Cardiology Rotation

Welcome to the arrhythmia service, we hope that you have an enriched experience.  The following document provides you with important elements of this rotation.  There is considerable flexibility with respect to observational / learning experiences and each student is encouraged to take initiative to pursue his/her areas of interest.

On your first day of the rotation, please contact the Arrhythmia Service Attending.  They can be paged through locating (ext. 14708) or found at the Pacemaker and Device Clinic on the 2nd floor.  If the elective was arranged with a specific attending, contact them.

As part of the arrhythmia service, the following activities are encouraged:

·       Arrhythmia Service

o   Contact the Arrhythmia Fellow on service to coordinate.

o   Ward consultations and follow-up of ward arrhythmia patients.

o   Daily rounding with Arrhythmia Attending.

·       Pacemaker and Device Clinic

o   Mainly following of patients with pacemakers, ICDs and CRTs. 

o   Suggested observation for 1-2 days.

·       Arrhythmia Clinics

o   Arrhythmia Clinic schedule varies week-to-week, if interested in attending please discuss clinic schedule with Arrhythmia Attending.

o   Inherited Arrhythmia Clinic – typically Fridays, if interested contact Dr. M. Green (mgreen@ottawaheart.ca) and Dr. Hansom (shansom@ottawaheart.ca). 

·       Electrophysiology (EP) Lab

o   Procedures are undertaken daily in 4 EP labs.

o   If interested in observing procedures, please discuss with Arrhythmia attending and they will direct you to EP lab.

o   Of note, suggested procedures for observations include pacemaker insertions and SVT ablations.

·       Arrhythmia Monitoring Center

o   Optional, if interested please contact mmulholland@ottawaheart.ca to arrange a day to observe.

The following are rounds undertaken to all elective residents:

·       Monday

o   0800 – Morning Report (Multimedia room, H2) - Contact Cardiology Residents for Zoom link.

o   1600 – ECG Rounds (Multimedia room, H2) - Contact Cardiology Residents for Zoom link.

o   1700 – Arrhythmia Device Rounds (Multimedia room, H2) - Contact EP Fellows for Zoom link.

·       Tuesdays

o   0745 – ICD rounds (H4430, optional) - Suspended during Covid restrictions.

o   0800 – Junior Teaching Rounds (Foustanellas Center, H2) - Contact Cardiology Residents for Zoom link.

·       Wednesdays

o   0730 – Grand Rounds (Foustanellas Center, H2) - Contact Cardiology Residents for Zoom link.

·       Thursday

o   0800 – ROLO (Review of Literature) Rounds (Multimedia, H2) - Contact Cardiology Residents for Zoom link.

·       Friday

o   0800 – Morning Report (Foustanellas East, H2) - Contact Cardiology Residents for Zoom link.

o   0200 – Chief Resident Teaching Rounds (Foustanellas East, H2) - Contact Cardiology Residents for Zoom link.

·       

Arrhythmia Journal club – Dinner at 6:30 pm, Every 2nd Tuesday of the month - Contact EP Fellows for Zoom link.

For any questions, please refer to the Arrhythmia Service Attending (EP staff) or contact Dr. Mouhannad Sadek (m@sadek.net)

In your 1st year rotation, the following assignments are made to provide you with an enriched experience. In addition to those assignments, it is the responsibility of the cardiology fellow to actively engage in device interrogation, observe procedures, and to seek opportunities for learning.

Before starting your rotation have a few minutes orientation meeting with Dr. Andres Klein or Dr. Mehrdad Golian is recommended.

Of note, EP rounds attendance are mandatory during your EP rotation, these include:

· Mondays – ECG rounds (4 pm), Device cases (5 pm).

· Fridays – EP rounds (7:30 am, you may be excused at 8 am).

· Journal club – Every 2nd month (except the summer months, emails will be sent prior, you may be asked to present).

On your first day, please present yourself following morning rounds to the device clinic to meet with your assigned supervisor (if your supervisor is different than the device clinic staff for that day, then page the fellow on call or your assigned supervisor).

For any questions, please refer to the assigned educational supervisor (EP staff) or contact Dr. Andres Klein.

C1 Objectives

· 2 Weeks of Device clinics (full days in clinic)

o Interrogate at least 15 pacemakers and 10 ICDs and 5 CRT devices

· 1 week of EP lab. Ep staff on call can help picking interesting lab days or cases.

· 1 week of outpatient consults.

· ECG reading. Bring tracings to ECG rounds! You can use ECG data base on ottawaarrhythmia.com for your EPA (see Below)

· Holter reading. Find Holters batch that will be assigned to you on start of the rotation through your ottawaheart onedrive - you will have access for 4 weeks. Please discuss the results if any questions with EP attending on service.  

Instructions to access EP schedule (for physician on service, reading holters/loops/ECGs, clinics etc).

· The EP staff schedule is posted in the EP office area (in front of Dr. Green’s office) or on Herathub

· It is your responsibility to schedule your sessions to meet your specific objectives

Instruction to arrange Outpatient Consults. If you are expected to do Email Clacey@ottawaheart.ca to arrange your clinics. She will help you coordinate the clinics and book patients with the different EP staffs

Instruction to assess other centers inpatient consults.

Contact EP triage coordinator at 67063 and let them know that you will be taking the consults to discuss later with the EP staff.

Instructions for reading Holters 

· Please view Holter teaching video: https://youtu.be/EGE7hW2c7U8

· Please view video on how to read Holters and access library: https://youtu.be/u2bYtzLfDvM

. Arrhythmia Monitoring Center – contact on first day to arrange mmulholland@ottawaheart.ca to get access to Holters and telemetries to read.

In your 2nd year rotation, the following assignments are made to provide you with an enriched experience. In addition to those assignments, it is the responsibility of the cardiology fellow to actively engage in assessing patients, rounding with the EP team, observe different EP procedures and seek opportunities for learning.

Of note, EP rounds attendance are mandatory during your EP rotation, these include:

· Mondays – ECG rounds (4 pm), Collect ECGs to show! Device cases (5 pm).

· Fridays – EP rounds (7:30 am, you may be excused at 8 am).

· Journal club – Every 2nd month(except the summer months, emails will be sent prior, you may be asked to present).

Before starting your rotation have a few minutes orientation meeting with Dr. Andres Klein or Dr. Mehrdad Golian

On your first day, please present yourself to the EP service team (page the fellow/staff on service). It is expected that you will participate in rounding in the EP service, seeing new consultations and interrogating devices for inpatients. Note that while you are on service, if the service is quiet then you can find further educational opportunities in observing in the EP lab or device clinic.

For any questions, please refer to the assigned educational supervisor (EP staff) or contact Dr. Andres Klein.

C2 Objectives

· 2 week of inpatient consults.

· 1 week of outpatient clinics

· 1 week of EP lab. Ep staff on call can help picking interesting lab days or cases.

· ECG reading. Bring tracings to ECG rounds! You can use ECG data base on ottawaarrhythmia.com for your EPA (see Below)

· Holter reading. Find Holters batch that will be assigned to you on start of the rotation through your ottawaheart onedrive - you will have access for 4 weeks. Please discuss the results if any questions with EP attending on service. 

Instructions to access EP schedule (for physician on service, reading holters/loops/ECGs, clinics etc).

· The EP staff schedule is posted in the EP office area (in front of Dr. Green’s office) or on Herathub

· It is your responsibility to schedule your sessions to meet your specific objectives

Instruction to arrange Outpatient Consults. If you are expected to do Email Clacey@ottawaheart.ca to arrange your clinics. She will help you coordinate the clinics and book patients with the different EP staffs

Instruction to assess other centers inpatient consults.

Contact EP triage coordinator at 67063 and let them know that you will be taking the consults to discuss later with the EP staff.

Instructions for reading Holters 

· Please view Holter teaching video: https://youtu.be/EGE7hW2c7U8 

· Please view video on how to read Holters and access library: https://youtu.be/u2bYtzLfDvM

Arrhythmia Monitoring Center – contact on first day to arrange mmulholland@ottawaheart.ca to get access to Holters and telemetries to read.

In your 3rd year rotation, the following assignments are made to provide you with an enriched experience. In addition to those assignments, it is the responsibility of the cardiology fellow to actively engage in device interrogation, observe procedures, and to seek opportunities for learning.

Of note, EP rounds attendance are mandatory during your EP rotation, these include:

· Mondays – ECG rounds (4 pm), Device cases (5 pm).

· Fridays – EP rounds (7:30 am, you may be excused at 8 am).

· Journal club – Every 2nd month (except the summer months, emails will be sent prior, you may be asked to present).

Before starting your rotation have a few minutes orientation meeting with Dr. Andres Klein or Dr. Mehrdad Golian

On your first day, please present yourself following morning rounds to the device clinic to meet with your assigned supervisor (if your supervisor is different than the device clinic staff for that day, then page the fellow on call or your assigned supervisor). Note that while you are on service, if the service is quiet then you can find further educational opportunities in observing in the EP lab or device clinic.

For any questions, please refer to the assigned educational supervisor (EP staff) or contact Dr. Andres Klein.

C2 Objectives

· 1 weeks of inpatient consults/EP lab.

· 2 weeks of outpatient clinics

· 1 week of device clinic

· 1 week of EP lab. Ep staff on call can help picking interesting lab days or cases.

· ECG reading. Bring tracings to ECG rounds! You can use ECG data base on ottawaarrhythmia.com for your EPA (see Below)

· Holter reading. Find Holters batch that will be assigned to you on start of the rotation through your ottawaheart onedrive - you will have access for 4 weeks. Please discuss the results if any questions with EP attending on service. 

Instructions to access EP schedule (for physician on service, reading holters/loops/ECGs, clinics etc).

· The EP staff schedule is posted in the EP office area (in front of Dr. Green’s office) or on Herathub

· It is your responsibility to schedule your sessions to meet your specific objectives

Instruction to arrange Outpatient Consults. If you are expected to do Email Clacey@ottawaheart.ca to arrange your clinics. She will help you coordinate the clinics and book patients with the different EP staffs

Instruction to assess other centers inpatient consults.

Contact EP triage coordinator at 67063 and let them know that you will be taking the consults to discuss later with the EP staff.

Instructions for reading Holters 

· Please view Holter teaching video: https://youtu.be/EGE7hW2c7U8 

· Please view video on how to read Holters and access library: https://youtu.be/u2bYtzLfDvM

Arrhythmia Monitoring Center – contact on first day to arrange mmulholland@ottawaheart.ca to get access to Holters and telemetries to read.