CVSx Rotation
Senior Rotation (PGY 5-6)
CARDIAC SURGERY EP ROTATION
The following assignments are made to provide you with an enriched experience. In addition to those assignments, it is the responsibility of the cardiac surgery fellow to actively engage in device interrogation, present at device rounds, and to seek opportunities for learning.
Of note, EP rounds attendance are mandatory during your EP rotation, these include:
· Mondays – Device cases (5 pm, multimedia) - During Covid restrictions, obtain Zoom link from EP fellows.
· Tuesdays – ICD rounds (7:45 am, H4430) - During Covid restrictions, obtain Zoom link from EP fellows.
· Journal club – Every 2nd Tuesday (except the summer months, emails will be sent prior).
The following is the weekly schedule for the rotation:
· Monday – Device Clinic
· Tuesday – EP Lab 1
· Wedensday – Academic Day
· Thursday – EP Lab 1
· Friday – EP Lab 1
Cardiac Surgery Objectives
· Interrogation of single and dual-chamber pacemakers / ICDs
o Interrogate at least 15 pacemakers and 10 ICDs
· Insertion of single and dual-chamber pacemakers / ICDs
· Observation / assistance during insertion of CRTs
· Present at least one case at device rounds and discuss troubleshooting
Responsibilities in Device Clinic
Please present to device clinic at 8:00 am
Along with the clinic nurse observe and actively interrogate pacemakers and ICD devices.
Responsibilities in the EP lab
Read all resources prior to starting.
Pre-round on all patients and consent.
o The risks of specific procedures are found in resources.
Actively engage in decisions regarding device indications, device choice, device programming.
Actively engage in the device insertion procedure.
Epic reports post-device implant.
Post-round on all patients
o Wound check and instructions.
o Check post-implant CXR for complications / lead position.
o Check post-implant ECG – interpret for appropriate sensing / pacing.
Junior Rotation (PGY1-2)
The following assignments are made to provide you with an enriched experience. It is the responsibility of the cardiac surgery fellow to actively engage in device interrogation, present at device rounds, and to seek opportunities for learning. There is considerable flexibility with respect to observational / learning experiences and each resident 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.
o Consider performing post-surgical arrhythmia consultations.
· Pacemaker and Device Clinic
o Mainly following of patients with pacemakers, ICDs and CRTs.
· Arrhythmia Clinics
o Arrhythmia Clinic schedule varies week-to-week, if interested in attending please discuss clinic schedule with Arrhythmia Attending.
· Electrophysiology (EP) Lab
o Procedures are undertaken daily in four EP labs and one procedure room.
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.
The following are rounds undertaken to all elective residents:
· Monday
o 1600 – ECG Rounds (Board room, H2) - During Covid restriction, request Zoom link from EP fellows.
o 1700 – Arrhythmia Device Rounds (Board room, H2) - During Covid restriction, request Zoom link from EP fellows.
· Arrhythmia Journal club – Dinner at 6:30 pm, Every 2nd Tuesday of the month (if interested, Please contact Amanda Sousa-Cabral (asousacabral@toh.ca)
For any questions, please refer to the Arrhythmia Service Attending (EP staff) or contact Dr. Mouhannad Sadek (msadek@ottawaheart.ca)