Cardiac physiologists provide a range of clinical, technical, and scientific services to many areas within the hospital. This includes ECGs, ambulatory monitoring and reporting, exercise testing, haemodynamic monitoring in the cath lab, cardiac device implantation & follow up, and performing diagnostic tests & operating ablation equipment during electrophysiology studies.
Trainee Physiologists undergo two years of structured training after completion of their undergraduate science degree. During this time they will cover electrocardiography, ambulatory monitoring, exercise stress testing, and cath lab monitoring. They will also start to be exposed to pacemaker implantation and follow up. Trainees must simultaneously complete a Postgraduate Diploma (MTEX) and Certification (CCP). The first year of the diploma can be done before employment (as a Postgraduate Certificate), but the second year requires the student to be employed as a physiologist. In this case, the trainee would be able to focus on the CPM/CCP during their first year of work. Further in their careers, physiologists may choose to undergo further study to complete the Graduate Diploma in Electrophysiology from CEPIA, or a certification exam from IBHRE.
Most physiologists are represented by Apex. Read our MECA.
The ECG is fundamental to the role of the physiologist, and students will gain a deep understanding of arrhythmia and other ECG changes through the CCP programme. Physiologists are required to perform ECGs on the wards around their respective hospitals to help diagnose and monitor patients with cardiovascular conditions.
Holter & event monitors are continuous ECG recording devices that are fitted to patients for extended periods of time, typically 24-48 hours for holters, and one or two weeks for events. Physiologists analyse the recording to generate a report for the doctors, looking for ECG abnormalities, and whether these correlate with patient symptoms.
Exercise tolerance testing is typically done on patients with suspected coronary artery disease. Working with a technician, the test involves setting up an ECG on a patient and exercising them on a treadmill while monitoring for signs of ischemia or arrhythmia.
During angiograms and percutaneous coronary interventions physiologists monitor the patient's haemodynamics and log the activities of the case. Physiologists are involved in 24/7 emergency responses to STEMI's and temporary pacing wire insertions, among other cases.
Physiologists work with implanting doctors to program and test pacemakers and ICDs devices while the patient is on the table. Once a patient has received a pacemaker or ICD they require ongoing follow-up. Physiologists see patients in clinic and through online home-monitoring to ensure the pacemaker is working optimally, and if needed, make changes to devices to extend battery life, troubleshoot, and improve symptoms.
Physiologists work with doctors during electrophysiology studies to set up the diagnostic and interventional equipment, taking measurements of various intracardiac signals, performing diagnostic pacing protocols, and creating 3D maps of the heart to identify arrhythmia. Once the regions of interest have been located, physiologists will operate the equipment required for treatment - cryo and radio-frequency ablation.