Fellowship in Cardiovascular Disease Clinical Laboratory Rotations
The Fellowship Training Program in Cardiovascular Disease, offered by the Leon H. Charney Division of Cardiology, provides clinical laboratory rotations in cardiac catheterization, electrophysiology, echocardiography, and nuclear cardiology and stress testing.
Cardiac Catheterization Laboratories
Experts at NYU Langone’s Cardiac Catheterization Laboratory and laboratories at NYC Health + Hospitals/Bellevue and the VA NY Harbor Healthcare System conduct about 9,000 diagnostic and interventional procedures each year. Our faculty offer a large peripheral vascular disease intervention program and an active structural heart disease program with demonstrated expertise in percutaneous atrial and ventricular septal defect closure, mitral valve repair, valve replacements, and balloon valvuloplasty, among other procedures.
Our interventional cardiologists have been instrumental in advancing antithrombotic therapies for acute coronary syndromes and coronary interventions since the first randomized trial of thrombolysis in acute myocardial infarction. These innovations in catheterization continue a tradition initiated in the Bellevue laboratory of Nobel Prize winners André Frédéric Cournand and Dickinson W. Richards.
The Cardiac Catheterization Laboratory gives fellows the opportunity to learn the theory and practice of invasive and interventional cardiology. We teach techniques through procedural performance with immediate and direct feedback from supervising faculty. Fellows develop competence in pre- and postprocedural evaluations, right- and left-heart catheterization, and systemic and coronary hemodynamic physiology. Progressive responsibility, coupled with case conferences and yearlong didactic seminars addressing a wide array of basic and advanced topics, fosters a deep knowledge base and hones clinical acumen.
Fellows rotate through the catheterization laboratories of NYU Langone and Bellevue for four months during the first two years of training. Those who have completed these basic four months reach the level of expertise required of a consultant in cardiovascular disease.
Fellows who extend their interventional cardiology training by three to four months during their third year rotate through the VA NY Harbor Healthcare System catheterization laboratory. Deciding to complete this additional block time enables trainees to independently perform diagnostic procedures and to become a highly competitive applicant for advanced fellowship training in interventional cardiology.
Cardiac Electrophysiology Service
The Cardiac Electrophysiology Service at NYU Langone’s hospitals, Bellevue, and the VA NY Harbor Healthcare System is well known for its exceeding expertise and technologically advanced diagnosis and treatment of arrhythmia. This rotation offers comprehensive exposure to all aspects of clinical cardiac electrophysiology, from the most common to the rarest electrophysiological disorders and arrhythmias. Fellows rotate through the Cardiac Electrophysiology Service for a combined minimum of two months during the first two years of training.
The Cardiac Electrophysiology Service faculty guide fellows through the diagnosis and management of cardiac arrhythmias. Trainees also participate in a variety of clinical consultations and gain hands-on experience with invasive procedures. Fellows also acquire skills in the following domains:
- management of complex atrial and ventricular arrhythmias
- invasive electrophysiological studies, including the introduction of electrode catheters for recording conduction times and refractory periods, and stimulation techniques for the initiation and termination of various tachycardias
- evaluation, implantation, and troubleshooting of pacemakers and implantable defibrillators
- catheter-based ablation therapies for arrhythmias
- interpretation of standard 12-lead electrocardiograms (EKGs), stress testing, ambulatory EKGs, signal-averaged EKGs, and transtelephonic recordings
- pre- and postoperative arrhythmia diagnosis and management
- antiarrhythmic drugs and their pharmacokinetics and pharmacodynamics
- critical analysis of published electrophysiological data from laboratory and clinical research
Fellows review clinical and pathophysiological data daily with expert faculty and become primary decision makers in the evaluation and treatment of cardiac arrhythmias at Bellevue and the VA NY Harbor Healthcare System.
At NYU Langone, trainees treat complex and resistant arrhythmias at a tertiary referral center serving the cardiology community of the greater northeastern United States. In collaboration with our robust cardiothoracic surgery program, our faculty treat arrhythmia in an array of complex surgical patients, including adults with congenital heart disease. As a result, fellows gain experience with the diagnosis and management of perioperative rhythm disturbances and those associated with congenital heart disease in the adult.
Our echocardiography program has an outstanding international reputation. Fellows rotate through the echocardiography laboratories at NYU Langone, Bellevue, and the VA NY Harbor Healthcare System for a combined minimum of four months during their first two years of training. Together, these labs perform more than 40,000 studies a year, including 2- and 3-dimensional imaging, a full array of spectral, color-flow, and tissue Doppler techniques, stress echocardiography, and carotid and renovascular imaging and strain analysis.
Fellows also develop expertise in transesophageal echocardiography in NYU Langone’s Noninvasive Cardiology Laboratory, which was the first to introduce this diagnostic modality to New York City. In addition, they gain experience in three-dimensional echocardiography and its application to invasive and structural heart disease. The laboratory’s faculty members and rotating fellows jointly publish widely on all aspects of echocardiography.
The educational curriculum within the echocardiography laboratory rotation is intensive, combining lectures, seminars, case conferences, interpretation sessions, and extensive hands-on training. With more advanced training during the third year, fellows have the opportunity to obtain Core Cardiology Training Symposium (COCATS) level 2 or level 3 competence and sit for the certification examination of the National Board of Echocardiography.
Nuclear Cardiology and Stress Testing Laboratories
The rotation through the Nuclear Cardiology and Stress Testing Laboratories at NYU Langone and Bellevue is a minimum of two months and occurs during the first two years of training. The laboratories combined perform more than 5,000 stress tests and single-photon-emission CT scan interpretations annually, including perfusion and functional studies, providing a remarkable case mix with regular clinical correlations with other imaging and diagnostic modalities.
During the rotation, fellows are responsible for the performance and supervision of exercise and pharmacological stress testing and imaging and attend academic sessions based on radionuclide scan interpretation. Trainees develop a keen knowledge of exercise physiology and related derangements, the physics of myocardial perfusion imaging, the biochemistry and physics of nuclear cardiology stressors, and isotopes in current use and in development. They also acquire the judgment necessary for the clinical application of these diagnostic procedures.
Literature reviews, an image library, an extensive reading list, case presentation conferences with angiographic correlations, a didactic lecture and seminar series, and progressive responsibility in hands-on technical training make this rotation a remarkable learning experience.
Third-year fellows may elect to complete more advanced training and have the opportunity to become eligible to sit for the examination of the Certification Board of Nuclear Cardiology.