Alternate Training Pathway — Expired October 2008
NOTE: The Heart Rhythm Society’s 2004 Clinical Competency Statement: Training pathways for the implantation of cardioverter-defibrillators and cardiac resynchronization therapy devices and its 2005 Addendum were developed to provide training guidance for non-electrophysiologists who wished to be privileged to implant ICD and CRT devices. As published in the Addendum, and with the backing of the Heart Rhythm Society Board of Trustees, the Alternate Training Pathway expired in October 2008 — those who were not able to complete all the requirements in the pathway by that deadline should NOT use the pathway to gain privileges. See "Alternate Training Pathway Sunsets in October 2008" to learn more about the recommended training. If you have any questions, please contact Sonja Olson, Director, Clinical Documents at solson@HRSonline.org.
Summary of Requirements for the Alternate Training Pathway
for ICD and CRT Implantations
In this area, visitors of the ICD/CRT Resource Center will find the Requirements Summary, the Washington Report: Alternate Training Pathway Update, the Clinical Competency Statement & Addendum which outlines the training requirements and minimum competency standards for implantation of cardioverter defibrillators and cardiac resynchronization devices as well as Frequently Asked Questions regarding the Alternate Training Pathway.
Documentation of current experience:
35 pacemaker implantations per year (of which at least 75 percentshould be new "full-system" implants)
100 implantations over the prior 3 years
Proctored ICD implantation experience:
10 implantations
5 revisions: revisions should include upgrades, lead extraction and replacement, pulse generator change and new lead insertion
Completion of a Heart Rhythm Society Sponsored or endorsed ICD/CRT didactic course, and passage of the IBHRE Exam (www.ibhre.org) for the physician within the last ten years, which included ICD knowledge testing
Monitoring of patient outcomes and complication rates: to be kept by the implanter and made available to their respective hospital credentialling committee
Established patient follow-up: follow-up should include device interrogation and reprogramming, including evaluation of pacing thresholds, lead impedances, sensing and rage cut-offs for defibrillation therapy
