Clinical Procedures

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

  • Direct current cardioversion (perform a minimum 10)
  • Echocardiography (perform a minimum of 150 and interpret a minimum of 300 Transthoracic studies and perform and interpret 100 TEEs. Typically, fellows perform close to 150 TEEs and interpret 600-800 TTEs and 100 stress echocardiograms)
  • Exercise stress testing (supervise a minimum of 50 stress ECG tests)
  • Right and left heart catheterization, including coronary arteriography (participate in a minimum of 300 catheterizations fellows typically perform 400-600 angiograms)
  • 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 CT.
  • 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.
  • Endomyocardial biopsy