ACC, AHA, HRS update CCEP training

The American College of Cardiology, American Heart Association and Heart Rhythm Society published a revised advanced training statement for clinical cardiac electrophysiology on April 22, 2026, replacing the prior 2015 framework. The document covers the competencies required for physicians pursuing Level III training in clinical cardiac electrophysiology, the subspecialty track used for board certification beyond a standard three-year cardiovascular fellowship. (professional.heart.org) ACC said the revision reflects changes in arrhythmia care, cardiac devices and catheter ablation since the last statement in 2015. The American Heart Association said the new version “transition[s] fully to a competency-based framework” for independent practice. ### What exactly did the societies change in this update? The April 22 statement replaces a training model centered more heavily on time spent and case counts with one that explicitly ties advancement to demonstrated competence. (acc.org) The American Heart Association’s summary said assessment is now centered on outcomes, proficiency and multisource evaluation rather than procedural volume alone, while ACC said the document lays out competency components and curricular milestones for trainees. The 2026 document still includes minimum procedural volumes, but ACC described those numbers as the volume “typically necessary” to demonstrate competency, not as a stand-alone endpoint. That framing links the statement to Accreditation Council for Graduate Medical Education milestones and contemporary credentialing practices, according to the AHA summary. (professional.heart.org) ### Which new skills are now treated as core electrophysiology training? Left atrial appendage occlusion is now a required core competency, the AHA summary said, reflecting its broader use for stroke prevention in atrial fibrillation. Conduction system pacing, especially left bundle branch area pacing, is also newly listed as essential training. (professional.heart.org) Pulsed field ablation is formally included in training expectations, and pericardial access is now a required skill, according to the AHA summary. Leadless pacemakers and non-transvenous implantable cardioverter-defibrillators also carry specific procedural experience requirements in the revision. Clinical Advisor, summarizing the statement on May 13, said additional new competencies in the update include diversity, equity and inclusion, leadless pacing systems and venoplasty. (professional.heart.org) It also said revised topics include inherited arrhythmia syndromes, coronary sinus leads and electroanatomic arrhythmia mapping. ### Who is this statement written for? ACC said the statement primarily addresses Level III training in clinical cardiac electrophysiology, which comes after the standard three-year cardiovascular fellowship. (professional.heart.org) ACC said all physicians seeking subspecialty board certification in clinical cardiac electrophysiology must complete that level of training. The writing committee was chaired by José A. Joglar, with Julia H. Indik as vice chair, according to the publication. (professional.heart.org) Clinical Advisor said the committee included electrophysiologists across career stages, training program directors, fellows, general cardiologists and cardiovascular nurse practitioners, with geographic and demographic diversity. ### How do the authors describe the reason for revising the 2015 version? “The ongoing evolution of the field since publication of the 2015 CCEP Advanced Training Statement requires reevaluation of the CCEP training curriculum,” the writing committee said in the ACC summary. (clinicaladvisor.com) ACC said the field has changed to include more complex cardioactive drugs, broader use of implantable devices, left atrial appendage occlusion devices and invasive ablation procedures for arrhythmia management. (acc.org) The American Heart Association said the revision also elevates systems-based care, safety, multidisciplinary collaboration and longitudinal outcomes as essential competencies alongside technical expertise. ACC separately said the statement includes training in emergencies, complications, rare syndromes, research and scholarly activity. (ahajournals.org) ### What does the document say about leadership and ongoing review? Clinical Advisor, quoting the ACC Competency Management Committee, said the recommendations are meant to guide competence assessment both for clinicians entering independent practice and for periodic review to ensure competence is maintained. The same report said practicing electrophysiologists remain responsible for continued self-assessment after initial certification. (acc.org) ACC’s summary said the statement also treats team leadership as an essential competency beyond procedural training. It said that skill can be developed through clinical practice, hospital and health system initiatives, professional societies and related organizations. ### Where can readers find the full document and what comes next? (professional.heart.org) The full statement was published online April 22, 2026 in the Journal of the American College of Cardiology, with parallel publication in Circulation: Arrhythmia and Electrophysiology and Heart Rhythm, according to ACC and the AHA publication pages. ACC has also posted a journal scan and a separate “key points” article summarizing the revision. The next practical step is implementation by training programs, credentialing bodies and clinicians using the new competency tables and procedural expectations in the 2026 statement. (clinicaladvisor.com) The official summaries and publication pages from ACC and the American Heart Association were updated on April 22, 2026. (professional.heart.org) (acc.org)