cardiologists with years of additional training, while some electrophysiologists started as surgeons or anesthesiologists.

In the United States, a cardiologist receives at least 10 years of medical training, which includes:

  • 4 years of medical school
  • 3 years of training in internal medicine
  • 3 to 4 years of specialty training focusing on general cardiovascular disease

An electrophysiologist receives 2 extra years of training beyond what’s required to become a board-certified cardiologist. These extra years of education give them the experience to perform advanced heart tests and interpret the results properly.

Electrophysiologists use their training to diagnose and treat a number of conditions, including:

The tests that an electrophysiologist performs include:

If your doctor or cardiologist discovers that you have an atypical heartbeat, they might recommend for you to undergo a test called an electrophysiology study (EPS).

This test is performed by an electrophysiologist. They will insert three to five specialized wires called electrode catheters into a blood vessel that leads to your heart. Usually, the catheters are inserted into your groin, arm, or neck.

Using the catheters, the electrophysiologist will send electrical signals to your heart and record your heart’s electrical activity.

The EPS will help determine:

  • the source of your atypical heartbeat
  • which medications might work to treat your arrhythmia
  • whether you need an implantable cardioverter defibrillator (ICD) or a pacemaker
  • whether you need a catheter ablation, which is when a catheter is used to destroy a very small part of your heart that is causing the atypical heartbeat
  • your risk for developing conditions like cardiac arrest

Most studies take about 2 to 6 hours and are outpatient, meaning you can go home on the same day.

What does it feel like to get an electrophysiology study?

Most people don’t describe feeling significant pain during electrophysiology procedures. You may feel slight discomfort when doctors use electrical currents to change the speed of your heartbeat. If you feel any pain, alert your medical team right away.

Before your procedure, you may be given a sedative to help you relax and to minimize your anxiety. You’ll also be given a local anesthetic around the site where the catheters will be inserted.

If your heartbeat is too slow (less than 60 beats per minute), too fast (more than 100 beats per minute), or irregular, an electrophysiologist can help find the cause and recommend treatment.

You also might be referred to an electrophysiologist if you receive a diagnosis of atrial fibrillation.

If it’s determined that you need invasive treatment, your electrophysiologist will likely lead or be part of the team that performs the catheter ablation, cardiac resynchronization therapy, or implantation of a pacemaker or ICD.

During your first appointment with your electrophysiologist, they’ll perform an initial evaluation considering your symptoms, medical history, and the results of a physical exam.

Once they gather information about your condition, they’ll develop a diagnostic plan to determine the problem.

Your electrophysiologist may order X-rays, which may be taken on the same day. They may also order other tests, such as an EPS, for a future date if they feel it’s necessary.

If your doctor or cardiologist discovers that you have an arrhythmia, they will likely refer you to an electrophysiologist.

An electrophysiologist is a doctor that has additional years of training specializing in the electrical activity of your heart. The electrophysiologist may use a variety of tests to properly diagnose your condition and to guide treatment options.