Cardiac Physiologist

CathLabCardiac physiology provides a range of clinical, technical and scientific services to all areas within the hospital. Departments consist of several sections according to their area of expertise. All of these sections strive to provide excellence in technical services so that patients may receive the best care and treatment available.

The work in cardiac physiology is varied and interesting, involving both contact with patients and state of the art medical technology. People with high personal standards will find a rewarding challenge.

A cardiac physiologist must be patient orientated, efficient and competent with dealing with confidential information. As he or she is dealing with patients of all ages and degrees of illness. A cheerful and reassuring manner is essential. Many of the procedures performed by the technologists last several hours at a time, demanding general good health and the ability to concentrate for prolonged periods.

Entry Requirements for the Training Programme

  • BSc Physiology (or other relevant major) is required for entry into the programme:
  • Previous work experience in dealing with the public is an advantage.
  • Applicants must have excellent English skills (spoken and written).

Structure of the Training Programme

Trainee physiologists are employed full time with a training period of two years in the Department. During this time the trainees rotate through the various technical procedures to gain practical experience in cardiac measurement techniques.

Practical Training

 In many DHBs a buddy system is used for trainees to learn each procedure. Trainees will then have a practical assessment in that procedure and once this is passed they may be able to work unsupervised in that procedure. The training and assessment system continues throughout the two years of training. A work book is provided for the training, which outlines what the trainee is expected to know for each assessment.

Cardiac Catheterisation Investigations

Cardiac catheterisation is a procedure requiring a specialist physician or Cardiologist, also nursing, technical and radiography staff. The cardiologist inserts a thin tube or catheter into a vein or artery, under x-ray viewing, and positions it within the heart. The technologist’s role is to monitor and record the ECG and intracardiac blood pressures during the procedures. A great deal of information can then be gathered about the function of the heart and the flow of blood. Angiograms and Angioplasties are the most common procedures performed in the cardiac catheterisation area. Cardiac catheterisation procedures are also performed on babies who are born with heart problems.

Electrocardiography

 This is a simple and quick (15-20 minutes) test that records the electrical activity of the heart. It is done by placing electrodes on the patient’s chest, arms and legs. The electrodes are then connected to an ECG machine by a cable and a series of recordings can be made on a paper chart. This test is of considerable diagnostic value so that accuracy is important. ECG’s are performed on patients in the wards and outpatients attending clinics.

Exercise Stress Testing

 The patient is connected to an ECG which is monitored while they exercise on a treadmill or bicycle. This test is used to determine whether the patient’s symptoms, such as chest pain, are due to heart disease and if so how severe. It is also used to determine what a safe level of exercise is for a patient after a heart attack and whether their treatment is effective

 

Opportunities to Specialise

Cardiac Physiology

On appointment to a permanent position the cardiac physiologist will continue to develop their skills in a range of advanced areas. As well as completing some of the procedures covered during the training, the physiologist will also perform several of the following specialist procedures:

  •  Pacemaker Implantation and Follow-up

Technologists assist the cardiologist during the implanting of pacemakers and carry out the patients follow-up checks. Pacemaker follow-up is included in training but because of its complexity it is a specialist field.

  • Implantable Cardioverter Defibrillators

 These work like an external defibrillator by delivering a shock and returning the heart to a normal rhythm. They are similar in size to a pacemaker and are implanted inside the patient. They sense some abnormal fast heart rhythms and work automatically when needed. Physiologists assist the cardiologist during the implanting and testing of these devices and perform follow-up checks in an outpatient’s clinic.

  • Electrophysiology

 The routine ECG is the simplest investigation of the electrical conduction system of the heart. More complex studies are undertaken by a specialist cardiologist with the help of technical and nursing staff. The cardiac physiologist operates the stimulating and recording equipment and assists in analysing the electrograms and reporting the findings.

  • Paediatric Cardiac Catheterisation

In this area, the physiologist is responsible for monitoring of the ECG and intra cardiac pressures. This data is then used to calculate flows, resistances, valve area and other measurements relating to the patient’s heart function.

  • Echocardiography

This is a specialty involving ultrasound to view the chambers, walls and valves of the heart. This can help the physician identify structural abnormalities that will lead to further treatments and often surgery. The echocardiographer operates individually and needs to be able to identify different disease processes to produce an accurate report to reflect this information.