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Professional societies laid out the roadmap to advanced training in interventional cardiology for the first time in a comprehensive statement of requirements.

The American College of Cardiology (ACC), American Heart Association, and Society for Cardiovascular Angiography and Interventions recommend a minimum 250 interventional procedures -- including at least 200 percutaneous coronary interventions -- during the 12-month interventional cardiology fellowship.

These groups also stipulate that at least 50 procedures should be a mix of coronary, peripheral vascular, and structural procedures. Another 25 procedures related to physiologic assessment and 25 related to intracoronary imaging are required during fellowship training as well, according to the multi-society writing group chaired by Theodore Bass, MD, of University of Florida Health Jacksonville.

The statement, published in the , provides a full overview of training in interventional cardiology and elaborates on existing training requirements for this subspecialty from the ACC's , the , and the .

"The document defines the required competencies for the full scope of interventional cardiology, providing trainees for the first time with the information to support training across all these areas," Bass said in a press release.

Altogether, the training pathway for interventional cardiology should comprise several milestones of advancement across the COCATS 4 competencies:

• A 3-year general cardiovascular disease fellowship bringing the individual to Level I competency in all aspects of cardiovascular medicine and Level II competency in diagnostic cardiac catheterization to pursue interventional cardiology training
• A 1-year interventional cardiology fellowship bringing the individual to Level III competency in diagnostic and interventional cardiac catheterization

Notably, Bass and colleagues acknowledged that the 1-year fellowship focusing on coronary interventions will likely be insufficient for competency in other areas of interventional cardiology, hence the option of post-fellowship training for peripheral vascular or structural heart interventions during an unspecified period.

In this case, peripheral vascular training should include 100 diagnostic and 50 interventional peripheral artery interventions (half as primary operator), 25 carotid stents, 20 endovascular aortic aneurysm repairs, and 20 peripheral venous interventions.

Structural heart training requires 50 transcatheter aortic valve replacements (25 as primary operator), various structural heart procedures, and adult congenital heart disease interventions.

Bass and colleagues also recommended that trainees get experience working with cardiac surgeons and cardiologists who have advanced training in electrophysiology, cardiac imaging, heart failure, and advanced practice providers, as well as with relevant multispecialty teams.

After initial training, certified interventional cardiologists are responsible for lifelong learning to ensure continued maintenance of certification and competence throughout their careers.

The training statement was developed in collaboration with and endorsed by the American Association for Thoracic Surgery, American Society of Echocardiography, Heart Failure Society of America, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, Society of Thoracic Surgeons, and Society for Vascular Medicine.

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