Listen in or read from the partial transcript below as Fima Macheret, MD, Cardiologist at Skagit Regional Health explores common symptoms of irregular heartbeats and learn what to do if you experience them. 

Joey Wahler (Host): This podcast is for informational purposes only, and not intended to be used as personalized medical advice. 

It treats abnormal heart rhythms, so we're discussing Cardiac Electrophysiology. Our guest, Dr. Fima Macharet. He's a Cardiac Electrophysiologist with Skagit Regional Health. This is Be Well with Skagit Regional Health. Thanks for joining us. I'm Joey Wahler. 

Hi there, Dr. Macharet. Welcome.

Fima Macheret, MD: Good morning, Joey. Thank you for having me.

Host: Oh, great to have you aboard. We appreciate it. So first, what in a nutshell does a cardiac electrophysiologist, also sometimes called an EP, do? And what made you choose to be one in the first place?

Fima Macheret, MD: Yeah, a cardiac electrophysiologist deals with the heart rhythm or the heartbeat that we all have. We specifically deal with heartbeats that are too slow, too fast or abnormal. I chose to be an electrophysiologist because I learned about the procedures that we do that can restore quality and quantity of life to people's lives.

Host: That's awesome. And so what's the training path to become a cardiac EP?

Fima Macheret, MD: We train first in undergraduate, then medical school and then internal medicine residency, followed by cardiology fellowship, followed by a two-year electrophysiology fellowship just devoted to electrophysiology procedures. I actually spent an extra five years doing internal medicine and clinical informatics in between my internal medicine and cardiology fellowship.

Host: And I guess it's safe to say, isn't it, Doc, that a healthy heartbeat, a regular one, if you will, is something most of us take for granted until it's irregular, right?

Fima Macheret, MD: I think that's exactly right. We have a heartbeat about once every second, thousands of them throughout our life. And most of the time, ideally, we don't notice them. It's when we start to notice them that could be a signal that there's actually something wrong.

Host: Right. So, speaking of which, can you describe for us the heart's electrical system and what happens when it malfunctions?  

Fima Macheret, MD: Absolutely. This is one of my favorite conversations to have with patients. Every heartbeat, the one we have every second, starts in a cluster of cells in the upper right chamber of the heart, called the sinoatrial node. It's also known as our own pacemaker cells. Under the influence of the nervous system that can speed up or slow down the heart rate; that cluster of cells releases a signal or an electrical wave front that travels through the upper chambers to the middle of the heart where it quickly travels down the bottom pumping chambers of the heart, the ventricles, and causing them to squeeze at exactly the same time.

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