Electrophysiologic Consultation Rotation

You will rotate 3 months per year in the electrophysiologic consultation service. This service provides consultative care for inpatients, including:

• Evaluation of patients with arrhythmic problems
• Bedside learning
• Physical diagnosis
• Electrocardiogram analysis
• Complex arrhythmia management

You will also receive training in the Arrhythmia Prevention Center in noninvasive, risk-stratification techniques, including the interpretation of Holter monitor recordings, signal averaged electrocardiograms, T wave alternans, heart rate and QT variability, and genotyping for long QT syndrome. In addition, you will perform cardioversions and tilt table tests during this rotation.

During your rotation, you will see patients under the supervision of one of the electrophysiologic faculty. Your work will happen in multiple settings, including:

• Outpatient. One half day per week will be spent in outpatient clinic work, in which you will obtain experience in diagnosing, evaluating and managing patients with arrhythmic problems.
• Inpatient. Our inpatient electrophysiologic consultation service is held in a 742-bed hospital. Approximately four to eight consults are referred each day. Inpatients are referred from internists, family practitioners, emergency department physicians, anesthesiologists and surgeons. You will see each of the consults with the electrophysiologic consult attending.
• Clinics. There are ongoing active outpatient arrhythmia clinics, as well as a separate outpatient device clinic. In the device clinic, you will also become experienced in troubleshooting and maintaining pacemakers and implantable cardioverter-defibrillators. You will play a prominent role in patient management and in decisions regarding the timing and choice of devices.  

An attending electrophysiologist will supervise all aspects of patient care. In most cases, you will collect and assimilate the data, examine the patients, and start to formulate a diagnostic and/or therapeutic plan prior to rounding with the attending electrophysiologist. The attending will examine the patient, review the data and talk with you about each patient’s care and management.

You will have daily feedback during bedside clinical rounds. You will read Holter monitors, electrocardiograms and event monitors every day during the inpatient consultation service, and the attending will review the tracings with you each day. At the end of the month/ each rotation, you'll be provided with a written evaluation of your work, and that report will be discussed with you.