electrophysiology

Discussion in 'Clinical Rotations' started by MacGyver, Aug 25, 2001.

  1. MacGyver

    MacGyver Banned
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    I've heard this term out there. Is an electrophysiologist and MD, PhD, or both?

    What kind of procedures do they perform? Do you have to go into a fellowship after cards or what? How many years is it?
     
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  3. I did a rotation through the department at Stanford and their website provides some information regarding the procedures that they do:

    http://cardiology.stanford.edu/Programs_CVMED/electrop.htm

    A Cardiac Electrophysiologist is a DO/MD who does a two year fellowship after a Cardiology Fellowship. So, you will spend 8 years in Internship/Residency/Fellowships after Medical School!
     
  4. UHS03

    UHS03 Senior Member

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    An electrophysiologist is a cardiologist who does additional fellowship training to specialize in the conduction system of the heart. There is no one better that I have seen at reading and interpreting EKG's, they do ablations, pacemakers, defibrillators, etc. They treat complex arrythmias and take care of the routine pacemaker/defibrillator check ups. There is overlap with cardiology in that many cardiologists (if they are trained for it) will work with pacemakers and defibrillators, but electrophysiologists are the true experts in cardiac electrophysiology. It's a superspecialized field and all the electrophysiologists I've met have worked at specialized heart centers and heart hospitals primarily.
     
  5. MacGyver

    MacGyver Banned
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    From what little I know of current trends in ECG interpretation, does the electrophysiologist design computer algorithms to detect certain rare arrythmias that cant be seen by eye on the ECG? Or is he/she really that good where he can spot rare anomalies only by looking at the ECG?

    It seems like something this specialized would almost demand computer assistance in every stage of EKG interpretation, except for simple things like VT or VF.

    I would imagine also that an electrophysiologist would work with engineers who design pacemakers/ICDs?
     
  6. David Orias

    David Orias New Member

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    Well as a practicing electrophysiologist, we don't all work at specialized heart centers. We do work at hospitals with open heart surgery programs and hospitals with cardiac catheterization labs as that is where we do our electrophysiology studies. Here in Santa Barbara, I work in two hospitals 30 - 40 miles south and 1 hospital 70 miles north as well as Cottage Hospital here in Santa Barbara. You need about 10-14 cardiologists to support one electrophysiologist. So, it is true that we tend to hang around bigger cities.

    Regarding EKG interpretation, I would find it very hard to program a computer to pick up subtle nuances of electrical rhythmn. If you look at computer interpretations, the rhythm seems to be the most inaccurate. But, I would not say you need to be an electrophysiologist to interpret heart rhythms, but since it is what I do day in and day out... I have gotten pretty good and feel more comfortable calling the rhythmn. But there are definitely times where a wide comlex tachycardia is a wide complex tachycardia and I can't be more specific than that. Then, I resort to the electrophysiology study to confirm the diagnosis.

    But remember, there is more to EKG interpretation than just rhythmn.

    Cardiac Electrophysiology is a great field because we see the healthy indivduals with supraventricular tachycardia, cure them and allow them to live a normal life, we see our defibrillator patients on a continual basis and develop the personal relationship that long term patients and their doctors develop.

    Certainly some of the academic electrophysiologist will deal with the engineers that design these devices, but most of us are pretty involved with day to day pateint care. But my hat is off to those engineers and physicians who have taken the field of electrophysiology to the state of the art it is today.
     
  7. CVPA

    CVPA Senior Member

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    Just one additional note. I recently started working for an electrophysiologist and love it thus far.

    The interesting thing is that apparently there are only approximately 600-700 true board certified EPs in the country. Many cardiologists may call themselves an EP, but from what I was told, there are not that many fellowship-trained EPs out there. Definately a superspecialized field, but also one with tremendous financial and professional rewards.
     

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