Electrophysiology
Overview
The Montreal Heart Institute offers a 1-2 year fellowship in clinical cardiac electrophysiology that is designed to train cardiologists in all aspects of the evaluation and treatment of cardiac arrhythmias. Fellows participate in all aspects of the invasive electrophysiology laboratory, in out-patient and in-patient evaluation of patients with suspected arrhythmia disorders, in ICD and pacemaker implantation and follow-up and participate in research in the discipline. At the end of the fellowship each fellow will have greatly surpassed the minimum requirements of operator volume of electrophysiology procedures as recommended by the American College of Cardiology.
Eligibility
- Candidates who have previously completed cardiology training
- Successfully completed USMLE step 2 or LMCC examination (exemptions from these examinations are possible if candidates are recommended by the dean of the faculty of medicine where specialty training was completed)
- See " Eligibility requirements" section for more details
Duration
The standard EP fellowship is 2 years in duration; a one year fellowship is possible for candidates with previous training in cardiac electrophysiology
Faculty
• Ramon Brugada MD (director of cardiac genetics clinic)
• Marc Dubuc MD
• Pierre Gagne MD
• Peter Guerra MD (Chief of Electrophysiology Service)
• Paul Khairy MD (arrhythmias associated with adult congenital heart disease)
• Laurent Macle MD
• Stanley Nattel MD (director of electrophysiology research)
• Pierre Page MD (surgical treatment of cardiac arrhythmias)
• Denis Roy MD
• Mario Talajic MD (EP fellowship program director)
• Bernard Thibault MD
Content
Scientific Meetings: Two weekly conferences are devoted to teaching in cardiac electrophysiology. The first is a mixture of case presentations, invited lecturers, fellow and staff presentations on a variety of subjects. The second is a weekly session devoted to intracardiac electrogram analysis.
Clinical Electrophysiology Laboratory : Two dedicated laboratories situated at MHI perform 1600 cases per year. A third lab for pediatric patients is situated at Ste Justine Hospital. Fellows participate in the following activities within the EP laboratories.
Diagnostic electrophysiology studies (300/year excluding ablations)
Catheter Ablation (approximately 450 cases per year). The typical case mix includes supraventricular tachycardias including WPW, ventricular tachycardias, pulmonary vein isolation for atrial fibrillation, and complex arrhythmias associated with adult congenital heart disease. The MHI electrophysiology service also is responsible for pediatric ablations. These are performed in a third EP lab situated at Ste Justine Hospital.
Fellows also receive extensive experience with a variety of ablation and mapping technologies. These include three dimensional mapping (CARTO, ESI, and Nav-X) and different ablation energy sources (RF, cooled RF, cryo-energy).
Pacemaker and ICD Implantation (450 PM/year, 450 ICD/year). These include implantations and revisions. This also includes approximately 150 CRT cases per year.
Laser Lead extraction (75/year)
Consultation service : Fellows perform consultations in patients with known or suspected cardiac rhythm disorders on an in- or out-patient basis. The Montreal Heart Institute is very large referral center and receives more than 3000 referrals annually for evaluation of known or suspected arrhythmia disorders. The out-patient clinics are divided into a general arrhythmia clinic, pacemaker and ICD clinic, cardiac genetics clinic dedicated to genetic disorders of cardiac arrhythmias and sudden death, and a clinic dedicated to patients with arrhythmias associated with adult congenital heart disease.
Research Experience : All fellows participate in clinical or basic research in cardiac electrophysiology and are supervised by faculty members. Simultaneous enrollment in a formal Masters or PhD program is also possible during the course of a 2 year fellowship. Research interests of the group include basic mechanisms of arrhythmias, genetics, treatment strategies of atrial fibrillation, risk stratification of sudden death, cryoablation, ablative strategies of atrial fibrillation and other complex arrhythmias, and pharmacologic therapy of arrhythmias.
Funding
To obtain funding, candidates are advised to apply for grants from recognized agencies. The Department of medicine at the MHI offers scholarships; however, a limited number of scholarships are available and they are awarded on a competitive basis.
