Clinical cardiac electrophysiology fellowship teaching objectives for the new millennium.

The Ž eld of cardiac electrophysiology has grown and changed dramatically since the last guideline on fellowship training objectives was published in 1988. Not only has the ability to diagnose arrhythmic diseases improved, but also the knowledge of genetic contributions and mechanisms of these disorders has expanded. Moreover, the treatment of these arrhythmias, including ablation and implantable cardioverter deŽ brillators (ICDs), has forever altered patient management. The purpose of this updated fellowship teaching objective is to outline the basic science, clinical components, and procedural aspects of electrophysiology and to provide relevant references that can be used as an educational guide. This work represents a compilation by experts in the Ž eld of electrophysiology but is not intended to give guidelines regarding fellowship requirements outlined in American Board of Internal Medicine (ABIM) and ACGME documents. This article is organized according to the following sections: (1) historical aspects of electrophysiology; (2) disease mechanisms, including basic electrophysiology and the genetic basis of arrhythmias; (3) diagnosis of arrhythmias, including surface ECG, invasive electrophysiologic evaluation, and laboratory safety; (4) treatment of arrhythmias, including basic pharmacokinetics and pharmacodynamics, ablation of supraventricular tachycardia, atrial Ž brillation and  utter, ablation of ventricular tachycardia (VT), pacemakers, and ICDs; and (5) syncope and sudden cardiac death.