Program Structure
Non-invasive Cardiology
The Cardiovascular non-invasive laboratory performs about 12,000 transthoracic echocardiograms, 2,500 trans-esophageal echocardiograms and 3,000 stress tests in addition to over 1,000 coronary CTs annually All general cardiology fellows acquire a minimum of level II training and are eligible for comprehensive ASE board certification.
Nuclear Cardiology
Nuclear laboratory performs 1000 stress tests every year. The fellows acquire minimum of level II training prior to graduation. Fellows are trained to perform the stress test and interpretate the scans. At graduation fellows are eligible for nuclear cardiology board certification.
Interventional Cardiology
The interventional cardiology program at NBI is one of the busiest in the state of New Jersey. The cardiac catheterization laboratory performs over 2000 diagnostic and over 1000 coronary interventions. Adult congenital disease, and peripheral and structural heart program include peripheral, carotid stenosis, renal artery stenosis, PFO/ASD closures and alcohol septal ablations. The TAVR program is one of the busiest the US with over 600 TAVRs performed at the center. There is a program in mitral interventions with use of Mitra-clip for degenerative mitral regurgitation patients who are not surgical candidates. The laboratory also performs about 1500 right heart catheterization and cardiac biopsies as part of advanced heart failure and transplant program.
General cardiology fellows are required to complete 6 months of core rotations in cardiac catheterization laboratory. All fellows are well trained to perform diagnostic cardiac catheterization through both radial and femoral approach. Fellows are well trained for invasive hemodynamic investigations and interpretation. The fellows interested in advanced training in interventional cardiology can spend more time in the catheterization laboratory during their third year.
Advanced Heart Failure and Cardiac Transplant Cardiology
The NBI heart failure and transplant program isone of the busiest in the USA. The center performs over 60 transplants a year. The advanced heart failure program includes the Swan-Ganz guided hemodynamic management including inotropic support and mechanical circulatory support (IABPs, LVAD, RVAD, Tandem hearts). The CCU management of transplant / LVAD patient includes the pre-op optimization and then followed by the post-operative management. Fellows spend a total of 4 months in the CCU during 3 years of training. The fellows who are interested in advanced training in heart failure and transplant can spend more time during their third year.
Electrophysiology
The general cardiology fellows rotate with electrophysiology faculty on EP consult service for 2 months. The fellows evaluate and manage all types of arrhythmias in extremely complex clinical situations including advanced heart failure patients, post STEMI patients, VT storms and post cardiac surgery patients. Fellows also work in electrophysiology laboratory and assist during procedures such as ICD implants, pacemakers, atrial fibrillation/flutter ablations, VT ablations and CRT placement. The fellows interested in advanced training in EP can spend more time during their third year.
Cardiology Consult / Telemetry Service
The cardiology consult service is one of the busiest rotations. The fellow runs the service with medical residents under supervision of cardiology faculty. The fellows provide the consultation services to variety of clinical situations including pre-op assessments. The consult fellow is also responsible for triaging the STEMI patients and post-op care of TAVR patients as team member with cardiothoracic critical care staff. All STEMI’s are discussed in clinical conferences where the decision making, management is critically reviewed with cardiology faculty.
EKG
The program at NBI plays special emphasis on fellow’s ability to correctly diagnose cardiac arrhythmias and systemic interpretation of EKGs. The program has incorporated weekly one-hour conference where each fellow is expected to interpret the electrocardiogram. The conference is mentored with electrophysiology faculty.
Cardiology Continuity Clinic
Cardiology fellows are scheduled in general cardiology clinic 6 half days a month (Every Friday and every other Monday). This is a unique opportunity where fellows take care of patients in continuity cardiology clinic and manage them as out patients. Significant autonomy is provided in clinical decision-making. All the cases are discussed with cardiology faculty. The fellows also supervise and educate the medical residents rotating in cardiology clinic.