Cardiac electrophysiology (EP) is the subspecialty of cardiology focused on the heart's electrical system. We diagnose abnormal heart rhythms, perform catheter ablation and device implantation, and provide longitudinal management of patients living with arrhythmias.
A new procedure center at the Texas Medical Center
The Advanced Cardiovascular Institute at the Texas Medical Center, at 6624 Fannin St, Houston, TX 77030, opens in June 2026, our new ambulatory surgery center for cardiac electrophysiology. It will perform catheter ablation, pacemaker, ICD, and loop recorder procedures in the Texas Medical Center for the comfort and convenience of our patients.
Consultations and follow-up continue at our Hargrave Rd clinic in Northwest Houston, with procedures performed at the most appropriate location: Houston Methodist Willowbrook, Houston Methodist Cypress, Baylor St. Luke’s Medical Center, St. Luke’s The Vintage, Memorial Hermann Memorial City, or the new TMC ASC. Learn more → or call (832) 478-5067 to schedule.
What is a cardiac electrophysiologist?
A cardiac electrophysiologist (EP) is a physician who specializes in the diagnosis and treatment of heart rhythm disorders. The work spans three domains:
Diagnosis: characterizing what rhythm is causing a patient's symptoms, using ECGs, ambulatory monitors, implantable loop recorders, and invasive EP studies
Procedural treatment: catheter ablation of abnormal circuits, implantation of pacemakers and defibrillators, and specialized procedures like WATCHMAN closure and lead extraction
Longitudinal management: medication selection and monitoring, device follow-up, remote rhythm surveillance, and lifestyle counseling
Cardiac electrophysiology is a relatively young subspecialty, it became a distinct board certification in the early 1990s, but it has grown rapidly, driven by advances in mapping technology, ablation energy sources, and device miniaturization.
Training: how an EP becomes board-certified
The training pathway:
Medical school (4 years)
Internal medicine residency (3 years)
Cardiovascular disease fellowship (3 years): broad cardiology including invasive and non-invasive imaging, heart failure, and ICU
Clinical cardiac electrophysiology fellowship (1-2 years): advanced training in rhythm management, ablation, and device implantation
Board certification by the American Board of Internal Medicine in Clinical Cardiac Electrophysiology
Total post-medical-school training is 7-8 years before independent practice. The EP boards are taken separately from the cardiology boards and require their own recertification cycle.
Many EPs also pursue additional credentials, FHRS (Fellow of the Heart Rhythm Society) and FACC (Fellow of the American College of Cardiology) signal continued engagement with the specialty's professional organizations and ongoing CME.
Conditions we treat
The scope of EP practice covers the full range of heart rhythm disorders:
Sudden cardiac death prevention: primary and secondary prevention, family screening
Heart failure rhythm management: CRT, defibrillator decisions, arrhythmia in HFrEF and HFpEF
Procedures and devices we offer
Procedural expertise covers:
Catheter ablation
Energy modalities: pulsed-field ablation (PFA), radiofrequency (RF), and cryoballoon. Procedures cover atrial fibrillation (with and without persistent disease), typical and atypical atrial flutter, SVT, idiopathic VT, scar-mediated VT, and AV-node ablation. Mapping with current-generation systems (Carto 3, EnSite X, Affera Sphere-9).
Pacemaker implantation
Single- and dual-chamber transvenous systems, leadless pacemakers (Micra VR/AV, Aveir VR/DR), and CRT-P for resynchronization in heart failure.
Defibrillator implantation
Transvenous ICD, subcutaneous ICD (S-ICD), and extravascular ICD (EV-ICD). Choice depends on patient anatomy, pacing needs, and lifestyle.
Lead extraction
Specialized removal of infected or malfunctioning device leads using laser and mechanical sheaths. Done with thoracic surgery backup at high-volume centers.
Left atrial appendage closure
WATCHMAN and Amulet devices for stroke prevention in AFib patients with contraindications to long-term anticoagulation.
Loop recorder implantation and cardiac monitoring
For unexplained syncope, cryptogenic stroke evaluation, and post-ablation rhythm surveillance.
Cardioversion and tilt-table testing
Standard supporting procedures performed in our practice.
What sets cardiac electrophysiology apart from general cardiology
General cardiology covers the full spectrum of cardiovascular disease, coronary artery disease, heart failure, valvular disease, hypertension, lipid management, preventive cardiology, plus a working knowledge of arrhythmia. A general cardiologist can manage uncomplicated AFib, place loop recorders, and refer patients for ablation or device implantation.
Cardiac electrophysiology starts where general cardiology stops with rhythm. EPs perform the catheter ablations, the complex device implants, the lead extractions, and the longitudinal management of patients with inherited arrhythmia syndromes. The technology, 3D mapping, intracardiac ultrasound, transseptal puncture, modern defibrillator programming, is what an EP fellowship adds to a cardiology training.
If your situation involves any of the following, EP referral is typically appropriate:
Considering ablation for AFib, atrial flutter, SVT, or VT
Inherited arrhythmia syndrome diagnosed or suspected
Complex pacemaker or ICD decisions, particularly upgrades, generator changes with complications, or lead concerns
Recurrent syncope after initial cardiology workup
Pacing-induced cardiomyopathy or CRT decisions
Pregnancy with arrhythmia history
Choosing the right cardiac electrophysiologist
For a deeper guide to evaluating and choosing among Houston's EPs, criteria, training markers, hospital affiliations, and questions to ask at your first visit, see our companion guide: How to choose a cardiac electrophysiologist in Houston.
Frequently asked questions
What is a cardiac electrophysiologist?
A cardiac electrophysiologist is a subspecialty cardiologist focused on the heart's electrical system. They diagnose and treat heart rhythm disorders, including atrial fibrillation, SVT, ventricular tachycardia, syncope, heart block, and perform catheter ablations and implant pacemakers and defibrillators.
What's the difference between a cardiologist and a cardiac electrophysiologist?
A cardiologist treats the full range of cardiovascular disease. A cardiac electrophysiologist has an additional one to two years of fellowship training specifically focused on the heart's electrical system. The two specialties overlap on basic rhythm management; EPs handle the procedural and complex-rhythm work.
How long does it take to train as a cardiac electrophysiologist?
After medical school, the training pathway is internal medicine residency (3 years), cardiovascular disease fellowship (3 years), and clinical cardiac electrophysiology fellowship (1-2 years). Total post-medical-school training is 7-8 years before independent practice.
What does FACC and FHRS mean after a doctor's name?
FACC stands for Fellow of the American College of Cardiology. FHRS stands for Fellow of the Heart Rhythm Society. These are professional society fellowships (different from board certifications) that recognize ongoing engagement with the specialty's academic and clinical organizations.
What procedures do cardiac electrophysiologists perform?
Catheter ablation (for AFib, atrial flutter, SVT, VT), pacemaker implantation (transvenous and leadless), defibrillator implantation (transvenous, subcutaneous S-ICD, and extravascular EV-ICD), cardiac resynchronization therapy (CRT), WATCHMAN and other left atrial appendage closure devices, loop recorder implantation, lead extraction, electrical cardioversion, electrophysiology study, and tilt-table testing.
