Program Overview

The American Board of Internal Medicine requires two years of electrophysiology fellowship training for board eligibility. During this time, the trainee needs to gain expertise in the theory and practice of cardiac electrophysiology, and our program provides in-depth training in both areas. There are weekly lectures that cover all aspects of cardiac arrhythmias, with lectures ranging from cellular electrophysiology to mapping and ablation of complex ventricular and supraventricular arrhythmias. The topics are presented by several of the 13 faculty members, but the fellows are also very involved in the formal teaching part of the program, presenting interesting cases from the clinical electrophysiology (EP) laboratory or from their office or rounding experience. The case presentations form a nidus for detailed discussions on EP lab diagnosis, eg, maneuvers and ablation, as well as how to manage complex patient arrhythmia cases. There is also a monthly EP journal club with the fellows and Dr Prystowsky. Classic articles in the field are reviewed giving the fellows a detailed background in the discoveries that were key to advancing knowledge in our field.

Expertise in the technical aspects of EP is a requisite for becoming a successful clinical cardiac electrophysiologist. During the two years of training the fellow will gain this expertise following our concept of “crawl-walk-run”, that is, a gradual increase in independence in performing procedures. It has been our experience that some fellows need more time to gain proficiency in a certain procedure, while others may not. So, we prefer to avoid “artificial” levels of when a fellow can advance to independence doing a specific procedure, eg, VT ablation only in their second year of training, and in this manner we can individualize and maximize each fellow’s training. There are substantial EP lab volumes to accommodate these goals: approximately 900 catheter ablations a year (> 500 AF, > 130 VT/PVC, > 125 PSVT), and approximately 1300 devices including pacemakers, ICDs, BiV pacing and conduction system pacing.

Fellows also participate in a weekly outpatient clinic, rounding on the inpatient EP service, and are expected to participate in research projects.