I believe people see a cardiologist second to their family physician or an ER internist who detects an arrhythmia. I think you and I would agree that it's almost a waste of time waiting to see a cardiologist, especially if the arrhythmia is intractable and won't back off with meds, and then having to wait again to see an EP. My cardiologist did buy me three years free of AF with meds, but then things began to slide quickly and it was only then that he asked if I'd like to see an EP. In our Canadian monopoly/socialist medicine, you have to wait in line, sometimes months, to see a specialist, who then refers you up the chain. Happened to me.

I know, in my case, when my cardiologist diagnosed my AFIB, I had never heard of an electrophysiologist. After several months when someone suggested to me that I see an EP, I called, but they would not see me without a doctor's referral. My cardiologist was hesitant to send a referral (it took several months for him to agree to do so); I can only assume that he thought he could manage my AFIB with meds (which didn't happen). Now I always see my EP for my AFIB.