The duration of required training for clinical cardiac electrophysiology will increase to two years, and the volume of procedures trainees should perform prior to completing their fellowship will increase, according to an updated Advanced Training Statement released Sept. 18 by the ACC, the American Heart Association (AHA) and the Heart Rhythm Society (HRS), and published in the Journal of the American College of Cardiology. The statement complements the Core Cardiovascular Training Statement (COCATS 4), released earlier this year.

At the request of the ACC, AHA and HRS, the American Board of Internal Medicine voted to increase the duration of training required to sit for the electrophysiology examination, due to the complexity and scope of the field. These changes in training will take effect in 2017. The statement also increases the recommended number of procedures trainees should complete during fellowship.

“This Advanced Training Statement addresses the added competencies required of sub-specialists in clinical cardiac electrophysiology (CCEP) for diagnosis and management of patients with cardiac arrhythmias and conduction disturbances at a high skill level,” says Douglas P. Zipes, MD, MACC, chair of the writing committee. 

The statement defines the six competencies for training in electrophysiology: medical knowledge, patient care and procedural skills, practice-based learning and improvement, systems-based practice, interpersonal and communication skills and professionalism. Curricular milestones for each competency provide a “developmental roadmap” for fellows as they progress through training.

Another important update is the detailed recommendations for procedural numbers that trainees should perform during their fellowship. These numbers have been increased from the previous training statement and are also presented with greater granularity.

“Training in CCEP has become more complex as the clinical specialty has matured,” says Hugh Calkins, MD, FACC, vice chair of the writing committee. “Use of cardioactive drugs, implantation and use of implantable electronic devices and left atrial appendage occlusion devices and performance of invasive catheter ablation procedures for arrhythmia management have reached a level of sophistication that has mandated a re-evaluation of the training curriculum and the duration of training.”

Keywords: Arrhythmias, Cardiac, Atrial Appendage, Catheter Ablation, Electrophysiologic Techniques, Cardiac, Electrophysiology, Internal Medicine, Patient Care

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