Fellowship Program Clinical Activities

Acute Coronary Care - UH provides acute cardiac care in an 8-bed coronary care unit and adjacent 20-bed telemetry step-down unit.
 

Cardiac Consultation - A consult service integrated between both hospitals provides cardiac consultation to a broad range of medical and surgical services. In conjunction with the faculty attending and supervises house officers and medical students rotating on this service. During this rotation,the fellow is exposed to a wide variety of patients with diverse manifestations of cardiovascular disease.
 

Non-invasive Cardiology Laboratories - UH and VAH Heart Stations are high-volume noninvasive laboratories which provide a wide range of diagnostic testing including resting and ambulatory electrocardiography signal-averaged electrocardiography,exercise and pharmacologic stress testing with or without perfusion scintigraphy, transthoracic and transesophageal echocardiography, and pharmacologic and exercise stress echocardiography. The combined noninvasive laboratories perform approximately 6000 echocardiographic studies and 5000 exercise stress tests (including 2500 nuclear studies) anually. Fellows rotating through the Heart Station are assisted by highly skilled technicians and supervised by cardiology faculty with special expertise in noninvasive cardiac procedures.
 

Cardiac Catheterization Laboratories - The cardiac catheterization laboratory at UH consists of two suites providing state-of-the art facilities for diagnostic cardiac catheterization, endo-myocardial biopsy, and percutaneous cardiac intervention. In 1997, the UH cardiac catheterization service performed 2200 procedures including 465 interventional cases and 118 endomyocardial biopsies. The VAH also has two cardiac catheterization laboratories renovated in 1999 with 1300 total procedures and 285 interventions performed last year. A broad variety of patients present for cardiac catheterization including those with coronary artery disease, valvular heart disease, congenital heart disease, primary myocardial disease, and receipients of orthotopic heart transplantation. The cardiology fellow is the primary operator on all diagnostic cardiac catheterization with direct faculty supervision and assists the interventional procedures. Ancillary imaging techniques such as intravascular ultrasound and physiologic assessment using coronary pressure and Doppler flow are available.
 

Electrophysiology - In 1999, the Electrophysiology/Pacemaker Service performed 51 electrophysiologic studies, 33 therapeutic radiofrequency ablations, 32 permanent pacemaker implantations and revisions, 12 implantable cardioverter defibrillator placements and revisions. Eight lead extractions were performed in the cardiac catheterization suite and in the operating room.
 

Heart Failure and Cardiac Transplantation - Since its inception 10 years ago, the UH Transplantation Service has performed over 100 successful heart transplants. These patients are followed regularly by cardiology and cardiothoracic surgery at the modern J. Kent Trinkle Center for Transplant Sciences. This center serves as a dedicated facility for the care of solid organ transplant recipients and consists of a 12-bed intensive care unit, a 17-bed step-down unit, and outpatient clinic and pharmacy. Patients are also followed in the cardiac catheterization laboratory during scheduled endomyocardial biopsies and yearly diagnostic cardiac catheterizations. Interested fellows have the opportunity to participate in the evaluation and treatment of patients with endstage heart failure as well as in the perioperative and long-term postoperative management of patients with heart transplantation.
 

Nuclear Cardiology - Nuclear cardiology testing including myocardial perfusion imaging and radionuclide ventriculography is performed by the Nuclear Medicine Divisions of both the University Hospital and the Audie Murphy VA Hospital. Fellows obtain substantial experience in interpreting these studies during the non-invasive rotation and in the course of patient care during their fellowship, particularly during the CCU rotations. The Nuclear Medicine Division also welcomes attendance during formal didactic teaching in nuclear physics. Cardiac Positron Emission Tomography is performed at the newly established Research Imaging Center of UTHSC. The University Hospital has a MRI unit with newly installed advanced generation cardiac software.
 

Cardiovascular Research - There are multiple basic and clinical research projects ongoing in the Division of Cardiology ranging from the molecular aspects of myocardial reperfusion injury to clinical trials of new cardiovascular drugs and multicenter trials involving coronary intervention, echocardiography, myocardial infarction,and heart failure. Each fellow is required to identify a faculty research mentor and participate in a research project with the goal being presentation of results at a national scientific meeting.
 

On-Call Schedule - No in-house call is required during the Fellowship Program. Fellows provide beeper call for cardiac emergencies during some weeknights and during alternate weekends during their CCU/Telemetry rotations. Additionally, fellows are on beeper call for emergency cardiac catheterizations every third week during their cardiac catheterization rotations.On other rotations,the call schedule is much lighter, filling in for the CCU/Telemetry fellows. The duty hours and call schedule conform to the requirements of the residency review committee of the ACGME.
 

Cardiology Conferences - There are several weekly mandatory conferences that all fellows attend. These include the Cardiovascular Research Conference/Journal Club, the Combind Cardiology/Cardiac Surgery Conference, the Non-Invasive Cardiology Conference, the Core Curriculum Didactic Conference, and a hemodynamic conference,for a total of five hours of conferences per week.