Clinical Cardiac Electrophysiology Training
Fellows in the Clinical Cardiac Electrophysiology Fellowship Program develop expertise in the diagnosis of cardiac arrhythmias by both surface electrocardiogram and intra-cardiac electrogram interpretation. They also participate in the management of patients with arrhythmia disorders on an inpatient consultative service and in an outpatient clinic. Our fellows become familiar with the use of evidence-based medicine and the application of clinical guidelines for patient management.
Fellows will rotate between University Hospitals Cleveland Medical Center, University Hospitals Harrington Heart & Vascular Institute and the Louis Stokes Cleveland VA Medical Center. There is also the opportunity to participate in cases at UH Ahuja Medical Center, one of the community hospitals in the University Hospitals system. With three dedicated EP labs and a hybrid OR at UH Cleveland Medical Center and one dedicated EP lab at the VA, the opportunity to acquire procedural skills in diagnostic electrophysiology studies, catheter ablation, device implantation and lead extraction meets or exceeds the recommended volumes to achieve competency. The laboratories are equipped with state-of-the-art recording equipment and fellows have exposure to cutting-edge technologies.
After completion of their cardiac electrophysiology training, fellows are able to perform all invasive electrophysiology procedures independently and are eligible for the ABIM Board Certification Examination in Clinical Cardiac Electrophysiology and Pacing.
Clinical Cardiac Electrophysiology Fellowship Curriculum
The program has two first-year and two second-year fellows every year. The fellows spend two weeks at a time assigned to either the UH EP lab, the VA Medical Center, or the clinical consult service at UH Cleveland Medical Center. The time spent in each rotation per year is 8.5-9 months in the UH EP labs, 2.5-3 months at VA Medical Center, 2-3 weeks on the UH EP consultative service and one month vacation. Travel to educational conferences is permitted after approval from the program director. While assigned to the UH EP laboratory, the fellows have the opportunity to participate in:
- Catheter ablation utilizing both radiofrequency and cryoablation
- Diagnostic EP studies
- Generator replacements
- Implantable cardioverter defibrillators
- Implantable monitors
- Implantation of cardiac pacemakers
- Intracardiac mapping
- Lead extraction
- Lead replacements
During the VA rotations, fellows perform procedures in the EP lab, in addition to cardioversions and tilt table testing. Inpatient consultation experience is gained at the VA Medical Center and during the UH EP consultative service. Fellows participate in an outpatient EP clinic ½ day per week.
Research Training in Cardiovascular Medicine
Academic development is an important part of the cardiac electrophysiology training program. Trainees are encouraged to engage in a variety of scholarly activities. Fellows have the opportunity to participate in basic science, translational and clinical research. Clinical research opportunities include industry-sponsored trials, physician-initiated studies and performance improvement projects. There are invited lectures and conferences throughout the year and medical school and resident teaching opportunities.
Basic and translational research opportunities also exist and fellows have been involved in a number of studies with several faculty members on these projects. An exciting new project is utilizing one of the most advanced epicardial mapping systems ever designed to study atrial fibrillation in humans during open heart surgery.
Clinical Cardiac Electrophysiology Conferences
Electrophysiology Conferences are held twice weekly on Monday and Friday morning for one hour each and rotate between didactic sessions on core curricula by our own faculty, special lectures by guest faculty from around the world, and case conferences given by the fellows and device conferences. There is also an EP Journal Club once a month to critically review contemporary and classic EP articles. Additional special sessions are held throughout the year with visiting faculty from world-renowned institutions.