The Heart Rhythm Management Services at Hartford Hospital includes the diagnostic and interventional electrophysiology laboratories, the Syncope Center, the Atrial Fibrillation Center, one of the largest device clinics in the region (8,000 encounters/year), and a busy consultation service. The heart rhythm management service provides over 1,000 consultations annually. First year fellows spend two months on the inpatient arrhythmia consult service, staffed by attending EP physicians. Patients from this service are routinely referred for invasive procedures in the EP labs at Hartford Hospital, including catheter ablation of atrial fibrillation/flutter, SVT, and VT, implantation and extraction of pacemakers (including subcutaneous and leadless pacemakers) and ICDs, EP studies, and implantation of left atrial appendage occluding devices. During the first year, fellows on the arrthymia service may assist in various studies, such as tilt-table testing, review of event/loop monitors, implantation of loop recorders, and elective cardioversions. The goals of the first year are to become skilled at identification and treatment of arrhythmias and to perform basic device interrogation independently.
In the second and third years, fellows are able to attend pacemaker and ICD clinics and learn device interrogation and programming. For fellows that are interested, elective time in the second and third years may be spent invasive EP lab to gain more exposure to device implantation and invasive ablation procedures. Throughout all three years of fellowship, fellows have dedicated one-on-one ECG teaching sessions with cardiology faculty.