EP= electrician...Cardio= plumber

[rilesnic]

I think I have read on this forum in the past that some people refer to cardiologists as plumbers and EPs as electricians, metaphorically speaking of course, with no offense against either profession. I spoke with a close family member the other day, who happens to be a prominant physician in one of our nation's largest cities, and who works under one of the top trauma surgeons in our state. I told him about the PVC, PAC, tachy, anxiety, panic issue and informed him of my recent symptoms and results. Not many people know of the heart issues I have, just because I always feel like a bother when I talk about it. He told me I definitely needed to get a 2nd opinion from an EP. He said anxiety can be an issue for people who have these symptoms, but I should see an EP to confirm all results are being interpreted the same way. He said cardios are great when you have cardiovascular disease and valve problems, but that I should be looked at by an EP to confirm because my results are being told to me they are electrical problems. He was also concerned about them increasing my atenolol since I'm asthmatic. I have since had to reduce back down due to shortness of breath and fatigue. How many of you see an EP compared to a cardio for the above mentioned problems or do you see both? I also confirmed with a close, childhood friend of mine that an EP would be the way to go for a 2nd opinion. She is an ER physician. Hated to tell both of them of what's been going on, but I was at my wits end. Thanks for any responses.

[Mom2four85]

Electrophysiologists are the "specialists" of heart arrhythmia's, they're cardiologists also, with additional education and training. I think EP's go through 8-10 years of school and cardio's may go through 4-6.  Some cardiologists think they don't need an outside opinion - which 2 of my last 4 were like that and wouldn't refer me out, which is frustrating with my problems.

My new cardiologist said exactly that - he's just the lowly plumber and takes the advice of treatment/diagnosis from my EP.  It took me 4 or 5 cardiologists though to find him and I'm so glad I did; it's rare you find one like this so you may need to keep searching until you find one who thinks this way.

I was told some EP's will not see patients who have not been referred by a cardiologist so sometimes it's difficult to get a referral if a cardio thinks he knows what's going on and doesn't want to refer you.

Close collaboration between EP's and other doctors who treat patients with heart problems is important.  So you need to have a good cardiologist who will refer you out to an EP even if it's just for an eval to see if they can find what's going on.  If yours won't refer you,  find one who will and then find a good EP; or if your insurance allows find an EP on your own for an evaluation to get their opinion.

[rilesnic]

Thanks Lisa! I have been given the names of 2 EP's as recommended by my family member. He said to let him know if I have any trouble getting in. I also spoke with my PCP's nurse (who is a dear friend) and she told me they would do whatever needed to get me to an EP. I have not asked my cardio for a referral. My insurance does not require a referral, but I've heard that some doctors do. I'm getting on that this morning. Thanks for clarifying!

[Mom2four85]

yay! good for you =) good luck on getting an appt quickly

[curmudgen]

May I add some thoughts....  I was under the impression that one have an ECG done to first determine if one is a candidate for an ablation. My PCP and cardiologist don't think I am at that point.  Some electrical issues do not respond as well as others. There are two types of ablation - RF that burns away heart tissue and Cryo that uses temperature to eliminate problem spots.  RF is quicker whereas Cryo is more forgiving since they can cool the spot down to see if it works before permanently removing it.  If you do an EP study you are committed, more or less, to an invasive procedure and probably an ablation while they are doing it.  There is no turning back from either procedure once done.  If it was me, and it almost was, I would do everything non-invasive that can be done first.  Just my two cents. Good luck.

[Mom2four85]

The problem with only going to a primary dr or cardiologist is they may miss something that an EP may find in diagnostic testing.  

While cardiologists can treat and diagnose some things; arrhythmia's should be checked out by an electrophysiologist also - especially when the treatment a dr has given a patient does not work.

As for ablation; a full cardiac workup and blood work, plus a full evaluation with an EP should be done prior to any EP Study; if they haven't been done at the cardiologist's office.  

Many people have arrhythmias that cannot be controlled with lifestyle changes or medications, then ablation may be necessary.  For some like me, even ablation doesn't help; but there are many that it does and they live a long healthy arrhythmia & medicine free life =)

[littlegreenman1]

I referred to my docs as Electricians and Plumbers.
As far as I know I made it up.  But I'm probably not the first one to use that analogy.

[curmudgen]

My cardiologist referred to himself as a plumber and his EP cohorts as electricians.

[rilesnic]

Thank you for your insight! I did not realize when they did an EP study, they may would do an ablation at that time, I appreciate your response. All input helps me to make an informed decision.