The program provides clinical training in the following areas: cardiac catheterization (four months), electrophysiology (two months), and imaging (seven months). Imaging includes echocardiography, nuclear cardiology, positron-emission tomography, magnetic resonance, and computerized tomography. Other skills acquired during these rotations include exercise stress testing, ECG interpretation, tilt-table testing and ambulatory electrocardiography interpretation.
Cardiac Catheretization (four months minimum)
YNHH Cardiac Catheterization Laboratories (Dr. Michael Cleman, Director), and the VACT Catheterization Laboratory (Dr. Steven Pfau, Director). The YNHH laboratory performs over 3000 diagnostic procedures and more than 1300 interventional procedures annually. The VACT lab performs more than 800 catheterizations annually and more than 200 interventional procedures. The fellow will acquire the cognitive and motor skills to perform left and right heart catheterizations. All procedures are performed under the direct supervision of an attending.
The primary experience for echocardiography is the YNHH Echocardiography Service (Dr. Robert McNamara, Director) which performs more than 9000 transthoracic and more than 450 transesophageal examinations per year. The population includes a wide spectrum of acquired and congenital heart disease in patients of varying age and gender. Stress echocardiography is performed at YNHH, as well as in the Branford cardiology office, and fellows are encouraged to become familiar with this technique. A searchable repository of digital echocardiography cases is available on the computer in the YNHH Echocardiography reading area.
Nuclear Cardiology and Stress Testing
The primary experience for this rotation is the YNHH Nuclear Cardiology and Exercise Laboratory (Dr. Albert J. Sinusas, Director) and the VACT Nuclear Cardiology Laboratory (Dr. Hitender Jain, Director). The YNHH laboratory is one of the largest clinical nuclear cardiology laboratories in the world, performing more than 8,000 clinically requested tests each year; including SPECT, SPECT/CT, and PET/CT. Both laboratories cooperatively engage in 2 areas of activity: 1) clinical evaluation and diagnosis, and 2) clinical research.
Advanced Cardiovascular Imaging Rotation (one month minimum)
The Yale Advanced Cardiovascular Imaging rotation is a newly devised (Jul 2009) addition to the Core Clinical Curriculum for all Cardiovascular Medicine trainees. Its purpose is to introduce the fellow to the background, basics and applications of advanced cardiovascular imaging techniques including cardiovascular computed tomography (CT) and magnetic resonance (CMR).
The rotation will comprise of 4 continuous weeks during 1st or 2nd year of Cardiology Training. The fellow will be expected to be available daily for assistance with imaging consultation with referring physicians, assistance in study scheduling, live image acquisition and study reporting. The Yale Advanced Cardiovascular Imaging service is staffed by a collaborative effort from faculty in both the Departments of Radiology and Cardiology. Cardiology fellows are expected to interact and work with trainees from other Departments such as Radiology residents or Nuclear Medicine residents.
VA Cardiac Imaging
The West Haven VA provides a full range of cardiac imaging, including echocardiography, nuclear cardiology, PET, CT, and CMR. Through the direction of Dr. Farid Jadbabaie (Echo) and Dr. Hitender Jain (Nuclear), fellows experience both hands-on experience with image acquisition and image interpretation of all modalities. The fellows are under the direct supervison of the attendings of the day.
Electrophysiology and Pacemaker/ICD follow-up (two months)
The primary Electrophysiology experience occurs at YNHH (Dr. William Batsford, Director) during a minimum of two dedicated months. The YNHH EP Laboratory provides comprehensive clinical services including arrhythmia consultation, cardiac pacing, defibrillator and resynchronization therapy. During this rotation, the fellow will work under the supervision of electrophysiology attendings and advanced fellows.