When people hear the word cardiologist, they often assume all heart doctors do the same thing. In reality, cardiology includes specialized fields, each focusing on different aspects of heart health. Two of the most important are General Cardiology and Cardiac Electrophysiology.

Understanding the difference between these specialties helps patients recognize their symptoms, seek the right care, and avoid delays in diagnosis or treatment.

How the Heart Works: A Simple Foundation

The heart depends on two systems working together:

The mechanical system – heart muscle, valves, and blood flow

The electrical system – signals that control when and how the heart beats

Problems in either system can cause symptoms, but they are treated by different specialists.

What Is General Cardiology?

General cardiology focuses on the heart’s structure, pumping ability, and blood circulation.

A general cardiologist evaluates how well the heart muscle works, whether the valves open and close properly, and if blood is flowing freely through the coronary arteries.

Conditions treated by general cardiology

• Coronary artery disease (blocked arteries)

• Chest pain and heart attack risk

• High blood pressure

• Heart failure

• Heart valve disease

• High cholesterol

• Shortness of breath related to heart function

Common tests used in general cardiology

• Electrocardiogram (ECG/EKG)

• Echocardiogram (heart ultrasound)

• Stress testing

• Cardiac CT or angiography

• Blood tests

In simple terms:
General cardiology checks the heart’s structure, strength, and circulation.

What Is Cardiac Electrophysiology?

Cardiac Electrophysiology is a subspecialty of cardiology that focuses on the heart’s electrical system.

A cardiac electrophysiologist (EP cardiologist) completes additional advanced training after general cardiology to diagnose and treat heart rhythm disorders, also known as arrhythmias.

Conditions treated by cardiac electrophysiology

• Atrial fibrillation (AFib)

• Supraventricular tachycardia (SVT)

• Ventricular tachycardia

• Slow heart rate (bradycardia)

• Heart block

• Irregular heartbeat

• Palpitations

• Fainting (syncope)

• Unexplained dizziness or sudden racing heart

EP-specific tests and procedures

• Holter monitors and event monitors

• Implantable loop recorders

• Electrophysiology (EP) studies

• Catheter ablation

• Pacemaker implantation

• Implantable cardioverter-defibrillator (ICD)

In simple terms:
Cardiac electrophysiology treats problems with the heart’s electrical wiring and rhythm.

Key Differences Between General Cardiology and Cardiac Electrophysiology

Focus of Care

General cardiology concentrates on how the heart is built and how blood flows through it, while cardiac electrophysiology focuses on how the heart’s electrical signals control heartbeat timing and rhythm.

Conditions Treated

General cardiologists manage conditions such as blocked arteries, valve problems, and heart failure. Cardiac electrophysiologists specialize in arrhythmias, including fast, slow, or irregular heartbeats that disrupt normal heart rhythm.

Common Symptoms

Patients seeing a general cardiologist often experience chest pain, swelling, shortness of breath, or fatigue related to poor circulation or heart muscle weakness. Patients referred to cardiac electrophysiology usually report palpitations, fainting, dizziness, sudden racing heartbeats, or skipped beats.

Diagnostic Approach

General cardiology relies on imaging and circulation-focused tests like echocardiograms and stress tests. Cardiac electrophysiology uses long-term rhythm monitoring and EP studies to detect electrical problems that may occur intermittently and are often missed on routine ECGs.

Treatment Methods

General cardiology treatments often involve medications, lifestyle management, and non-invasive cardiac care. Cardiac electrophysiology treatments may include catheter ablation to correct abnormal electrical pathways, pacemakers for slow rhythms, or ICDs to prevent dangerous arrhythmias.

Training and Expertise

A general cardiologist completes specialized training in cardiovascular medicine. A cardiac electrophysiologist undergoes additional fellowship training focused exclusively on heart rhythm disorders and advanced electrical procedures.

How These Specialties Work Together

General cardiology and cardiac electrophysiology are not competing specialties — they work as a team.

Most patients:

Start with a general cardiologist

Undergo basic heart evaluation

Are referred to a cardiac electrophysiologist if rhythm issues are suspected

This collaboration ensures patients receive accurate diagnosis and the most effective treatment.

When Cardiac Electrophysiology Is Especially Important

Patients should consider EP evaluation if they experience:

• Recurrent or worsening palpitations

• Unexplained fainting or near-fainting

• Irregular heartbeat not controlled by medication

• Atrial fibrillation considering ablation

• Slow heart rate needing pacing

• Symptoms that come and go without explanation

A Simple Way to Remember the Difference

General cardiology treats how the heart pumps and circulates blood.
Cardiac electrophysiology treats how the heart beats and stays in rhythm.

Final Thoughts

Both general cardiology and cardiac electrophysiology play essential roles in comprehensive heart care. General cardiology focuses on the heart’s structure, circulation, and overall function, while cardiac electrophysiology specializes in diagnosing and treating disorders of the heart’s electrical system that cause irregular heart rhythms.

If your symptoms involve palpitations, fainting, unexplained dizziness, or irregular heartbeats, specialized evaluation by a cardiac electrophysiology team may be necessary. For patients seeking cardiac electrophysiology–focused care, Cypress Cardiovascular Institute can be contacted for specialized assessment, advanced rhythm testing, and personalized treatment planning.

Early evaluation by the appropriate heart specialist can lead to more accurate diagnosis, targeted treatment, and improved long-term heart health.

Medical Disclaimer

The information provided in this article is for educational and informational purposes only and is not intended as medical advice, diagnosis, or treatment. This content should not be used as a substitute for professional medical care or consultation with a qualified healthcare provider.

Always seek the advice of a licensed physician or cardiology specialist regarding any heart-related symptoms, conditions, or treatment decisions. Do not delay or disregard medical care based on information contained in this article.