General Goals: Clinical Cardiac Electrophysiology requires an understanding of cardiac physiology, and anatomy, as well as cellular electrophysiology. Fellows must be able to diagnose and treat a variety of acute and chronic arrhythmias. This requires knowledge of safe and effective use of antiarrhythmic drugs as well as indications for pacemaker and defibrillator implantation, radiofrequency ablation, and electrophysiology testing. In addition, fellows are taught appropriate evaluation and management of documented or suspected arrhythmias, as well as risk stratification for sudden death. From a procedural standpoint, fellows should become competent in the insertion and manipulation of pacing catheters implanted transvenously.
- Gain proficiency in the diagnosis and treatment of cardiac arrhythmias.
- Understand indications and interpretation of in-hospital telemetry, Holter and transtelephonic ECG recording.
- Understand indications for EP studies, and other diagnostic tests, including limitations of tests.
- Understand indications for tilt table tests, including limitations, and how to perform tilt table testing.
- Understand indications for temporary and permanent pacemakers, how to place temporary pacers.
- Understand indications for ICDs. Understand how to interrogate pacemakers and ICDs.
- Understand indications for cardioversion, elective and emergent, and how to perform cardioversion.
- Understand the use of pharmacologic antiarrhythmic therapy.
- Understand indications, limitations, complication of catheter ablation.
- Understand how to record a His bundle electrogram.
- Understand indications, limitations of other diagnostic techniques – signal-averaged ECG, heart rate variability.
- Gain proficiency in the interpretation of standard ECGs, including correlating standard ECGs with intracardiac recordings.
- Gain proficiency in interpreting continuous ECG recordings (including telemetry, Holter, and transtelephonic monitors.
- Gain proficiency in the insertion of pacing catheters into the venous system.