Excellence in Arrhythmia Care

The Clinical Cardiac Electrophysiology (CCEP) Fellowship Program at Thomas Jefferson University (TJUH) in Philadelphia has been training outstanding electrophysiologists since 1984, and has produced generations of excellent electrophysiologists. The program was initiated by Dr. Arnold Greenspon, who was the program director for 17 years and recently retired from active clinical practice.  Dr. Behzad Pavri has been program director since 2001.

Jefferson is a storied institution in Philadelphia and in the United States, and is celebrating it’s 200th year in 2024. Jefferson was one of the first programs in the country to offer formal CCEP training. Patients are referred to Jefferson for electrophysiology care from all over the greater Philadelphia tri-state area. The core EP faculty have received teaching awards, are routinely invited to national and international meetings, and have published important research in the ever-expanding field of electrophysiology. Our team of 4 core EP faculty is complimented by outstanding support staff including fellows, nurse practioners, and nurses (both in the outpatient arena and in the EP laboratory).  We work together as a team to fulfill our tripartite mission of excellence in patient care, teaching at all levels, and clinical research to advance the field. 

The CCEP Fellowship Program at Thomas Jefferson University Hospital is a 2-year ACGME-accredited program that requires fellows to obtain competencies in the six areas as defined by the Accredited Council for Graduate Medical Education (ACGME) to the level expected of a new CCEP practitioner. The field of clinical electrophysiology is a procedure-based subspecialty; accordingly, the main emphasis of the CCEP fellowship training is to attain procedural proficiency in all aspects of invasive electrophysiology.  In addition our fellows are skilled at consultative electrophysiology (both in-patient and out-patient), and provide individualized ambulatory follow-up and troubleshooting for patients with implanted devices.

CCEP Fellows are selected from internal and nationwide applicants via ERAS. In the fall of each year, all qualified applicants are offered remote interviews. During the interview process, each applicant has an opportunity to meet individually with the CCEP Core Faculty member, and also with the current CCEP fellows and support staff. By early winter, the CCEP Core Faculty convenes and ranks the applicant with the best fit for the program. 

Didactics

All 4 EP core members are dedicated to teaching and board examination prep.  The program prides itself on intensive didactics, including:

• Electrogram Review conference (Mondays)
• High-level ECG conference (Wednesdays)
• EP Core Curriculum (Thursdays)
• Combined cardiology and subspecialty grand rounds (Fridays)
• EP Journal Club (monthly)

At the end of the CCEP fellowship program, the fellows should be able to:

• Provide expert consultation in all aspects of rhythm management and clinical electrophysiology, pacing and defibrillation, assessing the syncopal patient, and managing genetically transmitted diseases such as hypertrophic cardiomyopathy, long QT syndrome, and other “channelopathies.”
• Show knowledge of, indications for, procedural skills and critical thinking in all electrophysiologic procedures. Such procedures include diagnostic electrophysiology studies (with analysis of complex intra-cardiac electrograms), mapping and ablation for all types of supraventricular arrhythmias, mapping and ablation for ventricular tachycardia, atrioventricular node modification for rate control in atrial arrhythmias, defibrillator and pacemaker implantation (including conduction system pacing, leadless pacemakers, cardiac resynchronization devices with left ventricular lead placement and subcutaneous defibrillators), lead extraction (including laser and mechanical extraction), electric cardioversion, and loop recorder implantation.
• Show expertise in electroanatomic mapping, using both CARTO and Ensite X mapping systems.
• Provide individualized outpatient follow-up, management, and trouble-shooting of implanted defibrillators and pacemakers.
• Review, critique, and analyze published scientific literature and incorporate the findings of clinical trials into routine clinical practice.
• Propose, plan, and carry out clinical research that will confirm or refute a proposed hypothesis or investigate a clinical issue.
• Communicate effectively with referring physicians and other medical personnel.
• Above all, provide ethical, professional, and compassionate care to patients and their families.

Fellows in the Electrophysiology Fellowship Program are trained in:

• Catheter ablation of atrial tachyarrhythmias by radiofrequency, cryoballoon, and (in the near future) pulsed field ablation, including alcohol ablation of the vein of Marshall 
• Catheter ablation of ventricular arrhythmias
• Pacemaker insertion and management (including conduction system and leadless)
• Implantable defibrillator insertion and management (including subcutaneous)
• Implantation of phrenic nerve stimulator for central sleep apnea
• Implantation of the cardiac contractility modulation device
• Pharmacological management of arrhythmias
• Lead extraction (mechanical and laser)
• Left atrial appendage occlusion device implantation

Teaching Opportunities

Teaching opportunities are available including at conferences, participation in the Cardiology Grand Rounds series, as well as teaching the junior cardiology fellows/residents and allied staff.  Interested fellows have arranged teaching clinics for medical students of the Sidney Kimmel Medical College of Thomas Jefferson University in the past.