Excuse my ignorance. So what is the differ... - AF Association

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Excuse my ignorance. So what is the difference between and EP and a Cardiologist?

tiredandconfused profile image

Apparently I am under the lead cardiologist at the hospital that diagnosed this. Ironically I will not see him again until August, when they are presuming I will already have had a successful (please let it be) cardioversion.

So what is an EP and how are they different to the cardiologist, and should i find one, and can i request to see one on the NHS?

22 Replies

Hi An EP is an electrophysiologist who study the electric signals in the heart thats it in short BobD will explain it better but as he always says comparing a cardiolagist to an EP you wouldn,t get a plumber to re-wire your house so for AF you need to see an EP

BobD profile image
BobDVolunteer in reply to argzxoni61

You just stole my thunder there.> As somebody said to me recently-- note perfect.!


argzxoni61 profile image
argzxoni61 in reply to BobD

Sorry Bob,I,m starting to sound like a veteran,i,ll get back in my place Graham

BobD profile image
BobDVolunteer in reply to argzxoni61

No problem Graham. nice to see you are learning. lol

I'd also add that the word is not always used (in case you're looking for one). My EP refers to himself simply as a heart-rhythm specialist and he is listed under cardiology.

This explains drjohnm.org/about-electroph...


An EP Electrophysiologist, is a trained cardiologist with a special interest and additional training and experience with helping people with arrythmias, electrical disturbances within the heart, which AF/AFl/ATachy, PVs, SPVs etc are caused by, rogue electrical pathways that make the heart muscle contract when it shouldn't so that it doesn't pump oxygenated blood around our bodies. General Cardiologists are more equivalent to the plumbers, replace valves, put in stents do complicate open heart surgery etc. you can request to see an EP, if you go onto the AFA site they have an approved list so you can see who is nearer to you, although I should warn you that it not easy getting to see one on the NHS if you live outside of the major centres, Manchester, Liverpool, Birmingham & London.

Some people on this site booked a private appointment with an EP of their choice and then had treatment on the NHS. It is a way of getting onto the radar, although you will not be treated any faster, it is often worth the couple of hundred pounds to get an opinion from someone who has specialised knowledge and is up to date with all of the possible treatment possibilities. It can bring some peace of mind. I couldn't get to see an EP in my area, Devon, so went to London. Am afraid it really can be a post code lottery. Ask your GP for a referral, you will need one anyway whether or not you see someone privately. It is a relatively new speciality so they can be a bit thin on the ground.

Thank you both. I am learning slowly. So far apart from the echocardiagram in a couple of weeks, there doesnt seem to be anyone looking into why this has happened, if there is a reason that is. Does the EP look into this, the Cardiologist or my GP.

Why is not a question you will ever get answered, they will give you a report and may suggest therapies but I don't think there is any one single cause but lots of possible triggers. I believe you need to have a predisposition for AF but loads of things can trigger an episode, you will note people talking about their triggers here.

Do ask anything you don't know, none of us knew much when we came here first!

Thank you. I am an asthmatic and whilst not hospitalised for years with it my peak flow is very very low and to be honest my asthma hasnt been well managed. Since the onset of AF and it is persistent, this is worse and I just wonder if it is my asthma that has caused this all. I guess I will wait to see what the doctors say, but must admit i am starting to fall into a bit of dark hole in mood, i feel like this isnt ever going to get any better

Double check as your cardiologist may also be an ep. Also has anyone suggested ablation to you. When it works this will get rid of the irregular heart beats and all the other horrible symtoms. It can be a temporary "cure" and I am finding that I have my life back.

franksavage profile image
franksavage in reply to Dodie117

Hi lallym

From whai have read it sounds like Af is incurable? Reading your post has give me a little hope?.

I am 57 and have attacks pretty much daily! Is that a lot? Also i have had s cardiomemo on for a week about a month ago, what can I expect to hear next? I live in north london near Harlow.

Thanks for all the info! Brill!!!


Dodie117 profile image
Dodie117 in reply to franksavage

Absolutely - it is incurable. However, when the ablation works it can last for a number of years. Koll who posts on here had it done and she/he was fine for, I think, 8 years before it came back and now wants to have it done again. So although it is not a permanent cure it is fantastic - when it works. If you read all the posts on here you will see that for some people it takes a number of procedures before it works. I had mine done in November and so far my AF is gone I am off all medication except warfarin (I will need anticoagulation for life as it could come back) and feel 100% better.

Having attacks every day is a lot so if your cardiologist is not an EP I would say ask to be referred to one and then ask the EP about ablation. Most EPs seem to be saying the sooner it is done the better before AF becomes permanent. I saw a Dr O'Neill in St Thomas' and he was very helpful and all in favour of ablation. He let me choose the road I wanted to take - ablation or meds and I chose ablation. You are younger than me and all the more reason to find out if this is suitable for you as you don't want to be on medication for all those years.

I don't know what a cardiomemo is so maybe someone else can help with that.

Good luck on your journey with AF but stay optimistic as there is hope. Marie.

franksavage profile image
franksavage in reply to Dodie117

Thanks for your prompt and very informative reply Mary!

I think ill follow your advice and seek s refferal with sn EP. I would certainly choose ablation I think!


P.s. a cardiomemo is just a small boxlike device you wear and it records any attacks over a week.

Welcome Tired and confused!....(my exact words on a text when i was first diagnosed!!!) Cdreamer is right...its just one of those things...you will never know 'why'....! I was fairly fit and getting fitter....cycling ,walking etc. but gettin breathless in the house!

Stress is def a trigger for me....dealing with my mum's bereavement has upped the AF a notch....but this is site is great, i have learned so much and still learning..... don't feel alone anymore.....wish i found it a year ago!!

in reply to Wightbaby

I know exactly how you feel, I have found more information on here and I too could have done with it a year ago when I started with AF after loosing my Mum just over a year ago.

I feel the same w.

Is it genetic? I think my dad had it looking back, and I seem to get everything he got. They no doubt didn't know what it was back then. I remember him calling it a heart murmur. One day they'll have a fix, but for now it's more management and tweaks. I think for me it's genetic and then brought to the fore by a stressful job, stressful lifestyle and too much wine.


My mum asked me if it is genetic. My grandad was said to have suffered palpitations, but didn't do anything about it. Unfortunately he had a heart attack in 1968 and didnt make it. I often wish medicine was then what it is now, for all our moans and groans, in real terms things have moved on and I often think he would have survived had it happened now

BobD profile image
BobDVolunteer in reply to tiredandconfused

There is no concrete evidence to say it is genetic but there does seem to be a link in some families. The problem is that until about twenty years ago AF was considered a benign nuisance and you were told to get on with life so there is no real data available. Anecdotal evidence such as "my Nan had palpitations" etc .sadly doesn't constitute scientific evidence . You do normally need a pre-disposition to AF but there are two groups of people who can acquire this. Endurance athletes and fast jet pilots (fighter pilots) and it is believed that the training causes the left atria to enlarge and the stretching enables rogue pathways to form.


My grandad must have had it as he died suddenly at 50 (my unsympathetic family said it was due to the whisky but I htink not as he was an active, fit, engineer - people were like that in those days). I am convinced stress brought mine on coupled wiht repeated infections all untreated by a useless gp and then not spotted by same useless gp. My new gp spotted it but by then the heart was happy belting along at over 100 and in af. Three ablations numerous cardioversions and medication for life later and I more or less function like everyone else excpet I get very tired and can't walk up hills without stopping. It's always with me but I manage it not thei other way round. I've never ever been depressed about it, just something to deal with and find a way round.

Many thank Koll for a great link. It's helped to fill lots of knowledge gaps for me

Thank God for EPs that's all I can say.......

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