AFC Electrophysiology & Cardiac Pacing Fellowship

Fellowship Program at McMaster

Welcome to the Electrophysiology & Cardiac Pacing Fellowship Training Program at McMaster University. Our vision is to provide the trainees with excellent hands-on experience in the management of cardiac arrhythmias as well as exposure to world-class research in the field of cardiac electrophysiology.

Dr. Syamkumar Divakara Menon, Program Director
Dr. Syamkumar Divakara Menon, Program Director


Clinical care: We provide evidence-based management of cardiac arrhythmias through a multidisciplinary approach. Our team consists of cardiac electrophysiologists, nurses(including nurse clinicians and educators), and arrhythmia/cardiac rhythm device technicians. Fellows acquire expertise in clinical care through their rotations in the EP lab, device clinics, out-patient clinics and inpatient consult service. Hamilton arrhythmia group is one among the busiest programs in the country, performing nearly 600 EP studies and ablation (more than 60% of which are complex ablations) and about 1000 device implants (30-40% complex implants like CRTs, physiological pacing, and leadless pacemakers. We are one of the very few centers performing percutaneous left atrial appendage closure (LAAC).

Education: We offer a competency-based training program. Our structured training program aims at the achievement of milestones and entrustable professional activities (EPA) over the 2 years of training. The last 3 months of the training is marked as “transition to practice “where the trainee functions as a junior attending in managing cardiac arrhythmias. Weekly teaching programs include EP rounds, ECG rounds, complex ECG /intracardiac tracings /Device troubleshooting rounds. There is a dedicated device boot camp session scheduled in July /August every year.

Research: Trainees have ample opportunities to participate in research projects. There are many ongoing research projects and fellows have the opportunity to work with world-renowned researchers from McMaster University and Population Health Research Institute (PHRI)


Certification Outcome

The successful completion of the training will award a Fellowship Certification from McMaster University (Accredited by the Royal College of Physicians of Canada).


Entry Requirements

The fellowship program is designed for current residents or recent graduates of Cardiology. Recent graduates are required to submit an
application to the McMaster University Postgraduate Medical Education and fulfill the requirements for residents and fellows.


Application Deadline

The application deadline is November 30 each year.

Goals of Training

Upon the completion of training the trainee is expected to be competent in the following:

Clinical goals

1. Develop expertise in performing diagnostic electrophysiology studies.
2. Develop expertise in ablation of common and complex arrhythmias.
3. Develop expertise in the implantation of pacemakers and defibrillators including biventricular pacemakers.
4. Develop expertise in consultation and management of arrhythmia patients.
5. Develop expertise in the follow-up and management of patients with pacemakers and ICDs.
6. Develop expertise in left atrial appendage occlusion.
7. Expertise in management of the entire spectrum of cardiac arrhythmias including genetic arrhythmia syndromes.

Research goals

1. Develop expertise in understanding the methodology of clinical research including design of clinical trials, statistical aspects of clinical trials and methodology of clinical trials.
2. Develop the ability to critically analyze medical literature.
3. To perform independently small studies with the assistance of senior faculty.

On-call responsibilities

Clinical trainees will be responsible for on-call duties as per the clinical schedule which is prepared on a monthly basis. These will include responding as the first person on call to requests for consultation from other cardiologists/clinical services.

Length of Training

2 years (RCP accredited program)
Focused CRM device fellowship for 1 year also feasible

Curriculum Highlights

The curriculum for training is designed to meet the competencies specified by Heart Rhythm Society(HRS), Canadian Heart rhythm society(CHRS) and European Heart rhythm Association(EHRA). The curriculum is delivered in different methods which include training in the EP lab and device implant lab, formal rounds, journal club, bedside teaching and supervised clinics as well as consult services.

Supervision & Feedback

Assessment of trainees includes 1) Work bases assessments (WBA) for the three major learning environments (EP lab, clinics and consult service), 2) Trainee performance and 3) AFC portfolios (Encounter cards, ITERS, milestones and Logbook) will be formally reviewed on a quarterly basis. The Program Director will provide verbal and written feedback to the trainee.

At the end of each year, there will be a complete detailed written evaluation of each trainee. The trainee will review this written evaluation and provide feedback.

Diana Brierley

Medicine, Cardiology
Brierley, Diana
Fellowship Program Coordinator

Syamkumar Divakara Menon

Medicine, Cardiology
Syamkumar Divakara Menon
Associate Professor
Electrophysiology & Cardiac Pacing Fellowship Director

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