Table 2

Recommendations for Minimum Procedural Volume to Achieve and Demonstrate Competence in Clinical Cardiac Electrophysiology

ProceduresNumbers
Diagnostic electrophysiology studies (which can be performed with catheter ablation procedures)175
Catheter ablation procedures160
 SVT (not including atrial fibrillation or flutter)50
  Focal AT5
  AVN5
  AVNRT25
  AVRT/AP15
 Atrial flutter/macro–re-entrant AT30
  Isthmus dependent atrial flutter20
  Nonisthmus dependent/complex macro–re-entry atrial arrhythmias10
 Atrial fibrillation50
 VT/PVC ablation30
  Idiopathic VT/PVCs20
  VT/PVCs in patients with SHD10
CIED procedures
 CIED implantation100
  Pacemakers40
  ICDs60
  CRT pacemakers or ICDs25
 CIED replacement/revision30
 CIED interrogation/programming200
  CIED interrogation/programming, pacemakers100
  CIED interrogation/programming, ICDs100
  Remote device interpretation§50
 Lead extraction procedures (with one or more leads implanted >12 months previously)30
 Tilt table tests5

AP indicates accessory pathway; AT, atrial tachycardia; AVN, atrioventricular node; AVNRT, atrioventricular nodal re-entrant tachycardia; AVRT, atrioventricular reciprocating tachycardia; CIED, cardiac implantable electrical device; CRT, cardiac resynchronization therapy; ICD, implantable cardioverter-defibrillator; PVC, premature ventricular contraction; SHD, structural heart disease; SVT, supraventricular tachycardia; and VT, ventricular tachycardia.

  • Actual numbers that should be performed and/or interpreted successfully to achieve competence are intended as general guidance, based on the educational needs and progress of typical CCEP trainees.

  • Of which at least 20 should be dual chamber.

  • Also count as pacemaker or implantable cardioverter-defibrillator implants.

  • § The remote interrogations can be included as CIED interrogation/programming number requirements.

  • Lead extraction is a special competency not expected of all CCEP trainees.