DIET & NUTRITION 
PATIENT EDUCATION 
OBESITY/WEIGHT MANAGEMENT 
EXERCISE/TRAINING 
LEGAL MATTERS 
GUIDELINES/RECOMMENDATIONS ✅ Guideline Update
The ACC, AHA, and HRS jointly issued the 2026 advanced training statement for clinical cardiac electrophysiology, updating the 2015 framework with new competencies in conduction system pacing, leadless pacing, venoplasty, and health equity. Program directors and CCEP fellows face revised procedural benchmarks and assessment expectations.
Professional Impact:
- Procedural benchmarks formalized: 210 procedures generally required for diagnostic EP studies and catheter ablation; 145 CIED procedures for device competency.
- Left atrial appendage occlusion and pericardial access moved from optional to required proficiencies, reflecting expanded epicardial and stroke-prevention practice.
- New competencies include conduction system pacing, leadless pacing systems, and venoplasty as an optional skill for device upgrade and revision scenarios.
- Statement adds explicit competencies around social drivers of health, cultural awareness, and cardiovascular health equity across sex, race, and ethnicity.
Action Items:
- Review fellowship curriculum against the updated required versus optional procedural list.
- Document trainee procedural volumes and complexity to support board certification eligibility.
- Integrate health equity and social drivers content into didactic and case-based teaching.
- Establish assessment milestones aligned with the six ACGME general competency domains.
