Electrophysiology seen as one of the fastest-growing subspecialties

Electrophysiology is emerging as one of the fastest-growing subspecialties, according to hospital leaders who spoke with Becker’s. They said the field is expanding because it touches many parts of patient care and now covers a broad range of conditions across all ages. Clinicians also described a marked rise in procedure volume in recent years.

There is no nationally available data that confirms electrophysiology is the fastest-growing subspecialty, however. The source notes that databases such as the Bureau of Labor Statistics do not track this subspecialty, even as many hospital leaders say they are seeing rapid growth in practice.

One example comes from Paari Dominic, MD, director of electrophysiology at UI Health in Iowa City, Iowa. When he began the role in 2023, the team had three full-time electrophysiologists and performed about 900 procedures a year. By 2026, the team had grown to nine electrophysiologists, with three more expected to join in the coming months, and the program was performing more than 3,200 procedures a year. Dr. Dominic said that is about a 300% increase in volume over three years, not including outreach procedures.

Even with the larger staff, patients are still waiting 60 to 90 days to be seen and scheduled. Dr. Dominic said part of the growth at the main center was not simply new demand. He said the team had previously lacked enough manpower, which led to longer wait times and patients backing up. Addressing that staffing gap, he said, made it possible to absorb the increased volume.

Hospital leaders pointed to several factors behind the growth. One major driver is the aging population, which is increasing the number of patients with atrial fibrillation, heart failure and other complex rhythm disorders. Usha Tedrow, MD, director of fellowship and the Clinical Cardiac EP Program at Brigham and Women’s in Boston, said older patients were traditionally not good candidates for some procedures, including ablation. She said newer technology such as pulsed field ablation has changed that.

Pulsed field ablation is a non-thermal ablation technique that carries a lower risk of damage to heart tissue and other structures around the heart, making it a better option for older patients, according to Dr. Tedrow. The source says the method has taken over the field in the last few years and helped increase procedure volume.

Updated clinical guidelines have also contributed to growth by encouraging earlier intervention for many arrhythmias, Olivia Fleming, MSN, RN, corporate vice president of cardiovascular service line at LCMC Health in New Orleans, told Becker’s. At the same time, electrophysiology is seeing more use of leadless pacing, left atrial appendage occlusion and combined procedures, said Jessica Hennessey, MD, PhD, a cardiac electrophysiologist and assistant professor of medicine at Columbia University Vagelos College of Physicians and Surgeons in New York City. She said this has supported growth across all areas of EP care.

The specialty is also changing in pediatrics. Jeffrey Robinson, MD, medical director of pediatric cardiac electrophysiology and cardiology at Children’s Nebraska in Omaha, said pediatric electrophysiologists are primarily seeing young patients with arrhythmia, tachycardia, genetic arrhythmias and cardiomyopathies that carry a predisposition to arrhythmia or a risk of sudden cardiac death.

Taken together, hospital leaders said the field’s growth reflects changes in patient demographics, technology, clinical practice and staffing. The source does not report national workforce totals or broader industry-wide procedure counts, but it does show that individual programs are expanding quickly as demand continues to build.