Clinical Procedures

During their clinical training fellows will develop and demonstrate competence in the performance of the following cardiovascular procedures as required by the ACGM:

  • direct current cardioversion (perform a minimum 10)
  • echocardiography (perform a minimum of 75 and interpret a minimum of 150 studies, and observe the performance and interpretation of transesophageal cardiac studies)
  • exercise stress testing (perform a minimum of 50 stress ECG tests)
  • right and left heart catheterization, including coronary arteriography (participate in a minimum of 100 catheterizations)
  • conscious sedation
  • placement and management
    of temporary pacemakers, including transvenous and transcutaneous
  • programming and follow-up surveillance of permanent pacemakers and ICDs
  • demonstrate competence in the interpretation of ambulatory ECG recordings (Holter monitoring and event monitoring) and electrocardiograms (interpret a minimum of 3500 electrocardiograms)
  • nuclear cardiology (interpret a minimum of 100 radionuclide studies to include SPECT myocardial perfusion imaging and ventriculograms)
  • chest x-rays

In addition, fellows will have an opportunity, during their Required and /or Elective Rotations, to become familiar with other cardiovascular procedures such as:

  • advanced imaging techniques including MRI and cardiac
  • peripheral vascular diagnostic and therapeutic procedures such as ultrasound and percutaneous interventions
  • advanced cardiac catheterization diagnostic procedures such as IVUS, fractional flow reserve assessment, and complicated hemodynamic assessments
  • advanced percutaneous coronary interventions such as balloon angioplasty, bare metal and drug eluting stent placement, rotoblator, and athrectomy. Other advanced techniques will include IABP placement, pericardiocentesis, and percutaneous transvalvular replacement
  • advanced electrophysiology procedures such as intracardiac electrograms, intracardiac mapping, radiofrequency ablation, percutaneous lead extraction
  • endomyocardial biopsy