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Interview by Jodie Elrod

In this interview, Nadine Wlasiuk, DNP, APRN, emphasizes the critical role advanced practice providers (APPs) play in expanding access, improving efficiency, and enhancing continuity of care in electrophysiology (EP). She highlights how APPs help guide patients to the right provider at the right time by managing longitudinal care, optimizing patients before procedures, coordinating follow-up, and leading structured care pathways. In atrial fibrillation (AF) management, Wlasiuk noted that APPs are especially valuable in providing patient education, monitoring, and ongoing support across the full continuum of care. Looking ahead, she sees significant opportunities for APPs to lead standardized EP care systems that improve access, reduce bottlenecks, and support better patient outcomes, positioning APP integration as a strategic solution to growing workforce demands in EP.

Can you start with a brief introduction about yourself?

Nadine Wlasiuk, and I am one of the clinical electrophysiology nurse practitioners at UCSF Health in San Francisco.

From your perspective, what are the most critical ways advanced practice providers (APPs) contribute to the overall success and efficiency of electrophysiology practices today? 

We definitely help move the right patient to the right provider at the right time. In the high-volume specialty that electrophysiology is, access is one of our biggest challenges. So APPs expand capacity by managing longitudinal care. We can triage referrals, optimize patients before procedures, and create structured pathways for common EP needs. It's my opinion that the most successful EP programs don't use APPs just as physician extenders—they design APP roles intentionally with independent clinics, device and arrhythmia follow-up, periprocedural optimization, cardioversion pathways, loop recorder implantation, patient education, and postprocedural management. When APPs practice at the top of their scope, physicians can focus on the highest complexity decision-making and procedures while patients can still receive timely specialized and high-quality care.

In the management of atrial fibrillation (AF) specifically, how do APPs enhance patient care across the continuum—from diagnosis and education to long-term follow-up? 

AF is a perfect example of where APPs add value because AF care is not a single decision point, it's a continuum. Patients need education, risk factor modification, stroke prevention, rhythm and rate control discussions, procedural counseling, medication monitoring, and long-term follow-up. It's a lot. We often have the time and continuity to translate complex AF management into something that patients can understand and act on. We can assess the symptoms, review anticoagulation and stroke risk, reinforce the lifestyle and risk factor modifications, and coordinate all of the procedures and the follow-up care. The value isn't just more visits, it's better continuity and better execution of guideline-based care. AF patients need repeated touchpoints and APPs are well positioned to make sure the plan actually moves forward.

As the role of APPs continues to evolve, what opportunities do you see to further expand their impact in EP, particularly in improving access, outcomes, and care coordination?

I think the next opportunity is moving from individual APP productivity to APP-led systems of care. This means building standardized pathways where APPs can safely and efficiently manage high-volume EP needs, such as AF optimization, cardioversion readiness, left atrial appendage occlusion, referral screening, implantable loop recorder implants, device follow-up, and post-ablation care. The future is not about replacing physicians—it's about smarter team design. APPs can help identify which patients are procedure ready, which need more optimization, and which need physician input at the highest value decision point. This improves access, reduces unnecessary bottlenecks, and supports better patient outcomes. The EP workforce is definitely under strain and APPs are one of the most practical ways to scale specialized care without compromising quality. To me, the opportunity is to treat APP integration as a strategic workforce solution, not just a staffing solution.