When to refer your patient to an electrophysiologist

Your patient's EKG comes back abnormal, or they describe palpitations that won't resolve, episodes of fainting with no clear cause or dizziness that keeps disrupting their daily life. These findings don't always call for immediate intervention, but they do raise a critical question: is this patient's heart rhythm problem beyond the scope of primary care management?

Knowing when to refer to an electrophysiologist can meaningfully change your patient's outcome. The Novant Health Heart & Vascular team is here to help.

Electrophysiology: what it is and why it matters

Electrophysiologists are cardiologists who complete an additional two years of subspecialized training focused on diagnosing and treating the heart's electrical system. Where a general cardiologist manages overall cardiovascular health, an electrophysiologist investigates and treats the specific mechanisms behind arrhythmias, using advanced diagnostic mapping, catheter-based procedures and implantable cardiac devices. Because heart rhythm disorders become more common with age, timely subspecialty input grows increasingly valuable as your patient population ages.

When to refer your patient

Referring physicians typically recognize the need for electrophysiology consultation when primary care management isn't enough. Consider an EP referral when your patient presents with:

• Arrhythmia
• Chronic palpitations
• Unexplained syncope
• Frequent or recurrent dizziness
• Suspected or confirmed arrhythmias
• Ineffective first-line rhythm medications
• A need for device therapy
• Potential candidacy for catheter ablation
• Elevated genetic or family risk of sudden cardiac arrest

The threshold for referral doesn't need to be high. Earlier consultation supports better planning and gives your patient more options, particularly for conditions like atrial fibrillation (AFib), where the risks compound over time. People with AFib are five times more likely to experience a stroke than those without it.

"Heart rhythm disorders can be frightening and disruptive, but they're highly treatable with the right expertise. My goal is to work closely with patients to create individualized treatment plans that improve both longevity and quality of life," said Mark Liwanag, DO, electrophysiologist at Novant Health Heart & Vascular – Physicians Plaza on Hilton Head Island.

What referring physicians can expect

When you refer your patient to Novant Health Heart & Vascular, you're connecting them to subspecialized care. Here's what the referral experience looks like in practice:

• Access to advanced procedures
• Cardiac device implantation and management
• Long-term rhythm monitoring