Cardiovascular Disease Fellowship Training Structure

During training, the fellows will have six-nine months of general cardiology with exposure to high volume of complex cardiovascular disease cases on the floors, coronary and intensive care units. Each fellow will meet all the COCATS 4, level II requirements for echocardiography, nuclear medicine and cardiac catheterization. Interested fellows will also have the opportunity to achieve the desired level of exposure in cardiac CT.

In the outpatient setting, alongside general cardiology, the fellows will have the opportunity to participate in valvular heart disease and cardiac electrophysiology clinics for a more comprehensive experience. An excellent partnership with the cardiac surgery group enables the fellows to participate in perioperative care of patients undergoing cardiac surgeries. Dedicated heart failure rotation will take place at an outside hospital with a robust LVAD program.

Moreover, our training facility is a research site for various ongoing interventional cardiology trials. All our fellows are encouraged to aid in on-going research and also to spearhead their own projects.

Cardiac Imaging

Delray Medical Center has a busy echocardiography service. Fellows will have the opportunity learn the technique and the intricacies of the surface echocardiography equipment with an experienced echocardiographic technician. Transesophageal echocardiography is performed in a dedicated area in the Cath lab or intra-operatively during structural heart procedures. Our high-volume structural heart program allows for fellows to have hands-on experiences from their first month in training, and will be proficient in performing high quality 2D and 3D transesophageal echocardiography by the end of their training. All the fellows will fulfill COCATS 4, level II requirement for echocardiography with ease. Fellows will also have exposure to intracardiac echocardiography (ICE) as a part of structural heart interventions. Stress echocardiography requirements will be met by directly participating in exercise and dobutamine echocardiography.

Our facility also offers additional cardiac imaging modalities, such as Cardiac CT, FFR-CT and cardiac MRI. Interested fellows will have enough exposure and resources to sit for the cardiac CT board examinations by the end of their training.

Similarly, SPECT studies are routinely performed in the hospital with four additional outpatient rotations for the fellows; all fellows will be eligible for and are expected to take nuclear cardiology boards.

Cardiac Catheterization

Delray Medical Center has three fully functional cardiac catheterization laboratories. Fellows train under several experienced interventional cardiologists. They will routinely be exposed to functional assessment of coronary artery disease with FFR and iFR, intracoronary imaging with IVUS and OCT, as well as insight to complex high-risk coronary interventions including CTO, rotational, orbital and laser atherectomy, and mechanical circulatory support. Fellows are expected to meet COCATS 4 requirement for diagnostic coronary angiography with optional participation in interventional procedures for those interested.

Structural Cardiology

The fellowship offers a very robust exposure to structural heart procedures. Delray Medical Center is a high-volume center for structural heart procedures including transcatheter aortic valve replacement, left atrial appendage occlusion and transcatheter mitral valve repair. The fellows actively participate in these procedures, including the pre-op evaluation and post-op care of the patients. Fellows also run the structural heart clinic as a part of continuity of care for structural heart disease patients.

Cardiac Electrophysiology

Delray Medical Center has two state of the art cardiac electrophysiology laboratories. The fellows will get exposure to arrhythmia mapping, radiofrequency ablation of atrial and ventricular tachycardias, pacemaker insertion and management and implantable defibrillator.

Research

Delray Medical Center serves as a site for various structural cardiology research trials including REDUCE LAP II, SUMMIT, ASAP-TOO, CARILLON, TRILUMINATE trials. The fellows are also involved in various research studies derived from our own structural heart procedures database, including a homegrown prospective TELESTAR TAVR trial to evaluate the utility of remote monitoring after the TAVR procedure.

Fellowship Conferences

Our fellowship program provides protected time for academic conferences, including:

• Morning Report (weekly)
• General cardiology board review (weekly)
• General cardiology core lecture series (weekly)
• Echocardiography (weekly)
• Electrophysiology (weekly)
• Multidisciplinary valve conference (weekly)
• Cardiac Catheterization (bimonthly)
• Cardiac imaging (bimonthly)
• Journal Club (monthly)
• Cardiology Grand Rounds (bimonthly)