Blog by: Christine C. Chiu, MSc, CCDS, CEPS, FHRS, and Joel Archbald, BAppSciHMS, CEPS

This is the first of a series to profile our colleagues from around the world to learn about their role, work setting, education and their efforts to improve professional practice in EP.

A cardiac physiologist is a job title unique to the health care system in the United Kingdom (UK) and Australia. Individuals undergo a 4-year university program (BSc Hon.) in clinical physiology with further specialization in cardiology and on-the-job clinical rotations. They may register with the Registration Council for Clinical Physiologists (RCCP) and undertake subspecialty certification exams such as the International Board of Heart Rhythm Examiners (IBHRE) or Heart Rhythm UK (HRUK). These certifications are increasingly sought after by employers and allow individuals to become specialists within their fields, be it echo, electrophysiology (EP) or device management. Individuals without any tertiary education are referred to as cardiographers and perform noninvasive tasks (such as Holter and ambulatory blood pressure monitor application or ECG recording) under the supervision of cardiac physiologists.

In the EP lab, the cardiac physiologist assists with programmed stimulation, operation of the RF generator, 3D mapping and recording systems, and helps with device implant, device programming and troubleshooting. Each centre dictates the extent of the cardiac physiologist’s role in clinical care. Advanced centres with larger patient volumes will have follow-up clinics or EP procedures that are run by cardiac physiologist(s). This is heavily dependent on the establishment of a strong relationship between the physician and the cardiac physiologist. Smaller centres may be less independent and require industry support in the patient care process. Cardiac physiologists differ from nurses in that they do not provide direct medical care to patients such as physical exams, auscultations or administration of medications. Their role is similar to the cardiovascular technologists in North America.

The RCCP is working closely with its members to achieve recognition as a self-regulated professional body. HRUK is working to elevate the standards of their credentialing exams and educational courses. Although IBHRE accreditation is still considered the gold standard, hospitals and industries are now giving preferential support to HRUK accreditation in order to further increase its profile as a professional body with a standard of excellence within the UK.

Australia is more aligned with the USA in terms of professional standards. The IBHRE certification is essential for any cardiac physiologist wanting to be involved in EP or device management. Although small professional bodies exist in Australia, there is no specific regulatory body. Programs are being set up via universities and educational bodies such as the Cardiac Electrophysiology Institute of Australia (CEPIA) to promote the field and to standardize the level of education.

Useful educational articles in PDF files: http://www.hruk.org.uk/html/articles.html

Information on cardiac physiologists:
http://www.nhscareers.nhs.uk/details/Default.aspx?Id=261

Allied members of HRUK:
http://www.hruk.org.uk/html/council.html

CEPIA:
http://www.cepia.com.au

Christine Chiu is the EP Pacemaker Technologist at The Labatt Family Heart Centre of the Hospital for Sick Children, Toronto, Ontario, Canada.
Joel Archbald is the Chief Cardiac Physiologist in the Cardiology Department of the London Bridge Hospital, London, UK.