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Electrophysiology is the branch of cardiology that specializes in the diagnosis and treatment of abnormal heart rhythms. Although it is the fastest-growing cardiology field, electrophysiology specialists are not typically found in smaller communities. There are only two in Northwest Arkansas: Boris Bogomilov, M.D. and Soliman A. Soliman, M.D., who both practice at Washington Regional’s Walker Heart Institute. They work closely with other cardiologists to evaluate and treat patients with heart rhythm disorders.

Among the tools electrophysiologists use to manage cardiac arrhythmias are pacemakers and implanted cardioverter defibrillators (ICD). Both devices are essentially tiny computers, programmed to treat the patient’s specific condition and monitored remotely by the electrophysiology staff. “Very frequently we are aware that a patient is developing a problem before the patient feels anything or reports any symptoms,” Dr. Bogomilov says. Addressing those problems at such an early stage, he points out, cuts down on complications and reduces unnecessary hospitalizations.

Pacemakers and ICDs are placed under the skin, usually in the chest near the heart, during a minor surgery. Both must be replaced when their batteries run out, which typically is about every five years. A pacemaker, about the size of a pocket watch, is sometimes prescribed for patients with a slow or irregular heart rhythm. A pacemaker monitors a patient’s every heartbeat; if it senses the heart rate falling below the pre-programmed range, it sends a low-energy electrical pulse — undetectable to the patient — to correct the heart rhythm.

ICDs are slightly larger than pacemakers and are designed to treat abnormally fast heart rhythms. They can send a more powerful electrical pulse if necessary to restore regular heartbeat. The shock from an ICD lasts only a second, but patients typically report feeling it.

Soliman A. Soliman, M.D. is board-certified in both cardiovascular disease and electrophysiology. Dr. Soliman completed a residency in internal medicine and a fellowship in cardiology at Interfaith Medical Center, Brooklyn, N.Y., and a fellowship in electrophysiology at Downstate Medical Center in Brooklyn. He is a member of the Cardiac Electrophysiology Society.

Boris Bogomilov, M.D. is board-certified in both cardiology and electrophysiology. Dr. Bogomilov completed a fellowship in cardiology at the Medical College of Pennsylvania as well as a fellowship in electrophysiology at State University of New York at Brooklyn. He is a member of the Heart Rhythm Society.