Cardiac electrophysiology is the subspeciality of cardiology dealing with heart rhythm disorders, also known as arrhythmias.
The cardiac electrophysiologist is a cardiologist specialising in cardiac electrophysiology, which requires additional training in the management of rhythm disorders.
The conditions treated by the rhythmologist are (non-exhaustive):
Atrial fibrillation, atrial flutter, atrial extrasystoles/premature atrial contractions
Supraventricular tachycardia (Wolff-Parkinson-White syndrome, accessory pathway, atrioventricular nodal reentry (AVNRT))
Ventricular extrasystoles/premature ventricular contractions, ventricular tachycardia
Inappropriate sinus tachycardia
Postural orthostatic tachycardia syndrome (POTS)
Advanced syncope assessment
History of sudden death
Genetic diseases of the cardiac electrical system: long QT syndrome, Brugada syndrome, catecholaminergic polymorphic tachycardia, hypertrophic cardiomyopathy, arrhythmogenic right ventricular dysplasia, etc.
Heart failure: indication for pacemaker-defibrillator-resynchronisation therapy
Bradycardias: sinus node dysfunction/disease, atrioventricular block, conduction disorders
Monitoring/interrogation of defibrillators, pacemakers, implantable loop recorders/monitors, troubleshooting, home monitoring
Management of pacemaker/defibrillator lead problems (lead management)
The procedures carried out by a cardiac electrophysiologist include :
Implantation of pacemaker, defibrillator with or without resynchronisation function, leadless pacemaker, implantable loop recorder/monitor
Pacemaker or defibrillator lead removal/extraction
External electric shock or electrical/direct current cardioversion
Electrophysiological study
Catheter ablation of supraventricular tachycardia
Catheter ablation of atrial extrasystoles
Catheter ablation of atrial fibrillation
Catheter ablation of ventricular extrasystoles and ventricular tachycardia
Symptoms that may be associated with arrhythmias include:
Palpitations
Chest pain
Syncope/loss of consciousness/fainting
Shortness of breath (on exertion)
Fatigue
Dizziness
How to prepare for your arrhythmia/pacemaker consultation. You are advised to bring :
A list of your current medicines
A list of your medical history and allergies
Any medical reports and past medical tests (ECG, holter, blood tests)
Your pacemaker/defibrillator/implantable cardioverter card, if applicable