Learn More About Cardiac Medical Device Clinical and Sales Careers
What Does a Clinical Specialist Do?
A cardiac medical device or clinical specialist provides procedural support, patient monitoring, and training and education. The clinical specialist enables the clinical and technical applications of medical devices by performing diagnostic tests during complex cardiac procedures including device implantations and electrophysiology mapping and ablation. Duties are performed while a device implant or EP mapping procedure is being performed and during the post-operative monitoring of patients who have cardiac devices implanted. Additional patient monitoring responsibilities include device checks through in-person and remote monitoring.
What Are the Career Growth Opportunities?
Career growth opportunities are broad since clinical and device specialist jobs exist in all medical specialties. PrepMD has helped serve as a launching point for careers as clinical specialists, medical device sales and sales management professionals in a variety of medical specialities, including Cardiac Rhythm Management, Electrophysiology, Structural Heart, and Interventional Cardiology. Job titles in the cardiac space include field clinical representative, technical sales support representative and EP mapping specialist. In device clinics and healthcare systems, job titles include device technician, pacemaker tech, EP tech, and device clinician.
What is Cardiac Rhythm Management? Cardiac Rhythm Management (CRM) includes implantable devices to treat either too slow a heart rhythm (pacemakers) or too fast a rhythm (cardioverter defibrillators).
- Bradycardia (slow heartbeat)
- Tachycardia (fast heartbeat)
- Heart block (disruption of an electrical signal which controls the heart’s pumping action)
- Atrial fibrillation (irregular fast heartbeat in the atria)
- Ventricular fibrillation (irregular fast heartbeat in the ventricles)
- Long QT syndrome (when the heart takes dangerously long to recharge between beats)
A pacemaker is a small device containing a pulse generator and leads. It is placed under the skin in the chest with leads threaded through veins into the heart to help control abnormal heart rhythms (arrhythmias) using electrical pulses to prompt the heart to beat at a normal rate. Patients with a slow heart are said to have bradycardia. Pacemakers are implanted in patients with bradycardia to stimulate the heart to beat at a normal rate and pump more effectively. Bradycardia occurs when the electrical signal from the sinus atrial (SA) node slow or disappear and do not produce enough beats. Bradycardia may also occur when the patient has AV block when not all heartbeats are able to travel from the top chamber to the bottom chamber of the heart.
An Implantable cardioverter-defibrillator (ICD) detects and stops abnormal heartbeats or arrhythmias.The ICD continuously monitors the heartbeat and delivers electrical pulses or high energy shock to restore a normal heart rhythm when necessary. ICDs prevent sudden death in ventricular tachycardia or fibrillation patients. Ventricular tachycardia occurs when the bottom chambers of the heart (the ventricles) beat too fast and have a hard time pumping blood. Ventricular fibrillation occurs when the ventricles beat too fast and unevenly making the heart flutter resulting in little or no blood pumped to the body and brain.
Cardiac Electrophysiology procedures analyze, diagnose and treat the heart’s electrical activities. The treatments identify where an arrhythmia or abnormal rhythm is originating. Each heartbeat is triggered by an electrical impulse normally generated from special cells in the atrium (upper right chamber of the heart). When a person has atrial fibrillation, these signals are faulty, firing so rapidly that the upper chambers of your heart quiver (fibrillate) instead of beating efficiently.
Electrophysiology procedures take place in an electrophysiology (EP) Lab or a catheterization (Cath) lab at a hospital while the patient is mildly sedated. The EP mapping procedure is used to determine the appropriate therapy a patient needs; including medication, device implantation, cardiac ablation/cryotherapy, or cardiovascular surgery.
During an Electrophysiology (EP) study three to five electrically sensitive catheters are placed inside the heart to record electrical activity. An EP study, typically lasts from two to four hours. Additional time is spent if treatments such as cardiac ablation or cryotherapy are used. An EP mapping procedure in total may last three to six hours.
EP Ablation Procedures take place after the EP mapping study has identified the areas of electrical abnormality needing treatment. The doctor threads long ablation catheters through blood vessels to your heart. Ablation catheters using extreme heat or cold are used to disrupt or eliminate cardiac arrhythmias, or abnormal heart rhythms by disabling those cells that cause AF or Atrial Fibrillation, thus restoring the heart to a normal rhythm.
The most common EP technique for treating atrial fibrillation is a catheter ablation procedure using heat. The use of cryoablation or extreme cold is a newer technique. The doctor runs a catheter from the groin to the area of the heart where the arrhythmia originates. He or she then uses it to deploy and inflate a tiny balloon that freezes the area. The result in both hot or cold ablation procedures is scar tissue that stops the firing pathway of the faulty signals.
Structural heart disease is one of the fastest growing segments of cardiovascular therapies. Structural heart disease refers to defects in the heart’s valve, walls or chambers and can be congenital (present at birth) or develop with age. Atrial septal defect (ASD) is a structural defect is congenital and present at birth. Aortic stenosis and mitral valve prolapse are structural heart conditions that occur over time with age. Open-heart surgery may still be required for some structural heart disease, but new catheter-based percutaneous (through the skin) therapies provide the benefits of lower risk, faster recovery and shorter hospitalization.
Structural heart procedures are performed by passing instruments through catheters inserted through the leg into the heart to deliver treatment devices. For example, a patient with a diseased heart valve may receive a new valve inserted via catheter in a compressed state which is then expanded once in the correct position, where it becomes a fully functioning valve.
Common structural heart procedures include valve replacements, repairs, clips, closures. Therapies include Transcatheter Aortic Valve Replacement (TAVR), Transcatheter Mitral Valve Repair (TMVR), Atrial and Ventricular Septal Defects (ASD/VSD), Hypertrophic Cardiomyopathy (HOCM), Left Atrial Appendage Occlusion, Paravalvular Leak Repair, and Pulmonary Embolism.
Interventional cardiology treatments include cardiac catheterization, balloon angioplasty, and stent implantation.
A Cardiac Catheterization is a diagnostic test used to evaluate the presence, size, and location of plaque deposits in the arteries, the strength of the heart muscle, and the function of the heart valves. During cardiac catheterization, a catheter is inserted into a blood vessel in the leg or wrist and gently guided toward the heart. Contrast dye is injected into the arteries of the heart so that the cardiologist can trace the movement of blood through the arteries and the chambers of the heart.
Angioplasty which is also called Percutaneous Coronary Intervention is used to restore blood flow to the heart. This procedure is done as an emergency procedure for a heart attack patient or a scheduled procedure to treat the condition of chronically inadequate blood flow to the heart.
Balloon angioplasty uses a catheter with a balloon tip which is inserted into the site of the blocked artery and then inflated to stretch open the walls of the artery. An Atherectomy procedure uses a catheter with a special pulverizing device to open hardened blockages in the coronary arteries. A cardiac stent is a small metal coil which permanently holds a clogged vein open. Stenting and atherectomy procedures are often done in conjunction with angioplasty.
Understanding the Job and the Employers
Employed by a hospital
Cardiac Device Technician
Device Technician job description
- Does full evaluation and assessment of patients with pacemakers, ICD’s, CRT devices and ILR’s; Reprograms devices as required.
- Enrolls, interrogates and programs patients with cardiac devices and recognizes abnormalities, malfunctions and alert indicators.
- Assists in scheduling patients for follow up, remote monitoring, or replacement as indicated.
- Coordinates and prioritizes with other members of the healthcare team to respond to patients, plan, and initiate timely and efficient care.
- Educates patients and families regarding device function and remote and / or clinic follow up scheduling.
- Ensures timely and proper documentation and billing.
- Participates in the device recall team if necessary.
- Supports all aspects of documentation in the electronic CIED reporting system and the Electronic Medical Record.
- Maintains knowledge of hospital, department, and regulatory agency policies and requirements.
- Is available to perform duties in satellite and affiliate device clinics as needed.
EP Technician job description
- Assists the physician in the invasive testing and/or treatment of patients in the Electrophysiology Lab, including specialized technical support and assistance to the physician in the precise diagnostic mapping of patient-specific lesions, related testing and treatment of patients.
- Provides technical expertise including monitoring, recording and mapping systems and equipment used for ablations.
- Demonstrates a functional understanding of the radiology imaging equipment. Demonstrates an understanding of the features of various catheters and other supplies used for EP procedures and is able to assist with complex cases.
- Demonstrates a knowledge and ability to interpret complex cardiac rhythms during procedures in the EP lab.
- Demonstrates a knowledge and ability to interpret hemodynamic pressures and wave forms.
- Demonstrates the ability to safely scrub and assist the physician during the EP procedures including implantation of cardiac rhythm management device procedures.
Employed by a corporation
Cardiac Clinical Specialist
Clinical Specialist job description
- Serve as primary resource for clinical support in the areas of surgical coverage, basic troubleshooting, programming, and patient follow-up for company products.
- Educate physicians, nurses and hospital staff on the merits and proper clinical usage of company products by giving presentations and demonstrations.
- Attends cardiac device implants and therapies in the labs and operating room and performs patient follow-up to assure customer and patient success with the implanted products
- Develops relationships with hospital personnel to identify key decision makers to facilitate future sales.
- Trains on and maintains knowledge of clinical trial protocols, standard operating procedures, and compliance.
- Manages clinical trial activity within assigned territory.
- Educates clinical investigators on clinical trial protocols, clinical process, and investigational products and features.
- Responds to customer needs and complaints regarding products and service to develop optimal solutions.
- Follows company and divisional guidelines for managing product inventory.
- On-call duties may be required
EP Mapping Specialist
EP Mapping Specialist job description
- Serves as primary resource for clinical support in the areas of case coverage, basic troubleshooting, system/software development for EP mapping system and catheters.
- Educates on the merits and proper clinical usage of mapping system by giving presentations and demonstrations.
- Attends cases in labs of hospital accounts for case support and development efforts.
- Providing initial and continuous training and feedback for development team and sales representatives on mapping system, development process, products and features, and procedures involving those products and features.
- Meets with physicians, physician office groups at hospitals to identify their clinical needs, goals, and constraints related to patient care and to discuss and demonstrate how company products can help them to achieve their goals.
- Develops relationships with hospital personnel to make new contacts in other departments within hospital and to identify key decision makers in order to facilitate future sales.
- Responds to customer needs and complaints regarding products and service by developing creative and feasible solutions or working with other team members to develop optimal solutions.
- Will be required to maintain advanced clinical knowledge of cardiac ablation, cardiac ablation components, technical knowledge of EP technology, advancements, and business landscape.
A Career Outlook:
Cardiovascular Devices and Therapies Market
- 43% cardiac rhythm management (CIED, EP)
- 24% cardiac prosthetic devices (valves)
- 15% interventional cardiology
- 11% cardiac monitoring & diagnostics
- 7% others
Global Market Analysis
Cardiology is a branch of medicine that studies the diseases, abnormalities and treatments of the heart. Approximately 92 million Americans are living with cardiovascular disease. The overall global market for the cardiovascular devices market is expected to grow at an annual rate of 6.7% through 2027 and is expected to reach $60 billion by the year 2022. Historically, healthcare represented only 5% of the economy in 1960, 13% in 2000, and now healthcare holds nearly 18% of the U.S. economy. Labor experts claim that healthcare, regardless of the state of the economy, is consistently hiring.
Cardiac Rhythm Management includes implantable devices such as pacemakers and ICDs and electrophysiology therapies makes up the largest single segment of the cardiovascular medical device market.The Cardiovascular Implantable Electronic Device (CIED) most people are familiar with is the pacemaker, which helps control irregular or slow heartbeats by means of electronic stimulation. Pacemakers first came to market in the late 1950s, with the approval of the external pacemaker. The first implantable pacemaker was approved in the 1960s and the implantable cardiac defibrillator (ICD) which can shock a patient experiencing a sudden cardiac death (SCD) event came along in the 1980s.
Cardiac device manufacturers have continually refined the design and function of pacemakers, ICDs, electrophysiology (EP) mapping and ablation catheters over the years, making them safer and more effective for the patients who need them. Emerging developments in the field include cardiac remote monitoring and optimization of CIED performance over the internet, and miniaturization. Future generations of CIEDs are likely to be small enough to implant completely inside the heart.
Electrophysiology Mapping is a fast-growing segment of the market, with ablation catheters providing curative therapies for cardiac arrhythmias. Impressive technological advances include computer-assisted recording and electroanatomic 3-D mapping systems for ablation procedures. EP mapping therapies continue to evolve at a rapid rate. The cardiac electrophysiology (EP) mapping global market is expected to grow from $1.4 billion in 2019 to $2.1 billion by 2024, with North America accounting for more than one-third share of the global EP market.
Demographic factors such as an aging population, and increase of obesity and diabetes will continue to contribute to the need for cardiovascular therapies across the board. Interventional cardiology and peripheral vascular therapies include angioplasty and stent implantation. The global interventional cardiology devices market is expected to grow at an annual rate of 7.5% reaching $20.85 billion by 2022.
Demand for structural heart devices and therapies such as aortic stenosis and mitral regurgitation are on the rise. The global structural heart devices market was valued at $7.5 Billion in 2017 and expected to reach $18.9 Billion by 2026. It is estimated that in the U.S. alone, approximately 60 million individuals suffer from structural heart defects, potentially suitable for treatments including both valve repair and replacement procedures.
Innovation and advances in cardiovascular therapies and technologies will continue at a very fast rate. The role of the Cardiac Clinical Specialist is expected to evolve because of an increased need for product and therapy expertise during and after these procedures. The medical device specialist career path offers many dynamic and rewarding growth opportunities.