Table 5: Syllabus for the invasive cardiac electrophysiologist

• Kupó P, Pap R, Sághy L, et al. Ultrasound guidance for femoral venous access in electrophysiology procedures-systematic review and meta-analysis. J Interv Card Electrophysiol. 2020;59:407-414.
• Fabbricatore D, Malaczynska-Rajpold K. Vascular Access and Closure Management for Electrophysiological Interventions: Small Interventions Big Impact. Curr Cardiol Rep. 2025;27(1):35.

3. Cardiac access techniques: transoesophageal echocardiographic and intracardiac echographic and fluoroscopic guidance

• Bunch TJ, Day JD. Examining the risks and benefits of transesophageal echocardiogram imaging during catheter ablation for atrial fibrillation. Circ Arrhythm Electrophysiol. 2012;5(4):621-3.
• Enriquez A, Saenz LC, Rosso R, et al. Use of Intracardiac Echocardiography in Interventional Cardiology: Working With the Anatomy Rather Than Fighting It. Circulation. 2018;137(21):2278-2294.
• Preda A, Bonvicini E, Coradello E, et al. The Fluoroless Future in Electrophysiology: A State-of-the-Art Review. Diagnostics (Basel). 2024;14(2):182.
• Sommer P, Sciacca V, Anselmino M, et al. Practical guidance to reduce radiation exposure in electrophysiology applying ultra low-dose protocols: a European Heart Rhythm Association review. Europace. 2023;25:euad191.
• Farré J, Anderson RH, Cabrera JA, et al. Fluoroscopic cardiac anatomy for catheter ablation of tachycardia. Pacing Clin Electrophysiol. 2002;25:76-94.

4. Catheter placement techniques including guiding means (fluoroscopic or non-fluoroscopic, manual or remote navigation)

• Issa ZF, Miller JM, Zipes DP. Clinical Arrhythmology and Electrophysiology: A Companion to Braunwald’s Heart Disease. 3rd ed. Philadelphia: Elsevier; 2018., chapter 4 (page 84-101)
• Sunny S. Po. Warren Jackman’s Art of War: A Sniper’s Approach to Catheter Ablation. Self-published digital book. Chapter 1 (page 3-5)

5. Angiography of cardiac chambers and vascular structures, such as the pulmonary veins

• McAlpine, W.A. (1975) Heart and Coronary Arteries: An Anatomical Atlas for Clinical Diagnosis, Radiological Investigation, and Surgical Treatment. Springer, Berlin, Germany.

6. EP signals (bipolar/unipolar, filters and filter settings, voltage/timing/morphology)

• Sunny S. Po. Warren Jackman’s Art of War: A Sniper’s Approach to Catheter Ablation. Self-published digital book. Chapter 2 (page 20-49)
• Issa ZF, Miller JM, Zipes DP. Clinical Arrhythmology and Electrophysiology: A Companion to Braunwald’s Heart Disease. 3rd ed. Philadelphia: Elsevier; 2018., chapter 4 (page 101-107)

7. Electroanatomical mapping and analysis of voltage, activation, and complex electrograms (decremental, late, fractionated, split)

• Issa ZF, Miller JM, Zipes DP. Clinical Arrhythmology and Electrophysiology: A Companion to Braunwald’s Heart Disease. 3rd ed. Philadelphia: Elsevier; 2018., chapter 6 (page 156-203)

8. Merging of electroanatomical maps with imaging techniques

• Markman TM, Khoshknab M, Nazarian S. Catheter ablation of atrial fibrillation: cardiac imaging guidance as an adjunct to the electrophysiological guided approach. Europace. 2021;23:520-528.
• Issa ZF, Miller JM, Zipes DP. Clinical Arrhythmology and Electrophysiology: A Companion to Braunwald’s Heart Disease. 3rd ed. Philadelphia: Elsevier; 2018., chapter 6 (page 193-203)

9. Programmed electrical stimulation techniques (pulse width/amplitude, unipolar/bipolar, continuous/extrastimulus stimulation, atrial/ventricular/other location stimulation, pacing algorithms) and pharmacological tests and modulation

• Issa ZF, Miller JM, Zipes DP. Clinical Arrhythmology and Electrophysiology: A Companion to Braunwald’s Heart Disease. 3rd ed. Philadelphia: Elsevier; 2018., chapter 4 (page 109-122)

10. Ablation energies and techniques including radiofrequency, cryo-energy, electroporation, laser energy with their catheters, common uses, indications and outcomes for each energy source

• Ciconte G, Coulombe N, Brugada P, et al. Towards a tailored cryo-pulmonary vein isolation. Lessons learned from second-generation cryoballoon ablation. Trends Cardiovasc Med. 2019 Oct;29(7):420-425.
• Kawamura I, Neuzil P, Shivamurthy P, et al. How does the level of pulmonary venous isolation compare between pulsed field ablation and thermal energy ablation (radiofrequency, cryo, or laser)? Europace. 2021 Nov 8;23(11):1757-1766.
• Reddy VY, Neuzil P, Koruth JS, et al. Pulsed Field Ablation for Pulmonary Vein Isolation in Atrial Fibrillation. J Am Coll Cardiol. 2019 Jul 23;74(3):315-326.
• Della Rocca DG, Marcon L, Magnocavallo M, et al. Pulsed electric field, cryoballoon, and radiofrequency for paroxysmal atrial fibrillation ablation: a propensity score-matched comparison. Europace. 2023 Dec 28;26(1):euae016.
• Kuck KH, Brugada J, Fürnkranz A, et al. FIRE AND ICE Investigators. Cryoballoon or Radiofrequency Ablation for Paroxysmal Atrial Fibrillation. N Engl J Med. 2016 Jun 9;374(23):2235-45.

11. Ablation methods other than energy-based technologies (e.g. alcohol ablation of coronary arterial and venous system)

• Patel A, Nsahlai M, Flautt T, et al. Advanced Techniques for Ethanol Ablation of Left Ventricular Summit Region Arrhythmias. Circ Arrhythm Electrophysiol. 2022 Aug;15(8):e011017.
• Valderrábano M, Peterson LE, Swarup V, et al. Effect of Catheter Ablation With Vein of Marshall Ethanol Infusion vs Catheter Ablation Alone on Persistent Atrial Fibrillation: The VENUS Randomized Clinical Trial. JAMA. 2020 Oct 27;324(16):1620-1628.

12. ECG and EP (cardiac activation, responses to electrical stimulation and to drug administration, EP diagnosis) of normal HR and electrical impulse conduction

• Brugada J, Katritsis DG, Arbelo E, et al. 2019 ESC Guidelines for the management of patients with supraventricular tachycardiaThe Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC). Eur Heart J. 2020 Feb 1;41(5):655-720. doi: 10.1093/eurheartj/ehz467. Erratum in: Eur Heart J. 2020 Nov 21;41(44):4258.
• Padala SK, Cabrera JA, Ellenbogen KA. Anatomy of the cardiac conduction system. Pacing Clin Electrophysiol. 2021 Jan;44(1):15-25.
• Karki R, Raina A, Ezzeddine FM, et al. Anatomy and Pathology of the Cardiac Conduction System. Card Electrophysiol Clin. 2021 Dec;13(4):569-584
• Callans, DJ. Josephson’s Clinical Cardiac Electrophysiology: Techniques and Interpretations (8th ed). 2024; Wolters Kluwer.

13. ECG and EP (induction, cardiac activation, responses to electrical stimulation and to drug administration, cardiac activation, diagnosis) of the different types and variants of sinus and AV node and His-Purkinje impulse formation and conduction defects including sick sinus syndrome, AV block, intraventricular conduction blocks, and autonomous system mediated disorders (carotid sinus hypersensitivity, reflex syncope)

• John RM, Kumar S. Sinus Node and Atrial Arrhythmias. Circulation. 2016 May 10;133(19):1892-900.
• Ali M, Pachon Maetos JC, Kichloo A, et al. Management strategies for vasovagal syncope. Pacing Clin Electrophysiol. 2021 Dec;44(12):2100-2108.
• Aksu T, Brignole M, Calo L, et al. Cardioneuroablation for the treatment of reflex syncope and functional bradyarrhythmias: A Scientific Statement of the European Heart Rhythm Association (EHRA) of the ESC, the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS) and the Latin American Heart Rhythm Society (LAHRS). Europace. 2024 Aug 3;26(8):euae206.
• Callans, DJ. Josephson’s Clinical Cardiac Electrophysiology: Techniques and Interpretations (8th ed). 2024; Wolters Kluwer.

14. ECG and EP (induction, termination, electroanatomical mapping, responses to electrical stimulation and to drug administration, EP diagnosis and ablation) of the different types and variants of atrial arrhythmias: 

• Atrial ectopy
• Idiopathic atrial tachycardias
• Typical CTI-dependent atrial flutter
• Scar related atrial tachycardias and atrial flutters
• Atrial fibrillation: pulmonary vein isolation, linear ablation, ablation of fractionation
  • Veenhuyzen GD, Quinn FR, Wilton SB, et al. Diagnostic pacing maneuvers for supraventricular tachycardia: part 1. Pacing Clin Electrophysiol. 2011 Jun;34(6):767-82.
  • Veenhuyzen GD, Quinn FR, Wilton SB, et al. Diagnostic pacing maneuvers for supraventricular tachycardias: part 2. Pacing Clin Electrophysiol. 2012 Jun;35(6):757-69
  • Brugada J, Katritsis DG, Arbelo E, et al. 2019 ESC Guidelines for the management of patients with supraventricular tachycardia. The Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC). Eur Heart J. 2020 Feb 1;41(5):655-720.
  • Kistler PM, Chieng D, Tonchev IR, et al. P-Wave Morphology in Focal Atrial Tachycardia: An Updated Algorithm to Predict Site of Origin. JACC Clin Electrophysiol. 2021 Dec;7(12):1547-1556. doi: 10.1016/j.jacep.2021.05.005. Epub 2021 Jun 30. PMID: 34217661.
  • Masuda M, Inoue K, Tanaka N, et al. Long-Term Impact of Additional Ablation After Pulmonary Vein Isolation: Results From EARNEST-PVI Trial. J Am Heart Assoc. 2023 Sep 5;12(17):e029651.
  • Maglia G, Pentimalli F, Verlato R, et al. Ablation of CTI-dependent flutter using different ablation technologies: acute and long-term outcome from the LEONARDO study. J Interv Card Electrophysiol. 2023 Oct;66(7):1749-1757.
  • Natale A, Mohanty S, Sanders P, et al. Catheter ablation for atrial fibrillation: indications and future perspective. Eur Heart J. 2024 Nov 7;45(41):4383-4398.

15. ECG and EP (induction, termination, electroanatomical mapping, responses to electrical stimulation and to drug administration, EP diagnosis and ablation) of the different types and variants of junctional arrhythmias:

• Junctional ectopy
• Junctional accelerated rhythms
• Junctional tachycardias
• • Padanilam BJ, Manfredi JA, Steinberg LA, et al. Differentiating junctional tachycardia and atrioventricular node re-entry tachycardia based on response to atrial extrastimulus pacing. J Am Coll Cardiol. 2008 Nov 18;52(21):1711-7.
  • Veenhuyzen GD, Quinn FR, Wilton SB, et al. Diagnostic pacing maneuvers for supraventricular tachycardias: part 2. Pacing Clin Electrophysiol. 2012 Jun;35(6):757-69.
  • Soares Correa F, Lokhandwala Y, Sánchez-Quintana D, et al. Unusual variants of pre-excitation: From anatomy to ablation: Part III-Clinical presentation, electrophysiologic characteristics, when and how to ablate nodoventricular, nodofascicular, fasciculoventricular pathways, along with considerations of permanent junctional reciprocating tachycardia. J Cardiovasc Electrophysiol. 2019 Dec;30(12):3097-3115.
  • Alasti M, Mirzaee S, Machado C, et al. Junctional ectopic tachycardia (JET). J Arrhythm. 2020 Jul 27;36(5):837-844.
  • Dar T, Turagam MK, Yarlagadda B, et al. Outcomes of junctional ectopic tachycardia ablation in adult population-a multicenter experience. J Interv Card Electrophysiol. 2021 Jun;61(1):19-27.
  • Tchou P, Nemer D, Saliba W, et al. Junctional Tachycardia: A Critical Reassessment. JACC Clin Electrophysiol. 2023 Mar;9(3):425-441.

16. ECG and EP (induction, termination, electroanatomical mapping, responses to electrical stimulation and to drug administration, EP diagnosis and ablation) of the different types and variants of AV accessory pathways and pathway mediated arrhythmias including ectopy, escape and accelerated rhythms, and tachycardias

• Soares Correa F, Lokhandwala Y, Sánchez-Quintana D, et al. Unusual variants of pre-excitation: From anatomy to ablation: Part III-Clinical presentation, electrophysiologic characteristics, when and how to ablate nodoventricular, nodofascicular, fasciculoventricular pathways, along with considerations of permanent junctional reciprocating tachycardia. J Cardiovasc Electrophysiol. 2019 Dec;30(12):3097-3115.
• Romero J, Diaz JC, Alviz I, et al. Methodology of Typical Accessory Pathway Catheter Ablation. Card Electrophysiol Clin. 2020 Dec;12(4):541-553.
• Marazzato J, Marazzi R, Angeli F, et al. Ablation of Accessory Pathways with Challenging Anatomy. Card Electrophysiol Clin. 2020 Dec;12(4):555-566.
• Jackman WM. Accessory pathway recording and ablation. Heart Rhythm. 2021 May;18(5):833-834.
• l Hamriti M, Braun M, Molatta S, et al. EASY-WPW: a novel ECG-algorithm for easy and reliable localization of manifest accessory pathways in children and adults. Europace. 2023 Feb 16;25(2):600-609.
• Arruda MS, McClelland JH, Wang X, et al. Development and validation of an ECG algorithm for identifying accessory pathway ablation site in Wolff-Parkinson-White syndrome. J Cardiovasc Electrophysiol. 1998 Jan;9(1):2-12. doi: 10.1111/j.1540-8167.1998.tb00861.x.
• Pambrun T, El Bouazzaoui R, Combes N, et al. Maximal Pre-Excitation Based Algorithm for Localization of Manifest Accessory Pathways in Adults. JACC Clin Electrophysiol. 2018 Aug;4(8):1052-1061. doi: 10.1016/j.jacep.2018.03.018.

17. ECG and EP (induction, termination, electroanatomical endocardial and epicardial mapping, responses to electrical stimulation and to drug administration, EP diagnosis and ablation) of the different types and variants of ventricular arrhythmias:

• Guandalini GS, Liang JJ, Marchlinski FE. Ventricular Tachycardia Ablation: Past, Present, and Future Perspectives. JACC Clin Electrophysiol. 2019 Dec;5(12):1363-1383.
• Cronin EM, Bogun FM, Maury P, et al. 2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias: Executive summary. Heart Rhythm. 2020 Jan;17(1):e155-e205.
• Aryana A, Tung R, d'Avila A. Percutaneous Epicardial Approach to Catheter Ablation of Cardiac Arrhythmias. JACC Clin Electrophysiol. 2020 Jan;6(1):1-20.
• Tung R, Xue Y, Chen M, et al. First-Line Catheter Ablation of Monomorphic Ventricular Tachycardia in Cardiomyopathy Concurrent With Defibrillator Implantation: The PAUSE-SCD Randomized Trial. Circulation. 2022 Jun 21;145(25):1839-1849.
• Rottner L, Metzner A, Hochadel M, et al. Ten-Year Outcomes and Predictors of Mortality Following Catheter Ablation of Ventricular Tachycardia. J Am Heart Assoc. 2025 Jan 7;14(1):e034814.
• Bisceglia C, Limite LR, Baratto F, et al. Road-Map to Epicardial Approach for Catheter Ablation of Ventricular Tachycardia in Structural Heart Disease: Results From a 10-Year Tertiary-Center Experience. Circ Arrhythm Electrophysiol. 2024 Jul;17(7):e012181.

17.1 Idiopathic ventricular ectopy and tachycardias

•  Lee A, Walters TE, Gerstenfeld EP, Haqqani HM. Frequent Ventricular Ectopy: Implications and Outcomes. Heart Lung Circ. 2019 Jan;28(1):178-190.
• Ward RC, van Zyl M, DeSimone CV. Idiopathic Ventricular Tachycardia. J Clin Med. 2023 Jan 25;12(3):930.