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 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.
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.
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.
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.