Pediatric Electrophysiology Service

Program Description

The goal of the electrophysiology training for the fellows (residents) in the Division of Pediatric Cardiology at the University of Florida in Gainesville and Jacksonville is to provide a comprehensive background of the electrophysiologic mechanisms of arrhythmias in order to understand the approach to management of arrhythmias in the pediatric patient.

The pediatric cardiology fellow (resident) will spend 8 to 12 weeks of their training in Jacksonville at Wolfson Children’s Hospital where the electrophysiology limb of the training program is based. They will be instructed in clinical electrophysiology, interventional electrophysiology and pacing by Drs. Randall M. Bryant and Don Marangi, both trained pediatric electrophysiologists. The fellow will round daily with either Dr. Bryant or Dr. Marangi on the inpatient electrophysiology service and be involved in daily electrocardiogram rounds. The fellow will participate in all electrophysiology consults and will attend at least twice weekly electrophysiology clinics on either the Jacksonville campus (Pediatric Cardiovascular Center) or the Gainesville campus. He/she will be available by beeper for all electrophysiology consults.

The inpatient rounds consist of reviewing telemetry on all inpatients on the electrophysiology service. Additionally, all inpatient consults will be reviewed with regards to the recommendations. The fellow will assist with the telemetry review. Dr. Bryant or Dr. Marangi will be available for instruction on interpretation, management, and follow-up of all arrhythmias. Additionally, the fellow will be responsible for coordinating consults in concert with Sharon Redfearn, the pediatric nurse practitioner. During electrocardiogram rounds, the fellow will be instructed on the interpretation of electrocardiograms and stress tests.

Goals and Objectives

Electrophysiology Inpatient Activities

1. Understand the role of the pediatric electrophysiologist in the management of inpatients with arrhythmia issues;
2. Delineate pathologic from non-pathologic arrhythmias through telemetry and ambulatory monitoring; and,
3. Understand the use of anti-arrhythmic medications guided by analysis of the arrhythmia and its mechanism.

Review of Electrocardiogram

1. Become familiar with normal and abnormal electrocardiograms;
2. Learn the approach to electrocardiographic interpretation;
3. Learn the appropriate follow-up to an abnormal electrocardiogram; and,
4. Learn the normal variations that occur in the electrocardiogram as a child ages

Electrophysiology Ambulatory Clinic

1. Understand the mechanism and treatment of neurocardiogenic syncope;
2. Learn the approach to a child with palpitations; and,
3. Understand the basics of pacemaker and ICD follow-up and programming.

Interventional Electrophysiology

1. Understand the basic interpretation of intracardiac electrograms;
2. Delineate different types of arrhythmias based upon the intracardiac electrograms;
3. Understand the role of programmed stimulation in the induction of supraventricular and ventricular arrhythmias;
4. Review the role of intracardiac electrograms in localizing the site of the origin of arrhythmias; and,
5. Understand the role of radiofrequency ablation in the treatment of supraventricular and ventricular arrhythmias.

Randall M. Bryant, M.D.
Director, Interventional Electrophysiology and Pacing
Assistant Professor of Pediatrics
University of Florida-Jacksonville/Gainesville