The Interventional Cardiology fellow is a fourth-year cardiology fellow who has completed an ACGME-accredited cardiovascular disease program. The Interventional Cardiology fellow acts as a senior fellow working with the Clinical Cardiology fellows under supervision of the attending interventional cardiologist assigned to the catheterization laboratory.
The Interventional Cardiology fellow, as part of the Interventional Cardiology team, will care for these patients in various settings as appropriate: the general cardiology clinic, operating room, interventional cardiology laboratory, cardiac catheterization laboratory, coronary care unit, intensive care unit, and the emergency department during the evaluation, treatment, and follow-up processes. In the context of this training, the Interventional Cardiology fellow will continue to gain extensive experience in associated specialized skills such as use of antiarrhythmic drugs, cardiopulmonary resuscitation, cardioversion and defibrillation, cannulation (arterial and venous), use of thrombolytic and antithrombolytic agents, use of vasoactive agents for epicardial and microvascular spasm, and advanced cardiac life support procedures.
This experience will be structured so that the Interventional Cardiology fellow will perform a minimum of at least 250 coronary interventional cardiology procedures.
These procedures will be completed during the rotation through the interventional cath lab either as the primary physician or as an assistant actively involved in collecting and analyzing the data. The Interventional Cardiology fellow will gain the necessary knowledge of the technology used in interventional cardiology (e.g. intravascular ultrasound, cannulation, catheters, stents, balloons, AngioJet™, and Rotoblator™) measuring and analyzing data and providing follow-up care to the patient.
The Interventional Cardiology fellow will act as a senior resident working with the second-year clinical Cardiology fellows rotating through the Interventional Cardiology service in their respective month. The Interventional Cardiology fellow is expected to see patients who present with need for interventional cardiology.
All consults must be presented to the Interventional Cardiology attending. It is expected that the Interventional Cardiology fellow would play an active role in organizing the presentation, formulating the thought and explaining the rationale for her or his given therapeutic approach, which would be discussed with the attending.
During rotation in the Interventional Cardiology lab, the Interventional Cardiology fellow will gain clinical experience in acquiring knowledge of the indications, contraindications. risks, and limitations of interventional cardiology. The Interventional Cardiology fellow will learn the basic skills needed to do coronary interventions.
In addition, the Interventional Cardiology fellow must learn the appropriate radiation safety levels, since it will be necessary for him or her to successfully pass a radiation safety examination in order to qualify as a fluoroscopic examination operator. All Interventional Cardiology fellows must pass the advanced cardiac life-support exam.
The Interventional Cardiology fellow is required to attend the cardiology clinic once a week. This experience provides the fellow training in performing outpatient consultations of patients who require interventional cardiology care as well as giving long-term follow-up treatment (pharmacologic or non-pharmacologic).
Clinical research is considered an integral component of achieving competence in interventional cardiology. This educational development would evolve from determining key questions to investigate, formulating significant hypothesis, designing significant, and well-organized research protocols (based on sound scientific methodologies and data analyses) for grant and IRB submission, as well as preparing the data for abstract and manuscript formulation, preparation, publication, and presentation. The Interventional Cardiology fellow will also be enrolling patients in the clinical trials, collaborating in research protocols, data analysis, and presentations. Support staff is available and includes staff (faculty, nursing, technical, and ancillary), space and equipment resources, computer resources (including database, networking and analyses), and library, statistical, editorial and computer consulting support staff.
Research Initiatives
2020
Alreshq, R., Yager, N. Contrast-Functional Flow Reserve vs. Instantaneous Wave-Free Ratio for Functional Assessment of Coronary Stenosis: A Systematic Review and Meta-analysis. Circulation: Cardiovascular Quality and Outcomes. 2020, May; 12(1).
Fahad F, Saad Shaukat MH, Yager N. Incidence and Outcomes of Acute Kidney Injury Requiring Renal Replacement Therapy in Patients on Percutaneous Mechanical Circulatory Support with Impella-CP for Cardiogenic Shock. Cureus. 2020;12(1):e6591. Published 2020 Jan 7. doi:10.7759/cureus.6591.
Jou S, Patel H, Oglat H, et al. The prevalence and prognostic implications of pre-procedural hyperbilirubinemia in patients undergoing transcatheter aortic valve replacement. Heart Vessels. 2020;35(8):1102-1108. doi:10.1007/s00380-020-01588-y.
Saad Shaukat MH, Patel H, Alimohammad R, DeLago A. Transesophageal Echocardiography-Guided WATCHMAN Implantation Without Contrast Use: A Three-Year, Single-Center Experience. Cureus. 2020;12(5):e8375. Published 2020 May 31. doi:10.7759/cureus.8375.
Zheng WQ, Kumar S, El-Hajjar M. Fibromuscular dysplasia and coronary artery fistula: links to pulmonary hypertension. BMJ Case Rep. 2020;13(3):e234698. Published 2020 Mar 24. doi:10.1136/bcr-2020-234698.
2019
Schulman-Marcus J, Peterson K, Banerjee R, Yager, N. Current Treatment Options in Cardiovascular Medicine 2019. Coronary Revascularization in High-Risk Stable Patients With Significant Comorbidities: Challenges in Decision-Making.
Schulman-Marcus J, Peterson K, Banerjee R, Samy S, Yager N. Coronary Revascularization in High-Risk Stable Patients With Significant Comorbidities: Challenges in Decision-Making. Curr Treat Options Cardiovasc Med. 2019;21(1):5. Published 2019 Feb 9. doi:10.1007/s11936-019-0706-7.
Tatusov A, Patel H, Nappi AG. A Curious Hand Rash Following Application of Vascular Compression Band to the Radial Artery. JACC Cardiovasc Interv. 2019;12(22):2322-2323. doi:10.1016/j.jcin.2019.06.024.
Saad Shaukat MH, Tatusov A, Nappi A, Yager N. Transient sinus arrest due to sinus node artery thrombus after revascularisation of the left circumflex artery. BMJ Case Rep. 2019;12(2):e227878. Published 2019 Feb 22. doi:10.1136/bcr-2018-227878.
Schulman-Marcus J, Cochran-Caggiano N, El-Hajjar M, Singh C. An acutely occluded Cabrol graft presenting as an acute coronary syndrome. BMJ Case Rep. 2019;12(7):e229793. Published 2019 Jul 23. doi:10.1136/bcr-2019-229793.
Fahad F, Roddy K, El-Hajjar M, Schulman-Marcus J. Cryptococcal meningitis initially presenting with ST elevations and elevated cardiac biomarkers. BMJ Case Rep. 2019;12(5):e226990. Published 2019 May 8. doi:10.1136/bcr-2018-226990.
Conferences
The purposes of the cardiac catheterization conference are to
- Review and critique both diagnostic and interventional cases with respect to case selection, procedure conduct, and outcome. This conference is to review and discuss all adverse outcomes, which occur during the training program; and
- Present and discuss the cognitive interventional cardiology curriculum subject matter.
This conference is designed as a quality assurance as pertinent cases regarding deaths and serious complications are thoroughly discussed among peers. Each month one of the attending cardiologists acts as a narrator at the conference and can be contacted should a particular case be requested to be presented. Interventional Cardiology fellows should attend this conference as a learning experience.
A Journal Club conference will be designed to teach the Interventional Cardiology fellow how to read, interpret, and apply data from the appropriate articles in cardiology and interventional cardiology. The Journal Club will be established to sharpen the acumen of the Interventional Cardiology fellow in critically analyzing the methodology, results and data presented in selected articles in order to formulate the fellows interpretation of the strengths, weakness, as well as the clinical applications and implications of the given text.
These conferences are used to teach research methodology, including determining key questions to investigate, formulating significant hypothesis, and designing significant and well-organized research protocols (based on sound scientific methodologies and data analyses) for grand and IRB submission, as well as preparing the data for abstract and manuscript formulation, preparation, and publication, and presentation. Fellows will also work with the Albany Medical Center study coordinator to prepare the Case Report Forms (CRF) for the FDA and pharmaceutical sponsors.