Preserving Diagnostic Electrophysiology Skills: Essential Competencies for Today's Electrophysiology Fellows
Electrophysiology is undergoing rapid transformation, with pulsed field ablation, high‑density mapping, conduction system pacing, and leadless devices reshaping both practice and training. The 2026 ACC/AHA/HRS Advanced Training Statement reflects this shift by emphasizing competency‑based assessment and expanding core procedural exposure. Yet as automation streamlines workflows, it risks diminishing the mechanism‑based reasoning that has long defined the field, echoing broader concerns about physician deskilling. Ensuring that technology enhances rather than replaces interpretive skill is essential. The future electrophysiologist must pair technological fluency with the ability to independently explain arrhythmia mechanisms and interpret data skills that remain central to safe, thoughtful, and effective practice.