Cardiology Rotation

Welcome to the arrhythmia service, we hope that you have an enriched experience. The following document provides you with important elements of this rotation. There is considerable flexibility with respect to observational / learning experiences and each student 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.

· Pacemaker and Device Clinic

o Mainly following of patients with pacemakers, ICDs and CRTs.

o Suggested observation for 1-2 days.

· Arrhythmia Clinics

o Arrhythmia Clinic schedule varies week-to-week, if interested in attending please discuss clinic schedule with Arrhythmia Attending.

o Inherited Arrhythmia Clinic – typically Fridays, if interested contact Dr. M. Green (mgreen@ottawaheart.ca) and Dr. Hansom (shansom@ottawaheart.ca).

· Electrophysiology (EP) Lab

o Procedures are undertaken daily in 4 EP labs.

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.

· Arrhythmia Monitoring Center

o Optional, if interested please contact mmulholland@ottawaheart.ca to arrange a day to observe.

The following are rounds undertaken to all elective residents:

· Monday

o 0800 – Morning Report (Multimedia room, H2) - Contact Cardiology Residents for Zoom link.

o 1600 – ECG Rounds (Multimedia room, H2) - Contact Cardiology Residents for Zoom link.

o 1700 – Arrhythmia Device Rounds (Multimedia room, H2) - Contact EP Fellows for Zoom link.

· Tuesdays

o 0745 – ICD rounds (H4430, optional) - Suspended during Covid restrictions.

o 0800 – Junior Teaching Rounds (Foustanellas Center, H2) - Contact Cardiology Residents for Zoom link.

· Wednesdays

o 0730 – Grand Rounds (Foustanellas Center, H2) - Contact Cardiology Residents for Zoom link.

· Thursday

o 0800 – ROLO (Review of Literature) Rounds (Multimedia, H2) - Contact Cardiology Residents for Zoom link.

· Friday

o 0800 – Morning Report (Foustanellas East, H2) - Contact Cardiology Residents for Zoom link.

o 0200 – Chief Resident Teaching Rounds (Foustanellas East, H2) - Contact Cardiology Residents for Zoom link.

·

Arrhythmia Journal club – Dinner at 6:30 pm, Every 2^nd Tuesday of the month - Contact EP Fellows for Zoom link.

For any questions, please refer to the Arrhythmia Service Attending (EP staff) or contact Dr. Mouhannad Sadek (m@sadek.net)

In your 1^st year rotation, the following assignments are made to provide you with an enriched experience. In addition to those assignments, it is the responsibility of the cardiology fellow to actively engage in device interrogation, observe procedures, and to seek opportunities for learning.

Of note, EP rounds attendance are mandatory during your EP rotation, these include:

· Mondays – ECG rounds (4 pm), Device cases (5 pm) - Contact EP Fellows for Zoom link.

· Tuesdays – ICD rounds (7:45 am, H4430) - Contact EP Fellows for Zoom link.

· Fridays – EP rounds (7:30 am, you may be excused at 8 am) - Contact EP Fellows for Zoom link.

· Journal club – Every 2^nd Tuesday (except the summer months, emails will be sent prior) - Contact EP Fellows for Zoom link.

On your first day, please present yourself following morning rounds to the device clinic to meet with your assigned supervisor (if your supervisor is different than the device clinic staff for that day, then page the fellow on call or your assigned supervisor).

For any questions, please refer to the assigned educational supervisor (EP staff) or contact Dr. Mouhannad Sadek.

C1 OBJECTIVES

1. Arrhythmia and Device clinics from Mon-to-Thurs (full days in clinic)

o Interrogate 15 pacemakers and 10 ICDs

2. EP lab Friday (1 each of ablation, PPM, ICD & CRT implants)

3. 1 half-day spent observing in Arrhythmia Monitoring Center (Friday)

4. Over-reading 50 Holters (a mix of 48-hour and 14-day Holters).

5. Over-reading of 100 ECGSs

Instructions to access EP schedule (for physician on service, reading holters/loops/ECGs, clinics etc).

• The EP staff schedule is posted in the EP office area (in front of Dr. Green’s office).

• It is your responsibility to schedule your sessions to meet your specific objectives

Instructions for reading ECGs

• ECGs are to be picked up daily from the ECG department (H2, in front of clinic area).

• If note ready, request that the ECGs for the day be printed for you. Read them and correct the computer report in red ink

• Once they are read, please deliver to the EP staff reading on that day. If possible, review with the staff any ECGs you find challenging.

• Bring any interesting ECGs for discussion at ECG rounds (Monday).

Instructions for reading Holters

· Please view Holter teaching video: https://youtu.be/EGE7hW2c7U8

· For access to the Holter teaching library, please contact Dr. Mouhannad Sadek.

Arrhythmia Monitoring Center – contact on first day to arrange mmulholland@ottawaheart.ca

In your 2^nd year rotation, the following assignments are made to provide you with an enriched experience. In addition to those assignments, it is the responsibility of the cardiology fellow to actively engage in assessing patients, rounding with the EP team, observe different EP procedures and seek opportunities for learning.

Of note, EP rounds attendance are mandatory during your EP rotation, these include:

· Mondays – ECG rounds (4 pm), Device cases (5 pm) - Contact EP Fellows for Zoom link.

· Tuesdays – ICD rounds (7:45 am, H4430) - Contact EP Fellows for Zoom link.

· Fridays – EP rounds (7:30 am, you may be excused at 8 am) - Contact EP Fellows for Zoom link.

· Journal club – Every 2^nd Tuesday (except the summer months, emails will be sent prior) - Contact EP Fellows for Zoom link.

On your first day, please present yourself to the EP service team (page the fellow/staff on service). It is expected that you will participate in rounding in the EP service, seeing new consultations and interrogating devices for inpatients. Note that while you are on service, if the service is quiet then you can find further educational opportunities in observing in the EP lab or device clinic.

For any questions, please refer to the assigned educational supervisor (EP staff) or contact Dr. Mouhannad Sadek.

C2 OBJECTIVES

1. Inpatient arrhythmia service consults and rounds (3 weeks).

2. Outpatient arrhythmia and Device clinic (1 week).

3. Over-reading 100 Holters (a mix of 48-hour and 2-week Holters).

4. Over-reading of 200 ECGs.

Instructions to access EP schedule (for physician on service, reading holters/loops/ECGs, clinics etc).

• The EP staff schedule is posted in the EP office area (in front of Dr. Green’s office).

• It is your responsibility to schedule your sessions to meet your specific objectives

Instructions for reading ECGs

• ECGs are to be picked up daily from the ECG department (H2, in front of clinic area).

• If note ready, request that the ECGs for the day be printed for you. Read them and correct the computer report in red ink

• Once they are read, please deliver to the EP staff reading on that day. If possible, review with the staff any ECGs you find challenging.

• Bring any interesting ECGs for discussion at ECG rounds (Monday).

• Instructions for reading Holters

· Please view Holter teaching video: https://youtu.be/EGE7hW2c7U8

· For access to the Holter teaching library, please contact Dr. Mouhannad Sadek.

Arrhythmia Monitoring Center – contact on first day to arrange mmulholland@ottawaheart.ca.

In your 3^rd year rotation, the following assignments are made to provide you with an enriched experience. In addition to those assignments, it is the responsibility of the cardiology fellow to actively engage in device interrogation, observe procedures, and to seek opportunities for learning.

Of note, EP rounds attendance are mandatory during your EP rotation, these include:

· Mondays – ECG rounds (4 pm), Device cases (5 pm) - Contact EP Fellows for Zoom link.

· Tuesdays – ICD rounds (7:45 am, H4430) - Contact EP Fellows for Zoom link.

· Fridays – EP rounds (7:30 am, you may be excused at 8 am) - Contact EP Fellows for Zoom link.

· Journal club – Every 2^nd Tuesday (except the summer months, emails will be sent prior) - Contact EP Fellows for Zoom link.

On your first day, please present yourself following morning rounds to the device clinic to meet with your assigned supervisor (if your supervisor is different than the device clinic staff for that day, then page the fellow on call or your assigned supervisor). Note that while you are on service, if the service is quiet then you can find further educational opportunities in observing in the EP lab or device clinic.

For any questions, please refer to the assigned educational supervisor (EP staff) or contact Dr. Mouhannad Sadek.

C3 OBJECTIVES

1. Inpatient arrhythmia service consults and rounds (1 week).

2. Outpatient arrhythmia and Device clinic (3 weeks).

3. Over-reading 50 Holters (a mix of 48-hour and 2-week Holters).

4. Over-reading of 100 ECGs.

Instructions to access EP schedule (for physician on service, reading holters/loops/ECGs, clinics etc).

• The EP staff schedule is posted in the EP office area (in front of Dr. Green’s office).

• It is your responsibility to schedule your sessions to meet your specific objectives

Instructions for reading ECGs

• ECGs are to be picked up daily from the ECG department (H2, in front of clinic area).

• If note ready, request that the ECGs for the day be printed for you. Read them and correct the computer report in red ink

• Once they are read, please deliver to the EP staff reading on that day. If possible, review with the staff any ECGs you find challenging.

• Bring any interesting ECGs for discussion at ECG rounds (Monday).

• Instructions for reading Holters

· Please view Holter teaching video: https://youtu.be/EGE7hW2c7U8

· For access to the Holter teaching library, please contact Dr. Mouhannad Sadek.

Arrhythmia Monitoring Center – contact on first day to arrange mmulholland@ottawaheart.ca