The Clinical Cardiac Electrophysiology Fellowship program at Wake Forest University School of Medicine provides training for fellows interested in expanding their knowledge and expertise within the field.
EP Mentorship and Training
Below is a list of the labs and clinics fellows will be exposed to and the learning objectives of each lab/clinic.
Electrophysiology Lab
EP fellows will learn the following:
- Indications for invasive electrophysiologic testing
- Techniques of catheter placement and manipulation
- Techniques of intra-cardiac recording
- Techniques of programmed intra-cardiac stimulation as a method of arrhythmia induction and termination and to assess mechanisms of arrhythmias (resetting and entrainment)
- Strategies to map abnormal rhythms
- Methods of catheter ablation for treatment of rhythm disturbances
- Methods of external cardioversion using direct current shocks
- Indications for pacemaker or ICD implantation
- Surgical skills required for pacemaker/ICD implantation
- Lead placement skills
- Principles of pacemaker function including pacing and sensing threshold evaluation with emphasis on acute measurements
- Principles of ICD function, including defibrillation threshold testing and ATP
- Acute pacemaker/ICD troubleshooting
- Lead extraction (using laser-powered and mechanical tools)
- Conscious sedation techniques for DC Cardioversion
Outpatient Arrhythmia Clinic
- Gain exposure to a variety of arrhythmia patients in an ambulatory setting to assess response to therapy and to monitor for problems
- Learn appropriate use of diagnostic tests including:
- Evaluation and troubleshooting of pacemakers and ICDs
- Ambulatory heart monitors
- Genetic testing for arrhythmia syndromes
- Appropriate longitudinal monitoring for anti-arrhythmic drugs
- Tilt Table Testing
- Learn appropriate referral for EP procedures including:
- Cardioversions and anti-arrhythmic drug loads
- Invasive electrophysiologic testing and ablation
- Implant/upgrade/extraction of permanent pacemakers and ICDs
- Left atrial appendage occlusion
Weekly Conference
- There are 2 weekly conferences dedicated to EP fellow learning. One conference is allocated for EGM review and the other is for didactic learning. Didactic topics include:
- Core curriculum topics (ablation biophysics, 3D mapping, cellular electrophysiology, AF ablation, VT ablation, AP syndromes, atrial flutter [typical and atypical], conduction system physiology, genetic arrhythmia syndromes, PPM/ICD programming …)
- Quarterly Morbidity and Mortality review
- Journal Club
- Left atrial appendage imaging review
- Monthly device review
Inpatient Consult Service
- EP fellows will take 12 weekend calls over the course of their EP fellowship, during which they will learn:
- How to function as an EP consultant in the hospital setting
- When to refer inpatient consults for invasive EP procedures Signal-averaged electrocardiogram
- Team management
Research Experience
- Gain exposure to clinical research projects, with 10% protected time to complete projects and departmental statistical support
- Review current literature in Journal Club conferences
- Participate in the weekly Cardiology Research Conference
- Annual in-person attendance at the HRS Scientific Sessions