Cardiac Physiologists

Cardiac Physiologist are an important part of a multi-disciplinary team. This team includes medical, nursing and other healthcare professionals who work together in the investigation, diagnosis and treatment of patients with heart disease.

Cardiac Physiologist duties can be divided into invasive and non-invasive. Most invasive test are carried out in a sterile theatre like environment, where catheters and contrast are used to look at patients coronary arteries or insertion of a pacemaker .The range of services vary depending on each hospital and practice type.

Non Invasive Testing

Electrocardiography (ECG)

An ECG is a tracing of the electrical activity of the heart of the heart, usually presented on special paper. The recording is taken via electrodes positioned at specific sites on the limbs and chest. The heart rate is measured and the ECG pattern and rhythm interpreted. ECG recognition and interpretation are essential skills for all Cardiac Physiologists.

Ambulatory Monitoring

More commonly called Holter and Bp monitors. Holter Monitors are used to investigate possible heart rhythm changes with may be associated with palpitations or syncope. The Patient is fitted with a portable device which , usually over a 24 hour period, records the ECG via a cable attached to electrodes on the patients chest. The recording is then downloaded and analysed on a computerised system with any symptoms taken into account. BP monitors are also portable devices that record a patients BP over 24 hours .

Exercise ECG Stress

A treadmill, or occasionally a fixed bicycle, may be used to investigate causes of exercise-induced symptoms such as chest pain. Heart rate, ECG pattern and blood pressure are monitored during a programmed exercise stress test and during the following recovery phase. This test ,often led by Cardiac Physiologists, aids in the diagnosis of coronary artery and in the long term management of patients suffering from the disease.

Echocardiography(Echo)

Cardiac ultrasound or Echocardiography is preformed to assess the heart’s function or to investigate a murmur. An Echo is a series of ultrasound imaged displaying the structure, motion and blood flow of the heart and great vessels. This is a rapidly expanding and continually evolving field. Cardiac Physiologists perform and report on theses scans which provide vital information in the assessment of patients both pre operatively and post operatively.
Implantable Device Follow Up

This involves mainly Cardiac Physiologist lead clinics to assess the function and longevity of any implantable cardiac devices for example Pacemaker and Implantable Defibrillators. Regular attendance at these clinics is necessary for the patient so any necessary adjustments can be made to improve patients’ symptoms and quality of life also to accurately predict replacement time for these devices. In the case of the ICD Physiologists interpret recordings from these devices to ensure that any therapy delivered is appropriate.

Invasive Procedures

Cardiac Catheterisation

This procedure is used to view the heart’s own blood vessels, the coronary arteries and to measure pressures within the hearts chambers. The Cardiologist may carry out a variety of therapies, after specific images and blood pressure recordings are taken for example insertions of a tiny balloon in reduce narrowing’s and increase blood flow. The physiologist carefully monitors the ECG and blood pressure readings during these procedures and notifies the rest of the team of any inappropriate changes.

Pacemaker and AICD Implants

Pacemakers and AICD’s are implantable electronic devices. In the case of Pacemakers they stimulate the heart and restore a normal rate when for example, an extremely slow heart rate causes symptoms such as fainting. AICD’s monitor the patients’ rate and deliver appropriate therapy if the heart rate goes into dangerously fast heart rhythms. The Cardiologist positions the Pacemaker/AICD lead into a vein which leads to the heart. After several test measurements, performed by the physiologist, the lead is attached to the device which is then implanted under the skin usually in the upper chest.

Electrophysiology Studies(EPs)

An EP study can be used to diagnose and treat abnormal heart rhythms. The Cardiologist obtains ECG recordings from specific sites within the heart using carefully positioned electrodes. The physiologist uses computerised system to record specific ECG data helping in the diagnosis and successful treatment carried out by the Cardiologist. The ability to quickly recognise changes in heart rhythm and act promptly, as required, are necessary skills.

Cardiac Research

The more experienced Physiologist may apply many of the above techniques in research projects that can lead to improve patient care and further education.