American College of Cardiology (04/22/26) Joglar JA; Indik JH; Faza NN; et al.

The American College of Cardiology, American Heart Association and Heart Rhythm Society have released a revised Advanced Training Statement updating the core competencies required for subspecialists in clinical cardiac electrophysiology (CCEP). The new guidance replaces the 2015 version and reflects major advances in the field, including expanded use of complex cardioactive drugs, cardiac implantable electronic devices, left atrial appendage occlusion devices, and invasive catheter ablation procedures. The statement emphasizes Level III training — which is mandatory for CCEP board certification — and details standards for faculty, facilities, multidisciplinary collaboration, didactic education, clinical and procedural experience, research expectations, and emergency management. The statement outlines specific competency milestones, procedural volume expectations, and focused training areas such as congenital heart disease, diagnostic testing, and syncope, while also highlighting leadership development through participation in clinical practice, health system initiatives, professional societies, and quality improvement programs like the AFib Ablation Registry, EP Registry Suite, and LAAO Registry. The guidance concludes by recommending robust trainee evaluation methods, including direct observation, case logs, presentations, multisource assessments, portfolios, simulation, and ongoing self-assessment through approved maintenance pathways.

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