1. Noninvasive assessment of cardiac arrhythmias:
- Interpreting Holter monitors
- Reviewing transtelephonic event recorders
- Following up patients with transtelephonic pacemakers at The Kirklin Clinic
2. Permanent pacemakers
- Observe permanent pacemaker implantation
- Follow up patients with permanent Pacemakers at The Kirklin Clinic
- Develop a working knowledge of pacemaker management during the peri-operative period
3. Internal Cardioverter Defibrillator (ICD)
- Observe ICD implantations
- Evaluate patients before and after ICD implantation
- Learn the indications, contraindications, complications, and techniques involved with ICD’s
- Follow- up patients with ICD implantation devices at The Kirklin Clinic
4. ICD management
Develop a working knowledge of ICD management during the peri-operative period (including time in the operating room when electrocautery devices may be used).
5. Invasive EP Procedures
- Evaluate patients before and after EP procedures
- Learn the indications, contraindications, and complications of these procedures.
6. Observe EP studies
- Assist in programmed stimulation with the programmable stimulator.
- Scrub in on selected cases to gain experience in the placement of pacing catheters.
- Participate in the interpretation of intracardiac electrograms for proper diagnosis of cardiac arrhythmias.
- Assist in programmed stimulation using a programmable stimulator.
- Learn techniques of programmed electrical stimulation for assessment of atrial arrhythmias including:
- arrhythmias related to accessory pathways
- AV nodal reentrant tachycardia,
- atrial flutter
- atrial fibrillation,
- atrial tachycardias
- Learn the interpretation of intracardiac electrograms for the assessment of tachyarrhythmias & bradyarrhythmias.
- Learn the indications, contraindications, and complications of catheter ablation procedures.
- Learn the techniques of electrophysiologic recording and stimulation of ventricular arrhythmias (especially ventricular tachycardia).
- Learn the proper use of invasive EP techniques for the assessment of bradyarrhythmias including:
- sinus node dysfunction
- AV conduction disorders
- Attend all arrhythmia consultations from the inpatient services.
- See the patient promptly
- Review the history, physical, electrocardiographic findings, x-rays, and other diagnostic data with the electrophysiology faculty
- See the patient on the day in which the consult is requested
- Follow the patients’ course throughout their hospital stay.
- Know the techniques of history and physical examination relevant to cardiology and cardiac arrhythmias.
7. Outpatient Arrhythmia Consultations
- Participate in the outpatient arrhythmia clinics with the arrhythmia faculty members.
- Learn the techniques of
- taking histories
- physical examination
- ECG interpretation
- pacemaker follow-up & programming
- ICD follow-up and programming, Holter monitoring,
- transtelephonic event recording
- use of antiarrhythmic drugs
8. Pharmacology of Antiarrhythmic Drugs
Understand the basic pharmacology of antiarrhythmic drugs. Specific aims of the training program include:
- follow-up requirements of antiarrhythmic drug therapy
9. Basic Science of Electrophysiology
- Attend weekly EP conferences (Thursday morning from 7 to 8 AM), which alternate between:
- basic science
- clinical cases
- Present an interesting clinical case at the EP meetings
- accept instruction from the EP faculty members
10. Other Techniques
Learn the basic techniques and indications, contraindications, and complications of:
- temporary pacemaker insertion
- electrical and pharmacological cardioversions
- intracardiac tracings, including those following open-heart surgery