Electrophysiology (EP) Laboratory Procedural Requirements
Clinical Cardiac Electrophysiology fellows must perform a minimum number of the following procedures:
- EP diagnostic studies —150 intra-cardiac procedures as assistant or primary operator in at least 75 patients, with an average of three or more EP diagnostic/interventional catheter procedures per week as primary assisting operator
- Catheter ablations — 75, of which at least 50 percent are supraventricular, including atrioventricular nodal reentrant tachycardia, accessory pathway-mediated tachycardia, atrial flutter, atrial fibrillation and ventricular tachycardia ablation
- Pacemakers — 50 implants as primary operator; 100 follow-up visits
- Implantable cardioverter defibrillator (ICD) — 25 implants as primary operator; minimum 50 follow-up visits
Fellows perform procedures (electrophysiology studies, catheter ablations, pacemaker and ICD implantation and minimally invasive surgery for arrhythmia) in the electrophysiology procedure/catheterization lab and cardiac surgical operating room with the full-time staff and/or attending electrophysiology physician's supervision.
Clinical Outpatient Components
Fellows gain clinical experiences through weekly participation in outpatient clinics: CIED Clinic and EP Consult-Cardiology Clinic at Cedars-Sinai. Training in interrogation and basic testing of CIEDs are facilitated by device technicians and faculty.
Fellows are called upon to perform additional device testing and management for inpatients, such as in the emergency room and walk-in emergencies, and during consultations for device patients in the outpatient setting. Fellows are expected to be proficient in basic device interrogation and troubleshooting by the end of their training.
- EP Journal Club
This educational conference, conducted on the third Tuesday morning of the month, represents a detailed review of selected relevant published articles from scholarly journals. The fellow is responsible for presenting at the EP Journal Club. The fellow establishes and maintains an environment of inquiry and scholarship with the presentation of peer-reviewed publications from leading medical journals. Attendance is mandatory.
- CCEP Case Review
The case review conference occurs each Wednesday. The fellow is expected to present clinical cases for review during these conferences and develop interactive discussion with faculty and fellows on complex arrhythmia cases. Attendance is mandatory.
- EP Fellows Core Curriculum Lecture
Educational lecture presentations occur each Thursday morning. Guest faculty are invited to give comprehensive didactic lectures covering current topics in clinical, diagnostic and procedural electrophysiology, as well as anatomical and biomedical electrophysiology research on mechanisms of arrhythmias. Attendance is mandatory.
- EP Research Conferences
Conferences are conducted on the first Tuesday of the month. Fellows review basic and clinical research being conducted in the field and/or present protocols, proposals and results of original research.
- EP Device Case Review
This education conference, conducted on the second Tuesday of the month, provides a case-based review of CIED management focused mainly on CIED troubleshooting but also includes implantation techniques and complications, and clinical decision-making. Fellows are expected to present the cases and facilitate an interactive discussion with the faculty. Attendance is mandatory.
- High-Fidelity Simulation Training
In the state-of-the-art Women's Guild Simulation Center for Advanced Clinical Skills, fellows can practice virtual trans-septal puncture, intracardiac echocardiography, CIED implantation, catheter manipulation and left-atrial appendage occlusion procedures. These sessions are incorporated into the weekly core curriculum schedule and are guided by faculty.
The fellow is expected to participate in an ongoing clinical research project or pursue an original project. Research with emphasis on basic science investigation also is available, with particularly strong programs in sudden cardiac death investigation, atrial fibrillation, cardiac regenerative medicine and stem cell biology, including development of a biologic pacemaker. Presentation of research findings at national and international scientific meetings is encouraged.