Electrophysiology Technician

Electrophysiology (EP) technicians work in specialised cardiac catheterisation laboratories during electrophysiology studies and catheter ablation procedures for arrhythmias. Cardiac electrophysiology involves mapping the electrical conduction system of the heart using electrode catheters introduced via the femoral vein, recording intracardiac electrograms, and using radiofrequency or cryoenergy ablation catheters to eliminate arrhythmia substrates — most commonly for atrial fibrillation (AF), atrial flutter, supraventricular tachycardia (SVT), and ventricular tachycardia (VT).

EP technicians prepare the catheterisation laboratory — setting up mapping systems (such as Carto or EnSite), electrophysiology recording systems, stimulation equipment, and ablation generators. During the procedure they operate the mapping system under the electrophysiologist's direction, assist with catheter positioning fluoroscopy, monitor intracardiac recordings, and manage ablation energy delivery. EP technicians may also apply external defibrillator pads, monitor the patient's ECG and haemodynamics, and participate in time-outs and safety checks.

The role is closely allied to cardiac physiology. Many EP technicians are qualified cardiac physiologists who have developed additional EP laboratory training. NHS employment is standard, typically at AfC Band 5–6. Industry-employed clinical specialists (working for Biosense Webster, Abbott, Medtronic, or Boston Scientific in the EP lab environment) are an alternative employment model.

Catheter ablation for atrial fibrillation is one of the fastest-growing cardiac interventional procedures globally, supported by strong clinical evidence and increasing NICE guidance. As AF ablation becomes standard of care for a wider patient population, EP laboratory capacity and staffing requirements are growing substantially. The procedural complexity and equipment-specific expertise required mean that trained EP technicians are difficult to recruit and retain. Industry-employed clinical specialist roles provide an additional career track outside NHS employment, often with higher remuneration and manufacturer-funded training programmes.

Morning: set up the EP laboratory for a complex AF ablation — prepare the mapping system with 3D electroanatomical mapping, set up the intracardiac echo equipment, arrange catheters and sheaths, and run through the procedure checklist with the team. Procedure: operate the Carto mapping system throughout a two-hour pulmonary vein isolation procedure — build the 3D voltage map, guide catheter positioning to the operator, annotate ablation lesion sets, and monitor reconnection testing at the end of the case. Afternoon: prepare for a second case — an SVT diagnostic study; set up recording channels, prepare stimulation protocols, and assist with catheter positioning during the study.