• Cardiac Electrophysiology - Allied Professional

• Cardiac Rhythm Device Therapy - Physician and Allied Professional

“Certification Examination for Competency in Cardiac Electrophysiology”
for the Allied Professional
Exam Content Outline
Revised 2007

1. Fundamentals of Electronics – 2%

   1. Units of measurement

      1. Basic quantities

      2. Derived quantities

   2. Relationship of measurements

      1. Ohm's law: Current, voltage, and resistance

      2. Power and energy

   3. Signal concepts

   4. Electronic subsystems and circuitry

2. Cardiac Anatomy and Physiology – 5%

   1. Cardiac anatomy

   2. Hemodynamics of the cardiovascular system

3. Basic Pharmacology – 2%

   1. Types of drugs

   2. Major cardiovascular responses

4. Basic Electrophysiology – 10%

   1. Anatomy of the conduction system

   2. Electrophysiology of the conduction system

   3. Abnormalities of the conduction system

   4. Mechanisms of arrhythmia

      1. Reentry, triggered activity, automaticity, anisotropy, reflection

5. Clinical Assessment – 5%

   1. History

   2. Cardiac physical exam

   3. Non-invasive diagnostic tests and evaluation

      1. Signal average ECG

      2. Tilt table testing

      3. Ambulatory ECG monitoring

      4. Stress testing

      5. Echocardiography

      6. Novel non-invasive diagnostic test technologies

6. Electrocardiography – 6%

   1. Normal electrocardiogram

   2. Transesophageal electrocardiography

   3. Recognition of arrhythmia

7. Clinical Electrophysiology – 10%

   1. Initial assessment

      1. Diagnostic workup

   2. Clinical evaluation of arrhythmia

      1. Response to drugs

      2. Response to vagal maneuvers

      3. Emergency management

   3. Indications, contraindications for EP study

8. Laboratory Procedure – 5%

   1. Laboratory supplies, equipment, maintenance, troubleshooting

   2. Patient preparation

   3. Catheterization techniques

   4. Recording techniques

   5. Risks and complications

   6. Patient and family support

9. Safety – 5%

   1. Infection control

   2. Sterile technique

   3. Radiation safety

   4. Electrical safety

   5. Drug interaction

   6. Device interaction

10. Invasive Electrophysiology (13%)

    1. Baseline assessment

    2. Methods of recording and evaluation

       1. Electrogram recognition

       2. Assessment of conduction system

       3. Determination of refractory period

    3. Stimulation protocols

    4. ECG morphology during intracardiac pacing

    5. Evaluation of arrhythmia

       1. Supraventricular tachycardia

       2. Ventricular tachycardia

       3. Response to stimulation

       4. Response to drug studies

       5. Differentiation of arrhythmia mechanisms

11. Mapping Techniques – 10%

    1. Indications

    2. Procedural considerations

    3. Methods/strategies

    4. Novel mapping technologies

12. Conscious Sedation – 3%

    1. Intravenous sedation analgesia in the EP lab

    2. Monitoring requirements

13. Therapeutic Modalities – 10%

    1. Pharmacotherapy

    2. Device therapy

       1. Antitachycardia pacing

       2. ICD tiered therapy

    3. Catheter ablation

    4. Surgical therapy

14. Implantable Device – 8%

    1. Pacemaker modes and basic timing cycles

    2. Indications for implantation of devices, implant testing and troubleshooting

    3. Recognition of pacemaker ECG, EMI

    4. Lead extraction

    5. Basics of ICD function, implant and testing

15. Cardiac Life Support – 1%

    1. Advanced cardiac life support (ACLS)

    2. Defibrillation, cardioversion and rescue pacing

16. Other Topics – 3.5%

    1. Radiology

17. Medical Jurisprudence –  0.5%

    1. Negligence, liability, risk, responsibility

    2. Documentation

    3. Informed consent

18. Research Guidelines – 1%

    1. Study design

Successful completion of the IBHRE or IBHRE/AP/Pacing "Certification Examination for Competency in Cardiac Rhythm Device Therapy" and/or IBHRE/AP/EP "Certification Examination for Competency in Cardiac Electrophysiology" is not a requirement to perform or participate in pacemaker related and/or electrophysiology therapy, and does not attest to the overall capability or competency of any physician or allied professional. These examinations are written examinations only and do not include any testing in a practical setting. IBHRE does not intend to interfere with or to restrict the professional activity of a licensed physician because the physician has not successfully completed the examination. Similarly, IBHRE/AP/Pacing and AP/EP do not intend to interfere with or to restrict the professional activity of a non-physician because of these examination processes.

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