Cardiology

The Clinical Cardiac Electrophysiology (CCEP) Fellowship Program at Tufts Medical Center in Boston is an Accreditation Council for Graduate Medical Education (ACGME) accredited program affiliated with Tufts University School of Medicine (TUSM). This one-year advanced cardiology fellowship program has a more than 25-year history of training highly qualified cardiovascular fellows in a challenging and competitive setting.

During their time at Tufts MC, fellows are exposed to a wide range of inpatient and outpatient electrophysiology patients, including the evaluation and management of complex cardiac rhythm disturbances, evaluation and implantation of cardiac implantable electronic devices (CIEDs) and catheter ablations.

The advanced fellowship program prepares trainees for careers in academic medicine or private practice with heavy emphasis on research and teaching. CCEP fellows are expected to be involved in teaching house staff, medical students and cardiology fellows in addition to actively engaging in the intramural educational curriculum.

Upon completion of the Electrophysiology Fellowship, each of our fellows will have acquired the expertise needed to be a consultant in clinical cardiac electrophysiology. The curriculum ensures that the fellows achieve the knowledge, skills and practical experience that are required to become an ABIM certified clinical cardiac electrophysiologist.

Throughout their time in our program, fellows are given increasing responsibility for patient care and procedures. The program provides supervised procedural experience to the fellow so that he/she can gain the expertise required of a clinical cardiac electrophysiologist. The fellow will also:

• Understand the principals of basic electrophysiology, including basic determinants of normal cardiac electrophysiology and abnormal pathophysiology
• Understand the genesis of cardiac arrhythmias, including congenital and acquired arrhythmia syndromes and action of anti-arrhythmic drugs
• Develop advanced competency in the interpretation of surface electrocardiography and the interpretation of normal and abnormal intra-cardiac recordings
• Learn to evaluate non-invasive testing modalities, such as ambulatory EKG recordings, telemetry, event recordings, signal-averaged EKG's, exercise and pharmacological stress testing, heart rate variability and T wave alternans in the management of cardiac electrophysiologic disorders
• Understand the basic and advanced concepts underlying bradyarrhythmias (sinus node dysfunction, AV conduction disorders) and their management
• Understand the basic and advanced concepts underlying supraventricular and ventricular tachyarrhythmias, their evaluation and determining the best course of management to undertake
• Understand the basic and advanced concepts behind primary electrophysiological disorders such as long QT syndrome, Brugada syndrome, idiopathic ventricular fibrillation and hereditary cardiac conditions with pronounced electrophysiological manifestations such as arrhythmogenic right ventricular cardiomyopathy/dysplasia and hypertrophic cardiomyopathy
• Develop advanced skills in performing invasive electrophysiological evaluation including principles of premature stimulation, evaluating the sinus node and the AV conduction system and the invasive evaluation of patients with supraventricular and ventricular arrhythmias
• Develop the necessary skills for the safe and competent catheter ablation of complex left- and right-sided supraventricular and ventricular arrhythmias, including trans-septal catheterization
• Understand the concepts of mapping using both basic and advanced, electroanatomical, three-dimensional systems, contact and non-contact mapping in order to create anatomic, voltage and activation maps
• Understand the role and use of advanced imaging techniques to help guide interventional procedures such as intracardiac echocardiography
• Comprehend the pharmacokinetics and pharmacodynamics of anti arrhythmic and other drugs used in electrophysiology
• Establish a comprehensive method to evaluate patients with electrophysiological disorders, both on an inpatient and outpatient basis and assess the future risk for sudden cardiac death in certain high risk populations with cardiovascular disorders
• Safely and competently perform electrical cardioversion
• Develop advanced skills in the safe and successful implantation of pacemakers, implantable cardioverter defibrillators (ICDs) and cardiac resynchronization therapy devices
• Participate in and acquire the expertise to perform outpatient device evaluation in the pacemaker and ICD clinics
• Be exposed to the principles of managing cardiac implantable electronic device infections including the principles and methods of lead extraction

Through very close coordination, the CCEP fellows are expected to attend the core competence lectures given to the general cardiology fellows. These include lectures in risk management, ethics, biostatistics, combined cardiology/cardiothoracic conferences and morbidity mortality conferences.

Fellows are expected to become involved in research during their advanced CCEP training. They are exposed to a wide range of research opportunities, including basic science, translational and clinical research. Most fellows also become involved in ongoing EP clinical trials and will have the opportunity to present at local and national meetings. They will also have the opportunity to apply for publication of manuscripts in peer review journals.

The Molecular Cardiology Research Institute and the Division of Cardiology offer a variety of research areas related to heart failure and ventricular function. Fellows work closely with mentors to design a curriculum and research program that is both educational and productive.

A full range of inpatient, outpatient, clinical and research laboratory facilities are available to the CCEP fellows at Tufts MC. Fellows work with high quality, cutting-edge equipment. In addition, a complete medical library is available at Tufts University School of Medicine.

CCEP fellows have a centrally-located, dedicated, quiet workspace equipped with desks, computers and a lounge area. Fellows also have access to the cardiology conference spaces, including the Modestino Cricitiello Library and the Herbert J. Levine Conference Room.

Our outstanding faculty members are among the nation’s leaders in electrophysiology bringing the latest advances in cardiovascular diagnosis and care into clinical practice. The Tufts MC Clinical Cardiac EP faculty is composed of five full-time academic staff at Tufts University School of Medicine and dedicated to teaching fellows.

Munther K. Homound, MD
Jonathan Weinstock, MD

Prospective fellows are encouraged to apply provided they have completed the necessary training to become ABIM board-eligible in internal medicine.

Interested applicants are encouraged to apply in the fall, no later than November 1. Please send a curriculum vitae to the address below. Applicants will also be required to have three letters of reference.  A thorough review is undertaken of each application and a select number of applicants are invited for an interview to meet with staff and to tour the facilities.

Munther K. Homoud, MD
Program Director,
Clinical Cardiac Electrophysiology Fellowship Program
Co-Director, Cardiac Electrophysiology and Pacemaker Laboratory
Director, Arrhythmia Monitoring Center

Division of Cardiology
Tufts Medical Center
800 Washington Street, Box 173
Boston, MA  02111

Tel: 617-636-5902; Fax: 617-636-7830
Email: mhomoud@tuftsmedicalcenter.org

• American Board of Internal Medicine
• Accreditation Council for Graduate Medical Education (ACGME)
• American College of Cardiology
• American Heart Association
• Heart Rhythm Society