Arrhythmia Technologies Institute: Marking Its 30th Year

Background

The idea for the Arrhythmia Technologies Institute (ATI) came after presenting at a cardiac rhythm management (CRM) manufacturer’s two-day seminar. Two nurses approached me and asked, “If you want to get into this field as a career, where do you go to learn it?” Already feeling that patients’ devices commonly weren’t being optimized, I thought a formal training program might help to meet that need. I spoke to our medical director, the late Dr. Robert L. Batey (Figure 1) about the idea, and he said, “Let’s do it.” I contacted a long-time friend, Richard Forney, who was finishing up his PhD at Clemson University, and asked if he would be interested in moving to Bradenton, Florida to learn pacing and help start a school, which he did. The original name of the school was Pacemaker Systems Technology School, Inc. The school was formed as a 501(c)(3) non-profit postsecondary institution, and the first class (of three students) started in September 1988. Earl Bakken, President and Founder of Medtronic, and Dr. Robert Hauser, President of Cardiac Pacemakers Inc. (later becoming Guidant and now Boston Scientific), spoke at our opening ceremonies. The school was basically a volunteer effort for the first nine years, with Dr. Richard Forney being the only full-time and paid staff. The conference room at the Robert L. Batey Cardiology Center, which Dr. Batey and his partners donated for our classroom, could only accommodate up to eight students. Dr. Batey had three consistent tenets with which he ran his practice over the 17 years that I worked with him: 1) Don’t try to look good by putting others down — just do a great job; 2) Don’t be afraid to surround yourself with people who are better than you (Figure 2); and 3) Treat “everyone” well. ATI’s mission has always been patient-centric by educating clinicians to ultimately impact arrhythmia patients in a more positive way. 

Time of Transition

After Dr. Batey’s untimely death at age 55, Dr. Forney and I felt led to consider moving and expanding the school. The school was in its ninth successful year, the field of electrophysiology was growing, implantable defibrillators were emerging, and there were a series of what we believed to be serendipitous events. I wish that I had space in this article to tell the whole story, but I will relay one example. Dr. Forney’s family, myself, and my wife and three children were all happy where we were. I really didn’t want to quit my job, not knowing if the school could support us. In fact, my wife and kids were against moving. One morning, I told my wife that before a final decision was made to move the school, there were four people that I wanted to talk to. Number one on that list was the late Dr. Seymour Furman, a well-known figure in modern cardiac pacing. He introduced a transvenous technique for cardiac pacing, co-founded the North American Society for Pacing and Electrophysiology (NASPE; now the Heart Rhythm Society), served as the first editor of Pacing and Clinical Electrophysiology (PACE), established the NASPExAM (now the International Board of Heart Rhythm Examiners), in addition to many other valuable contributions to the field. 

On that very day that I mentioned Dr. Furman’s name to my wife, he called me. He said that he was in Florida for the first time, on vacation with his wife Evelyn. He asked if he could come and talk with me. Keep in mind, at the time I was working as a device clinician at a private practice cardiology center, and Dr. Furman was the most influential person in the CRM field at the time. (Figure 3) Why would he leave the beach in Siesta Key to come and talk with me? To this day, I don’t know why he wanted to talk with me. I was interested in speaking with him about CRM and its future, and about industry taking part in direct patient care (device implants and follow-up). With our plans to expand the school, we would be training more people to be hired by industry. He said, “Mark, I’ve fought a battle against industry employees taking part in direct patient care for years, and if anything, I see them playing an even greater role in patient care in the future. I think your plans are right on track. Let’s get those people as well trained as possible.” Within three weeks, the rest of the three people on my list (Susie Song, Marleen Irwin, and Bev Taibi) contacted me after Dr. Furman’s visit and encouraged us to move forward with our expansion plans. During a trip to Greenville, South Carolina to meet with some physicians, I had by chance come across Genesis 26:3, which says, “Sojourn in this land, and I will be with you and bless you.” We moved the school to Greenville in July 1997, and Dr. Furman presented at our opening ceremonies. We changed our name to the Arrhythmia Technologies Institute, and increased the size and scope of the program.

The Current Academic Year Program and Changes

Two years ago, we moved into a new office location with more space. This has enabled us to expand our offering of programs for students and industry/institutional clients. Our academic year program is comprised of more than 1100 hours of training over eight months. The classes run Monday-Friday beginning at 7:30 AM (as of this year). We have four full-time faculty on-site, and average over 60 guest faculty on-site, with presentations from electrophysiologists, graduates, and industry personnel. In addition, there are approximately another 50-60 physicians, clinicians, and industry personnel that train off-site on-the-job during our students’ clinical rotations. Therefore, there is a tremendous team effort for the program. The course begins by building a foundation with ECGs, cardiac anatomy, and physiology, before moving into implantable devices and EP mapping and ablation. The training is a combination of classroom lectures, hands-on exercises in our device, EP, and programming simulation labs (Figures 4-7), and clinical rotations at numerous hospitals and device clinics (Table 1). We do a lot of mentoring and advising with our students. ATI instructor Kimber Walters provides tips on professional development, resume instruction, how to professionally conduct oneself, and how to address individual clinical and career situations. With our current class (Figure 8), we will have had over 650 individuals go through the academic year program. In addition to the eight-month program, we have had thousands of individuals attend our shorter, custom programs that run anywhere from one day to six weeks. Our most popular short programs are our IBHRE review course and a two-week course titled Jumpstart (usually attended by healthcare professionals, device clinicians, and industry new hires).

Besides our larger office space, class size, and additional programs, our most notable change is the modification of the curriculum to reflect the growth of electrophysiology mapping and ablation. Ten years ago, we noticed a trend in industry hiring our graduates for mapping and ablation roles. Approximately 50% of our curriculum is dedicated to electrophysiology mapping and ablation, with over 75% of the 2017 class being hired into roles with EP mapping responsibilities. 

Reasons for Success

ATI has maintained a greater than 99% placement rate for 29 years, with at least 25 years at 100%. ATI has never charged a placement fee to those hiring our graduates. Even though we don’t advertise or recruit, our classes fill up six months in advance, on average, with students from all over the United States, including Alaska and Hawaii. In my opinion, the most valuable part of our program is the clinical rotations. Our physicians, clinicians, and medical facilities have been wonderful in giving their time and energy to provide a real-world learning environment for our students. Their willingness to contribute to our students’ learning experience ends up benefiting patients all over the country, and we cannot thank our clinical partners enough for their vital contribution. Each year, we are fortunate to have many guest speakers including electrophysiologists, industry personnel, ATI alumni, and device patients (Figure 9). Industry has also been tremendous in partnering with us to provide equipment and personnel for our training efforts. Even though this is a very competitive industry, it has been wonderfully rewarding to partner with numerous medical facilities and manufacturers towards our efforts to positively impact patients.

Whether it’s a one-day or eight-month program, we remain patient-centric in our efforts and maintain an industry-neutral position. We are happy to work with anyone to find a solution to their CRM/EP educational and training needs. 

Future

We’d like to thank our clinical sites, CRM/EP industry partners, and students for the past 30 years. It’s been a great ride with so many wonderful people who have utilized their talents, time, and resources to make a positive impact in cardiac patients’ lives. We continue to run ATI on Dr. Batey’s three tenets, and look forward to exciting years ahead. It’s been a remarkable team effort that we could not have come close to accomplishing on our own. To celebrate our 30-year milestone, we will be hosting an ATI alumni reunion, and we hope you will join us.

For more information, including curriculum, please visit: atischool.org