Symptoms affecting the heart should never be overlooked as cardiovascular conditions and disorders can be fatal. When these telltale signs arise, you may find yourself being referred to a heart specialist. There are many types of doctors that specialises in treating the heart and these two specialists are usually mistaken with one another: an electrophysiologist and a cardiologist. While both specialisations oversee the heart’s health, there are differences in their roles, focus areas, and training. This article serves as your guide to know when you should see a cardiologist vs an electrophysiologist in Singapore when your symptoms need to be checked.
What is an Electrophysiologist?
A cardiac electrophysiologist, or electrophysiologist, is a cardiologist specialises in diagnosing and treating conditions and disorders that affect the electrical system of the heart, specifically arrhythmias. Electrophysiologists undergo a rigorous medical training before completing their subspecialty, including:
- A medical degree
- An internal medicine residency for three years
- A cardiology fellowship for three years
- Additional subspecialty fellowship in clinical cardiac electrophysiology for one to two years
If you are experiencing signs that disturbs the regular rhythm of your heart, an electrophysiologist can perform tests and procedures to accurately diagnose your condition. These include:
- Catheter ablation
- Electrophysiology studies (EPS)
- Implanting defibrillators or pacemakers
Catheter ablation – This is a minimally invasive procedure that is done to treat arrhythmias by targeting specific parts of the heart that causes the irregular heart rhythm and destroying these in order to restore the heartbeat back to normal. The procedure uses a catheter, which is a thin, flexible tube that is threaded through a blood vessel to the heart. Once the catheter reaches the problematic tissue, heat is delivered to the area to destroy it. The heart’s rhythm is improved when the abnormal electrical pathways are eliminated.
Electrophysiology studies (EP) – This is a specialised test that is done to evaluate the heart’s electrical system in order to diagnose and provide treatment for arrhythmias. It also uses catheters that are inserted into the heart to measure and document its electrical activity. The report from this test allows electrophysiologists to locate the source and cause of the abnormal heart rhythms.
Implanting defibrillators or pacemakers – Implanted defibrillators (ICD) and pacemakers are both medical devices that are used to regulate the rhythm of the heart, but their purposes are different. Defibrillators work to prevent the heart from experiencing cardiac arrest by delivering a strong electrical shock to correct an irregular or dangerously fast heartbeat. On the other hand, a pacemaker stabilises the heart’s rhythm by delivering electrical impulses then it beats too slowly.
What is a Cardiologist?
A cardiologist is a doctor of medicine that focuses on diagnosing and treating conditions and diseases affecting the cardiovascular system. This involves not only the heart, but also the blood vessels. They are able to manage a range of cardiovascular conditions like arrhythmias, coronary artery disease, and heart failure.
Cardiologists can subspecialise in other areas:
- Heart failure and transplant cardiology
- Interventional cardiology
- Pediatric cardiology
- Preventive cardiology
To be able to practice, cardiologists complete the following:
- A medical degree
- A residency in internal medicine for about three years
- A fellowship in cardiology for another three years
If you are experiencing symptoms such as chest pain, irregular heartbeats, high blood pressure, or shortness of breath, then you may be referred to a cardiologist first.
What are the notable differences between an electrophysiologist and a cardiologist?
An electrophysiologist and a cardiologist differ in various aspects, such as:
- Specialisation
- Cardiologist: A cardiologist’s scope of practice is more broad. They can deal with a variety of cardiovascular diseases including coronary artery disease, hypertension, heart failure, and conditions that affect the heart’s structure.
- Electrophysiologist: An electrophysiologist focuses on the concerns involving the electrical function of the heart. A heart doctor that specialises in this area generally does not manage common problems that influence the heart, unless the symptoms trigger problems to the heart’s rhythm.
- Training
- Both heart specialists undergo extensive training, but electrophysiologists clock in more time as they have additional years of training that concentrates particularly on cardiac electrophysiology.
- Types of Procedures Performed
- Cardiologist: For diagnostic procedures, a cardiologist can perform cardiac CT/MRI, echocardiograms, general ECGs, and stress tests. They can also do angioplasty, cardiac catheterisation, and blocked artery stenting as interventional procedures.
- Electrophysiologist: For diagnostic procedures, an electrophysiologist can perform advanced rhythm monitoring, invasive electrophysiology (EP) studies, and tilt table tests. They can also do interventional procedures like catheter ablations, CRT device placements, ICD and pacemaker implantations.
- Use of Technology
- Cardiologist: The tools that cardiologists use include angiography equipment, echocardiography and stress testing machines. These are used to evaluate and treat problems that affect the heart’s physical and structural functions.
- Electrophysiologist: The technology used by electrophysiologists greatly rely on advanced mapping systems, implantable cardiac devices, and electrical signal tracking equipment.
- Management of heart issues
- Cardiologist: A cardiologist will refer you to see an electrophysiologist when your symptoms are linked to disorders affecting your heart’s rhythm, which needs specialised care.
- Electrophysiologists: An electrophysiologist typically does not manage cardiac issues that are not related to its electrical system. Hence, they may refer you back to a cardiologist for regular cardiovascular management and treatment.
What are the common heart problems managed by an electrophysiologist and a cardiologist?
Here are the common heart problems managed by an electrophysiologist and a cardiologist:
Cardiologist:
- Angina or chest pain
- Coronary artery disease
- Heart failure
- High blood pressure or hypertension
- High cholesterol or hyperlipidemia
- Valvular heart disease
Electrophysiologist:
- Atrial fibrillation (AFib)
- Bradycardia
- Heart block
- Sudden cardiac arrest risk management (using ICDs)
- Supraventricular tachycardia (SVT)
- Ventricular tachycardia (VT)
Which specialist should you see for your symptoms?
Knowing whether to consult with a cardiologist or an electrophysiologist is important to get accurate diagnosis and treatment for your heart concerns.
See a general cardiologist when:
- You experience chest pain, fatigue, or shortness of breath that might be due to heart disease.
- You have been diagnosed with heart conditions such as coronary artery disease, valvular heart disease, or heart failure.
- You have underlying medical conditions like hypertension, high cholesterol, or a family history that doubles your risk of developing a heart disease.
- You need to undergo regular check ups to monitor your heart’s health.
See an electrophysiologist when:
- You are at risk for sudden cardiac arrest.
- You have symptoms that cause irregular heartbeats like dizziness, fainting, palpitations, shortness of breath, which can be linked to arrhythmia.
- You have been diagnosed with a certain arrhythmia such as atrial fibrillation, VT, or SVT.
- You have a complicated heart rhythm dysfunction that has not been addressed by standard treatments.
- You need to be assessed for an ICD or pacemaker.
Conclusion
Understanding the roles and responsibilities of a cardiologist and an electrophysiologist can empower you to take charge of your heart’s health. While both professions focus on the heart’s health, there are many differences in the conditions they diagnose and treat, the procedures they perform, and the tools that they use. By consulting with the right specialist, you can get the proper treatment that your heart ultimately needs.
Cadence Heart – Dr Devinder Singh
Mt Elizabeth Hospital
3 Mount Elizabeth #14-13
Mt Elizabeth Medical Centre
Singapore 228510
Tel: (65) 8318 9884
Whatsapp: (65) 6369 8789
