Cardiac electrophysiology is a unique and growing field that has made numerous advances in the past 15 years. Specifically, the field is advancing in terms of types of procedures as well as scope of practice. Pacemakers, implantable cardioverter-defibrillators (ICDs), and ablations have been the cornerstone of the field and continue to treat more and more conditions. This chapter will convey a birds-eye view of the types of the procedures in electrophysiology, the indications/contraindications, and the advances in the past 15 years. Additionally, local vs. general anesthesia in these procedures as well as the indication for the type of anesthesia will be discussed. The overall aim of this chapter is to present a unique viewpoint of cardiac electrophysiology as well as elaborate on the various types of anesthesia in this field.