PerspectiveElectrophysiology 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.
EditorialCardiovascular medicine has evolved rapidly, while physician certification remains largely centered on periodic knowledge-based examinations. The emergence of increasingly capable artificial intelligence (AI) systems challenges this traditional model and raises a fundamental question: should certification continue to primarily measure what physicians know, or should it measure how physicians apply knowledge in clinical practice? I propose a modern certification framework focused on demonstrated clinical competence, continuous learning, individualized assessment, practice improvement, and the ability to appropriately use, supervise, and override AI. Such a model could better reflect the evolving competencies required of contemporary cardiologists while maintaining accountability and professional standards. The future of cardiovascular certification should be centered not simply on knowledge acquisition, but on clinical judgment, adaptability, and competence in an AI enabled healthcare environment.
- Cardiovascular medicine
- Board certification
- Artificial Intelligence
- Medical education
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